Christine M Khosropour, Arianna Rubin Means, Roxanne P Kerani, Emma M Murphy, Krupa Mehta, Kristina Santana, Kenneth Sherr, & Matthew R Golden.
University of Washington affiliated authors are displayed in bold.
Published: April 2025
Lawrence A. Palinkas, Benjamin Springgate, Leopoldo J. Cabassa, Michelle Shin, Samantha Garcia, Benjamin F. Crabtree & Jennifer Tsui
University of Washington affiliated authors are displayed in bold.
Published: April 2025
Community engagement is widely recognized as critical to successful and equitable implementation of evidence-based practices, programs, and policies. However, there are no clear guidelines for community involvement in data collection and analysis in implementation research.
We describe three specific methods for engaging community members in data collection and analysis: concept mapping, rapid ethnographic assessment, and Photovoice. Common elements are identified from a case study of each method: 1) selection and adaptation of evidence-based strategies for improving adolescent HPV vaccine initiation rates in disadvantaged communities, 2) strategies for implementing medication for opioid use disorders among low-income Medicaid enrollees during natural disasters, and 3) interventions to improve the physical health of adults with severe mental illness living in supportive housing.
In all three cases, community members assisted in participant recruitment, provided data, and validated preliminary findings created by researchers. In the Photovoice case study, community members participated in both data collection and analysis, while in the concept mapping, community members also participated in the initial phase of organizing and prioritizing evidence-based strategies during the data analysis.
Community involvement in implementation research data collection and analysis contributes to greater engagement and empowerment of community members and validation of study findings. Use of methods that exhibit both scientific rigor and community relevance of implementation research also contributes to greater community investment in successful implementation outcomes. Nevertheless, the case studies point to the importance and efficiency of the division of labor embedded in community-engaged implementation research. Building capacity for community members to assume greater roles in obtaining and organizing data for preliminary analysis prior to interpretation is recommended.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Christine A March, Elissa Naame, Ingrid Libman, Chelsea N Proulx, Linda Siminerio, Elizabeth Miller, & Aaron R Lyon
University of Washington affiliated authors are displayed in bold.
Published: March 2025
School-partnered interventions may improve health outcomes for children with type 1 diabetes, though there is limited evidence to support their effectiveness and sustainability. Family, school, or health system factors may interfere with intervention usability and implementation.
To identify and address potential implementation barriers during intervention development, we combined methods in user-centered design and implementation science to adapt an evidence-based psychosocial intervention, the collaborative care model, to a virtual school-partnered collaborative care (SPACE) model for type 1 diabetes between schools and diabetes medical teams.
We recruited patient, family, school, and health system partners (n=20) to cocreate SPACE through iterative, web-based design sessions using a digital whiteboard (phase 1). User-centered design methods included independent and group activities for idea generation, visual voting, and structured critique of the evolving SPACE prototype. In phase 2, the prototype was evaluated with the usability evaluation for evidence-based psychosocial interventions methods. School nurses reviewed the prototype and tasks in cognitive walkthroughs and completed the Intervention Usability Scale (IUS). Two members of the research team independently identified and prioritized (1-3 rating) discrete usability concerns. We evaluated the relationship between prioritization and the percentage of nurses reporting each usability issue with Spearman correlation. Differences in IUS scores by school nurse characteristics were assessed with ANOVA.
In the design phase, the partners generated over 90 unique ideas for SPACE, prioritizing elements pertaining to intervention adaptability, team-based communication, and multidimensional outcome tracking. Following three iterations of prototype development, cognitive walkthroughs were completed with 10 school nurses (n=10, 100% female; mean age 48.5, SD 9.5 years) representing different districts and years of experience. Nurses identified 16 discrete usability issues (each reported by 10%-60% of participants). Two issues receiving the highest priority (3.0): ability to access a virtual platform (n=3, 30% of participants) and data-sharing mechanisms between nurses and providers (n=6, 60% of participants). There was a moderate correlation between priority rating and the percentage of nurses reporting each issue (ρ=0.63; P=.01). Average IUS ratings (77.8, SD 11.1; 100-point scale) indicated appropriate usability. There was no difference in IUS ratings by school nurse experience (P=.54), student caseload (P=.12), number of schools covered (P=.90), or prior experience with type 1 diabetes (P=.83), suggesting that other factors may influence usability. The design team recommended strategies for SPACE implementation to overcome high-priority issues, including training users on videoconferencing applications, establishing secure forms for school data reporting, and sharing glucose data in real-time during SPACE meetings.
Cross-sector interventions are complex, and perceived usability is a potential barrier to implementation. Using web-based cocreation methods with community partners promoted high-quality intervention design that is aligned with end-user priorities. Quantitative and qualitative assessments indicated appropriate degree of usability to move forward with pilot-testing.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Kelly A. Aschbrenner, Callie Walsh-Bailey, Meagan C. Brown, Tanveer Khan, Travis P. Baggett, Salene M.W. Jones, Douglas E. Levy, Lydia E. Pace, and Jonathan P. Winickoff
University of Washington affiliated authors are displayed in bold.
Published: March 2025
The primary purpose of this study was to assess perceived burdens and benefits of participating in implementation research among staff employed in resource-constrained healthcare settings. Another objective was to use findings to generate considerations for engaging staff in research across different phases of implementation research.
This qualitative focus group and consensus building study involved researchers affiliated with the National Cancer Institute Implementation Science Centers in Cancer Control program and nine Community Health Centers (CHCs) in Massachusetts. Six focus groups (n = 3 with CHC staff; n = 3 with researchers) assessed barriers and facilitators to staff participation in implementation research. During consensus discussions, we used findings to develop considerations for engaging staff as participants and partners throughout phases of implementation research.
Sixteen researchers and 14 staff participated in separate focus groups; nine researchers and seven staff participated in separate consensus discussions. Themes emerged across participant groups in three domains: (1) influences on research participation; (2) research burdens and benefits; and (3) ways to facilitate staff participation in research. Practical considerations included: (a) aligning research with organizational and staff values and priorities; (b) applying user-centered design to research methods; (c) building organizational and individual research capacity; and (d) offering equitable incentives for staff participation.
Engaging staff as participants and partners across different phases of implementation research requires knowledge about what contributes to research burden and benefits and addressing context-specific burdens and benefits.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Nkiru Osude, Harriette Van Spall, Hayden Bosworth, Konstantin Krychtiuk, John Spertus, Sam Fatoba, Lee Fleisher, Edward Fry, Jennifer Green, Stephen Greene, Michael Ho, Jennifer Jackman, Jane Leopold, Melissa Magwire, Darren McGuire, George Mensah, Katherine R. Tuttle, Vincent Willey, Neha Pagidipati and Christopher Granger
University of Washington affiliated authors are displayed in bold.
Published: March 2025
Rachel A Pozzar, James A Tulsky, Donna L Berry, Jeidy Batista, Paige Barwick, Charlotta J Lindvall, Patricia C Dykes, Michael Manni, Ursula A Matulonis, Nadine J McCleary, and Alexi A Wright
University of Washington affiliated authors are displayed in bold.
Published: March 2025
People with advanced ovarian cancer and their caregivers report unmet supportive care needs. We developed a Collaborative Agenda-Setting Intervention (CASI) to elicit patients’ and caregivers’ needs through the patient portal before a clinic visit and to communicate these needs to clinicians using the electronic health record.
We aimed to assess the usability and acceptability of the CASI and identify barriers to and facilitators of its implementation.
We recruited English- and Spanish-speaking patients, caregivers, and clinicians from the gynecologic oncology program at a comprehensive cancer center. Participants used the CASI prototype and then completed individual cognitive interviews and surveys. We assessed usability with the System Usability Scale (scores range 0‐100, scores ≥70 indicate acceptable usability) and acceptability with the Acceptability of Intervention Measure and Intervention Appropriateness Measure (scores for both measures range from 1 to 5, higher scores indicate greater acceptability). Interviews were audio recorded, transcribed, and analyzed using directed content analysis. Domains and constructs from the Consolidated Framework for Implementation Research comprised the initial codebook. We analyzed survey data using descriptive statistics and compared usability and acceptability scores across patients, caregivers, and clinicians using analyses of variance.
We enrolled 15 participants (5 patients, 5 caregivers, and 5 clinicians). The mean System Usability Scale score was 72 (SD 16). The mean Acceptability of Intervention Measure and Intervention Appropriateness Measure scores were 3.9 (SD 1.0) and 4.1 (SD 0.8), respectively. Participants viewed the CASI content and format positively overall. Several participants appreciated the CASI’s integration into the clinical workflow and its potential to increase attention to psychosocial concerns. Suggestions to refine the CASI included removing redundant items, simplifying item language, and adding options to request a conversation or opt out of supportive care referrals. Key barriers to implementing the CASI include its complexity and limited resources available to address patients’ and caregivers’ needs.
The CASI is usable and acceptable to patients with advanced ovarian cancer, caregivers, and clinicians. We identified several barriers to and facilitators of implementing the CASI. In future research, we will apply these insights to a pilot randomized controlled trial to assess the feasibility of comparing the CASI to usual care in a parallel group-randomized efficacy trial.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Jennifer Im, Erin Blakeney, Danae Dotolo, Anna Ungar, Rebecca Barton, Bryan J Weiner, Kathryn I Pollak, Elizabeth Nielsen, Lisa Hudson, Nancy Kentish-Barnes, Claire Creutzfeldt, Ruth A Engelberg, J Randall Curtis
University of Washington affiliated authors are displayed in bold.
Published: February 2025
Asia S. Bishop, Sarah C. Walker, Ella B. Baumgarten, Kristin Vick, & Taquesha Dean
University of Washington affiliated authors are displayed in bold.
Published: February 2025
Youth in contact with the juvenile legal system experience disproportionate rates of homelessness. While system contact is a critical intervening point, juvenile courts do not typically offer housing services. One solution is to refer youth to evidence-based, community-based services to meet housing-related needs, but a myriad of individual and organizational factors often impede court staff from making such referrals. Housing Stability for Youth in Courts (HSYNC) is a novel, cross-system service linkage model for court-involved youth facing housing instability. HSYNC was developed using codesign as a strategy to improve usability and incorporated evidence on juvenile court linkage strategies effective at increasing service referrals and improving outcomes.
The current study utilized a multimethod approach to evaluate the usability of HSYNC from the perspective of juvenile probation counselors (JPCs) as one group of end-users. As part of the pilot implementation study, survey (N = 15) and semi-structured interview (N = 20) data were obtained from JPCs from four juvenile courts in one northwestern state.
Survey results indicated good usability for HSYNC (mean implementation strategy usability scale score of 80). Themes from the interviews complemented survey findings, pointing to HSYNC as a value-added program that integrated well with existing probation practices. The housing navigator's approach was highlighted as a strong facilitator of program usability. Themes also provided greater insight into implementation barriers (i.e., individual and contextual factors) and areas for improvement (e.g., eligibility screening process).
Drivers of program usability and implications for program improvement to address identified implementation challenges to ensure the HSYNC model is effective and sustainable long-term are discussed.
A study examining the key factors impacting successful implementation of a novel housing stability program to address homelessness risk for court-involved youth and their families.
Court-involved youth experience disproportionate rates of homelessness, yet housing services are not traditionally offered by juvenile courts. Court staff, such as probation staff, can refer youth to community-based services to meet their housing needs. Unfortunately, many factors complicate whether these referrals are made, including staff feeling overburdened by other work obligations and uncertainty about whether referring youth to community services fits within their job responsibilities. In this study, we surveyed and interviewed probation staff who were responsible for implementing a new referral-based housing stability program—Housing Stability for Youth in Courts (HSYNC)—to understand whether the program addressed previously identified barriers to referral-making. A unique feature of HSYNC is that there is a dedicated housing navigator, who works as a “linkage specialist” to support probation staff in making referrals while working directly with youth and families to access housing-related services in the community. Our findings suggest that, from the perspective of probation staff, HSYNC is considered to be a user-friendly program that is well-aligned with existing court practices. The housing navigator and their unique approach to working with probation staff, youth, and families was perceived as the strongest facilitator of implementation success; meanwhile, screening for program eligibility was the biggest barrier, pointing to the need for improvement before HSYNC is widely implemented. The persistent intersection of youth housing instability and court involvement calls for better coordination between juvenile courts and community agencies providing housing-related services. From the probation perspective, HSYNC offers a viable solution to meeting youths’ housing needs without creating additional workload burden for court staff.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Theresa E Matson, Amy K Lee, Edward J Miech, Paige D Wartko, Rebecca C Phillps, Mary Shea, Andrea Altschuler, Aimee N C Campbell, Colleen T Labelle, Julia H Arnsten, Jordan M Braciszewski, Joseph E Glass, Viviana E Horigian, Mark T Murphy, Mohammad Zare-Mehrjerdi, and Katharine A Bradley
University of Washington affiliated authors are displayed in bold.
Published: February 2025
Adam P. Ostendorf, Tobias Loddenkemper, Lindsey A. Morgan, Brian Appavu, Raquel Farias-Moeller, Dana Harrar, Craig Press, Nicholas S. Abend, William D. Gaillard, Shasha Bai, Mariah Eisner, Lauren McHenry, Emily Kroshus, Kathryn Vannatta, and Howard P. Goodkin
University of Washington affiliated authors are displayed in bold.
Published: February 2025