Implementation Science

Implementation Science research guides the implementation of evidence-based interventions across a range of healthcare settings.

Implementation Science is Imperative to the Optimization of Obstetric Care

Dec. 15, 2020

Rebecca F. Hamm, Brian K. Iriye, Sindhu K. Srinivas

Abstract [from journal]

In an effort aimed at improving outcomes, obstetric teams have enacted comprehensive care bundles and other clinical tools. Yet, these practices have had limited degrees of success on a national scale. Implementation science aims to bridge the divide between the development of evidence-based interventions and their real-world utilization. This emerging field takes into account key stakeholders at the clinician, institution, and health policy levels. Implementation science evaluates how well an intervention is or can be delivered, to

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Integrating the Built and Social Environment Into Health Assessments for Maternal and Child Health: Creating a Planning-Friendly Index

Dec. 10, 2020

Xi Wang, Jennifer Whittaker, Katherine Kellom, Stephanie Garcia, Deanna Marshall, Tara Dechert, Meredith Matone

Abstract [from journal]

Environmental and community context earliest in the life course have a profound effect on life-long health outcomes. Yet, standard needs assessments for maternal and child health (MCH) programs often overlook the full range of influences affecting health in-utero and early childhood. To address this, we developed a methodology for assessing community risk in MCH based on six domains integrating 66 indicators across community, environment, socioeconomic indicators, and MCH outcomes. We pilot this methodology in Pennsylvania, and share

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Retrospective Development of a Novel Resilience Indicator Using Existing Cohort Data: The Adolescent to Adult Health Resilience Instrument

Diana Montoya-Williams, MD
Dec. 10, 2020

Diana Montoya-Williams, Molly Passarella, Scott A. Lorch

Abstract [from journal]

Background: Cohort studies represent rich sources of data that can be used to link components of resilience to a variety of health-related outcomes. The Adolescent to Adult Health (Add Health) cohort study represents one of the largest data sets of the health and social context of adolescents transitioning into adulthood. It did not however use validated resilience scales in its data collection process. This study aimed to retrospectively create and validate a resilience indicator using existing data from the cohort

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Effect of Remote Monitoring on Discharge to Home, Return to Activity, and Rehospitalization After Hip and Knee Arthroplasty: A Randomized Clinical Trial

Dec. 1, 2020

Shivan J. MehtaEric HumeAndrea B. Troxel, Catherine Reitz, Laurie Norton, Hannah Lacko, Caitlin McDonald, Jason Freeman, Noora Marcus, Kevin G. VolppDavid A. Asch

Abstract [from journal]

Importance: Hip and knee arthroplasty are the most common inpatient surgical procedures for Medicare beneficiaries in the US, with substantial variation in cost and quality. Whether remote monitoring incorporating insights from behavioral science might help improve outcomes and increase value of care remains unknown.

Objective: To evaluate the effect of activity monitoring and bidirectional text messaging on the rate of discharge to home and clinical outcomes in patients receiving hip or knee

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Prevalence of Informal Caregiving in States Participating in the US Patient Protection and Affordable Care Act Balancing Incentive Program, 2011-2018

Dec. 1, 2020

Rebecca Anastos-Wallen, Rachel M. WernerPaula Chatterjee

Abstract [from journal]

Importance: The Balancing Incentives Program (BIP), established under the 2010 Patient Protection and Affordable Care Act provided federal funding for states to shift long-term care out of institutional settings and into the home. However, the association of its implementation with informal caregiving is not known.

Objective: To evaluate the association between BIP participation and the prevalence and frequency of informal caregiving and socioeconomic disparities among caregivers.

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Integrating Implementation Science in Clinical Research to Maximize Public Health Impact: A Call for the Reporting and Alignment of Implementation Strategy Use With Implementation Outcomes in Clinical Research

Nov. 25, 2020

Brittany N. RuddMolly DavisRinad S. Beidas

Abstract [from journal]

Background: Although comprehensive reporting guidelines for implementation strategy use within implementation research exist, they are rarely used by clinical (i.e., efficacy and effectiveness) researchers. In this debate, we argue that the lack of comprehensive reporting of implementation strategy use and alignment of those strategies with implementation outcomes within clinical research is a missed opportunity to efficiently narrow research-to-practice gaps.

Main body: We review ways that

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Predictors Of Specialty Certification Among Pediatric Hospital Nurses

Linda Aiken honored by Irish Surgeons
Oct. 22, 2020

Karen B. LasaterRebecca R. S. Clark, Margaret A. McCabe, Warren D. Frankenberger, Paula M. Agosto, Kathryn A. RimanLinda H. Aiken

Abstract [from journal]

Aims and objectives: To evaluate differences in hospitals' proportion of specialty certified nurses and to determine whether and to what extent individual nurse characteristics and organizational hospital characteristics are associated with a nurse's likelihood of having specialty certification.

Background: Prior research has shown that patients in hospitals with high proportions of specialty certified nurses have better outcomes including lower mortality and fewer adverse events; yet less is

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Impact Of Covid-19 Pandemic On Training: Global Perceptions Of Gastroenterology And Hepatology Fellows In The USA

Oct. 19, 2020

Kofi Clarke, Mohammad Bilal, Sergio A. Sánchez-Luna, Shannon Dalessio, Jennifer L. Maranki, Shazia Mehmood Siddique

Abstract [from Digestive Diseases and Sciences]

Background: The COVID-19 pandemic has impacted numerous facets of healthcare workers' lives. There have also been significant changes in Gastroenterology (GI) fellowship training as a result of the challenges presented by the pandemic.

Aims: We conducted a national survey of Gastroenterology fellows to evaluate fellows' perceptions, changes in clinical duties, and education during the pandemic.

Methods: A survey was sent to Gastroenterology (GI)

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Early Noninvasive Cardiac Testing After Emergency Department Evaluation For Suspected Acute Coronary Syndrome

Benjamin Sun, MD
Oct. 5, 2020

Aniket A. Kawatkar, Adam L. Sharp, Aileen S. Baecker, Shaw Natsui, Rita F. Redberg, Ming-Sum Lee, Maros Ferencik, Yi-Lin Wu, Ernest Shen, Chengyi Zheng, Visanee V. Musigdilok, Michael K. Gould, Steve Goodacre, Praveen Thokala , Benjamin C. Sun

Abstract [from journal]

Importance: Professional guidelines recommend noninvasive cardiac testing (NIT) within 72 hours of an emergency department (ED) evaluation for suspected acute coronary syndrome. However, there is inexact evidence that this strategy reduces the risk of future death or acute myocardial infarction (MI).

Objective: To evaluate the effectiveness of early NIT in reducing the risk of death or acute MI within 30 days.

Design, setting, and participants: This retrospective,

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Heart Transplant Waiting List Implications of Increased Ventricular Assist Device Use as a Bridge Strategy: A National Analysis

Oct. 1, 2020

Jason J. Han, Hadi Elzayn, Matthew M. Duda, Amit Iyengar, Andrew M. Acker, William L. Patrick, Mark Helmers, Edo Y. Birati, Pavan Atluri

Abstract [from journal]

Background: The use of ventricular assist devices (VAD) as a bridge to heart transplant (HT) is increasing, while HT volume remains stagnant. This may portend longer waiting times and an otherwise more competitive environment for all patients on the HT waiting list.

Methods: A retrospective analysis of patients who were listed for HT in the United Network for Organ Sharing (UNOS) database from 2000 to 2015 was conducted. Mean waiting time, proportion of HT reception (%HT), proportion of death

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Inside The Black Box Of Improving On Nursing Home Quality Measures

Sep. 28, 2020

Heather Davila, Tetyana P. Shippee, Young Shin Park, Daniel Brauner, Rachel M. Werner, R. Tamara Konetzka

Abstract [from journal]

Nursing Home Compare (NHC) reports quality measures (QMs) for nursing homes (NHs) as part of its 5-star rating system. Most of the QMs are based on facility self-reported data, prompting questions about their validity. To better understand how NHs interact with the QMs, we used qualitative methods, including semistructured interviews with NH personnel (n = 110), NH provider association representatives (n = 23), and observations of organizational processes in 12 NHs in three states. We found that most NHs are working to improve the

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Predicting Implementation: Comparing Validated Measures Of Intention And Assessing The Role Of Motivation When Designing Behavioral Interventions

Sep. 28, 2020

Jessica Fishman, Viktor Lushin, David S. Mandell

Abstract [from journal]

Background: Behavioral intention (which captures one's level of motivation to perform a behavior) is considered a causal and proximal mechanism influencing the use of evidence-based practice (EBP). Implementation studies have measured intention differently, and it is unclear which is most predictive. Some use items referring to "evidence-based practice" in general, whereas others refer to a specific EBP. There are also unresolved debates about whether item stems should be worded "I intend to," "I will," or "How

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