Emma K Hendrix, Nicole L Henderson, Tanvi V Padalkar, Tara Kaufmann, Stacey A Ingram, D'Ambra N Dent, Chao-Hui Sylvia Huang, J Nicholas Odom, Bryan J Weiner, Doris Howell, Angela M Stover, Ethan M Basch, Chelsea McGowan, Jennifer Young Pierce, and Gabrielle B Rocque
University of Washington affiliated authors are displayed in bold.
Published: December 2024
Nandana D Rao, Stephanie M Fullerton, Brian H Shirts, Annie T Chen, & Nora B Henrikson
University of Washington affiliated authors are displayed in bold.
Published: November 2024
Implementation science frameworks with a focus on health equity have emerged to help guide the introduction of new interventions into healthcare and community settings while limiting health disparities. The purpose of this research was to explore the applicability of such frameworks to guide the equitable implementation of population genetic screening programs.
We searched PubMed and reference lists for relevant frameworks and examples of their use in health settings. We then assessed if and how selected frameworks provide guidance for different stages of population genetic screening: recruitment, sample collection, result return, follow-up care and long-term management, and cascade screening. Findings were synthesized into a list of health equity considerations specific to each stage.
We identified 5 implementation frameworks that focus on health equity. Guidance varied by framework type: determinant (explaining what affects implementation outcomes), process (translating research into practice), or evaluation (assessing implementation). Common characteristics included focusing implementation efforts on populations who have historically experienced health inequities and adapting interventions to fit local contexts. Process models also highlighted the importance of community partnerships.
Overall, frameworks offered broad recommendations applicable to population genetic screening program implementation. However, gaps still exist in guidance provided for later stages of population genetic screening. To improve the equitable implementation of genetic screening, future programs may benefit from utilizing one or more of these frameworks or by incorporating the health equity considerations and outcomes compiled in this analysis.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Mark Savill, Lindsay M. Banks, Regina Gemignani, Jamie Mouzoon, Bethney Bonilla-Herrera, Matthew L. Goldman, Joy Melnikow, and Cameron S. Carter
University of Washington affiliated authors are displayed in bold.
Published: November 2024
Aaron M. Norr, Devon Sandel-Fernandez, Janelle Nguyen, Heather Schacht Reisinger & Greg M. Reger
University of Washington affiliated authors are displayed in bold.
Published:October 2024
Allison M. Cole, Gina A. Keppel, Laura-Mae Baldwin, Erika Holden and Michael Parchman
University of Washington affiliated authors are displayed in bold.
Published: August 2024
Nicholas R. Murphy, Kristina Crothers, Madison Snidarich, Jehan Z. Budak, Meagan C. Brown, Bryan J. Weiner, Nicholas Giustini, Tanner Caverly, Katherine Durette, Katie DeCell, and Matthew Triplette
University of Washington affiliated authors are displayed in bold.
Published: July 2024
Gwendolyn M. Lawson, Julie Sarno Owens, David S. Mandell, Samantha Tavlin, Steven Rufe, Aubrey Depa, Aaron R. Lyon, & Thomas J. Power
University of Washington affiliated authors are displayed in bold.
Published: June 2024
Schools need effective, sustainable implementation strategies to support teachers in using effective Tier 1 (i.e., whole class) and Tier 2 (i.e., targeted) behavioral interventions in the classroom. This paper describes an iterative, community-partnered process of developing implementation resources to support teachers in using Tier 1 and 2 positive behavior management interventions; we call these resources the Positive Behavior Management Toolkit (PBMT). There were two key aspects to the iterative development process: 1) working with a Program Development Team of district—and school-employed partners to identify priorities, interpret data, provide feedback on resources, and plan for sustainment; and 2) conducting a series of tryouts in which teachers used a version of the PBMT in their classrooms and provided quantitative and qualitative feedback on acceptability, appropriateness, feasibility, and recommendations for improvement. In partnership with the Program Development Team, we used data from the tryouts to inform revisions to the PBMT. This paper presents quantitative and qualitative data from the tryouts and describes how these data informed revisions to the PBMT. We also describe the processes by which we engaged the team, considerations related to contextual appropriateness, and lessons learned related to community-engaged intervention development research.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Yuvaram N V Reddy, Matthew D Kearney, Michaela Ward, Robert E Burke, Ann M O'Hare, Peter P Reese, Meghan B Lane-Fall & IM-HOME Advisory Board
University of Washington affiliated authors are displayed in bold.
Published: June 204
Developing strategies to improve home dialysis use requires a comprehensive understanding of barriers. We sought to identify the most important barriers to home dialysis use from the perspective of patients, care partners, and providers.
This is a convergent parallel mixed-methods study.
We convened a 7-member advisory board of patients, care partners, and providers who collectively developed lists of major patient/care partner-perceived barriers and provider-perceived barriers to home dialysis. We used these lists to develop a survey that was distributed to patients, care partners, and providers—through the American Association of Kidney Patients and the National Kidney Foundation. The surveys asked participants to (1) rank their top 3 major barriers (quantitative) and (2) describe barriers to home dialysis (qualitative).
We compiled a list of the top 3 patient/care partner-perceived and top 3 provider-perceived barriers (quantitative). We also conducted a directed content analysis of open-ended survey responses (qualitative).
There were 522 complete responses (233 providers; 289 patients/care partners). The top 3 patient/care partner-perceived barriers were fear of performing home dialysis; lack of space; and the need for home-based support. The top 3 provider-perceived barriers were poor patient education; limited mechanisms for home-based support staff, mental health, and education; and lack of experienced staff. We identified 9 themes through qualitative analysis: limited education; financial disincentives; limited resources; high burden of care; built environment/structure of care delivery that favors in-center hemodialysis; fear and isolation; perceptions of inequities in access to home dialysis; provider perspectives about patients; and patient/provider resiliency.
This was an online survey that is subject to nonresponse bias.
The top 3 barriers to home dialysis for patient/care partners and providers incompletely overlap, suggesting the need for diverse strategies that simultaneously address patient-perceived barriers at home and provider-perceived barriers in the clinic.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Yanchen Zhang, Madeline Larson, Mark G. Ehrhart, Kevin King, Jill Locke, Clayton R. Cook, & Aaron R. Lyon
University of Washington affiliated authors are displayed in bold.
Published: May 2024
Integrated care involves care provided by a team of professionals, often in non-traditional settings. A common example worldwide is integrated school-based mental health (SBMH), which involves externally employed clinicians providing care at schools. Integrated mental healthcare can improve the accessibility and efficiency of evidence-based practices (EBPs) for vulnerable populations suffering from fragmented traditional care. However, integration can complicate EBP implementation due to overlapping organizational contexts, diminishing the public health impact. Emerging literature suggests that EBP implementation may benefit from the similarities in the implementation context factors between the different organizations in integrated care, which we termed inter-organizational alignment (IOA). This study quantitatively explored whether and how IOA in general and implementation context factors are associated with implementation outcomes in integrated SBMH.
SBMH clinicians from community-based organizations (CBOs; nclinician = 27) and their proximal student-support school staff (nschool = 99) rated their schools and CBOs (clinician only) regarding general (organizational culture and molar climate) and implementation context factors (Implementation Climate and Leadership), and nine common implementation outcomes (e.g., treatment integrity, service access, acceptability). The levels of IOA were estimated by intra-class correlations (ICCs). We fitted multilevel models to estimate the standalone effects of context factors from CBOs and schools on implementation outcomes. We also estimated the 2-way interaction effects between CBO and school context factors (i.e., between-setting interdependence) on implementation outcomes.
The IOA in general context factors exceeded those of implementation context factors. The standalone effects of implementation context factors on most implementation outcomes were larger than those of general context factors. Similarly, implementation context factors between CBOs and schools showed larger 2-way interaction effects on implementation outcomes than general context factors.
This study preliminarily supported the importance of IOA in context factors for integrated SBMH. The findings shed light on how IOA in implementation and general context factors may be differentially associated with implementation outcomes across a broad array of integrated mental healthcare settings.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Zoé Poirier Stephens, Caislin Leah Firth, Michael Cantinotti, Daniel Fuller, Meghan Winters & Yan Kestens
University of Washington affiliated authors are displayed in bold.
Published: May 2024