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Research Studies is a compilation of published research articles funded by ´óÏóÊÓƵor authored by ´óÏóÊÓƵresearchers.

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1 to 25 of 215 Research Studies Displayed
Childs E, Swan H, Evans L
´óÏóÊÓƵAuthor: Perfetto D, Hogan E
A toolkit to implement opioid quality improvement efforts in primary care: findings from a mixed-methods study.
This study evaluated the How-to-Implement Toolkit for the Six Building Blocks program, which aims to improve opioid management for chronic pain in primary care settings. Eight healthcare organizations with 62 clinics participated in the evaluation. Through interviews and surveys with clinical staff, researchers found that while organizations valued the Toolkit's resources, they preferred having practice facilitator support during implementation. Participants reported using specific tools rather than the entire Toolkit. The findings emphasize the importance of implementation support for opioid quality improvement initiatives in primary care settings. The Toolkit and related resources are available through the ´óÏóÊÓƵ.
AHRQ-authored.
Citation: Childs E, Swan H, Evans L . A toolkit to implement opioid quality improvement efforts in primary care: findings from a mixed-methods study. J Opioid Manag 2025 Jan-Feb; 21(1):29-40. doi: 10.5055/jom.0894..
Keywords: Quality Improvement, Primary Care, Opioids, Medication, Quality of Care, Implementation
Gupta A, Quinn M, Greene MT
Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned.
Researchers conducted a pre-test/post-test pilot study of physicians at a tertiary-care, academic medical center to understand situational factors that predispose diagnostic errors. Participants rated their confidence in patient diagnoses and completed a survey on their use of a multi-component intervention designed to reduce diagnostic error. The study demonstrated poor feasibility and uptake of the intervention.
AHRQ-funded; HS024385, HS025891.
Citation: Gupta A, Quinn M, Greene MT . Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned. Diagnosis 2025 Feb 1; 12(1):68-73. doi: 10.1515/dx-2024-0099..
Keywords: Diagnostic Safety and Quality, Implementation
Goriacko P, Chao J, Fassbender P
Optimizing neuromuscular block monitoring and reversal: a large-scale quality improvement initiative in a diverse healthcare setting.
This quality improvement initiative sought to optimize neuromuscular block monitoring and reversal practices at a large multi-campus urban medical center. Using the Institute for Healthcare Improvement framework across 35,198 surgical cases, the team implemented interventions that increased Train-of-Four monitoring from 42% to 83% and improved documentation of monitoring ratios and appropriate use of reversal agents. These changes corresponded with a 41% reduction in postoperative respiratory complications. Financial incentives for achieving department-wide monitoring targets proved most effective at improving practice. The study demonstrates successful implementation of evidence-based practices in a diverse healthcare setting while identifying both barriers and effective strategies for translating research into clinical practice.
AHRQ-funded; HS026396.
Citation: Goriacko P, Chao J, Fassbender P . Optimizing neuromuscular block monitoring and reversal: a large-scale quality improvement initiative in a diverse healthcare setting. J Clin Anesth 2025 Feb; 101:111709. doi: 10.1016/j.jclinane.2024.111709..
Keywords: Quality Improvement, Implementation, Quality of Care
Kenzie ES, Weekley T, Barnes C
Co-created improvement goals and strategies for implementing SBIRT and MAUD in primary care settings in a facilitator-supported, tailored implementation study.
This study’s goal was to create improvement goals and and strategies for implementing screening, brief intervention, and referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) in primary care settings in a facilitator-supported, tailored implementation study. The authors used practice facilitation to support the implementation of SBIRT and MAUD in 48 clinical practices across Oregon, Washington, and Idaho. They used clinic contact logs, individual interviews, group periodic reflections with practice facilitators, and exit interviews with clinic staff to inform qualitative analysis. Clinics identified goals spanning SBIRT, MAUD, reporting, targeted patient outreach, and quality improvement capacity. Goals addressed both the technical (e.g., data tracking) and social (e.g. staff training) aspects of SBIRT and MAUD. A decision tree was also created that summarized emergent findings into a tool to support future implementation of SBIRT in primary care settings.
AHRQ-funded; HS027080.
Citation: Kenzie ES, Weekley T, Barnes C . Co-created improvement goals and strategies for implementing SBIRT and MAUD in primary care settings in a facilitator-supported, tailored implementation study. Transl Behav Med 2025 Jan 16; 15(1). doi: 10.1093/tbm/ibae059..
Keywords: Primary Care, Implementation, Evidence-Based Practice, Alcohol Use, Substance Abuse, Behavioral Health, Screening
Yuh T, Lalley-Chareczko L, Zanders D
Acceptability and feasibility of implementing a home-based HIV pre-exposure prophylaxis program in an urban clinic.
This study assessed the acceptability and feasibility of a home-based HIV pre-exposure prophylaxis (PrEP) program among stakeholders at an urban HIV and primary care clinic. The authors surveyed and interviewed PrEP patients and their health care team, with a baseline of 112 PrEP users. Of those, 65% expressed interest in switching to the home-based PrEP program. Seventeen patients over the course of follow-up started home-based PrEP, including 12 patients who completed both a telemedicine visit and a self-administered lab kit, and 5 patients who completed only a telemedicine visit. Over 80% of those had positive feedback on the telemedicine visits. There was excellent acceptability and feasibility of the lab kits. There were mixed feelings from the 5 surveyed PrEP providers on telemedicine visits, but most felt that the program made PrEP care delivery easier for patients and would encourage their patients to use the program if it were a good fit. Barriers included shipping delays and staff turnover during program implementation.
AHRQ-funded.
Citation: Yuh T, Lalley-Chareczko L, Zanders D . Acceptability and feasibility of implementing a home-based HIV pre-exposure prophylaxis program in an urban clinic. AIDS Patient Care STDS 2024 Dec; 38(12):566-73. doi: 10.1089/apc.2024.0159.
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Implementation, Telehealth, Health Information Technology (HIT)
Nasrallah C, Schmajuk G, Hamblin A
Leveraging the Consolidated Framework for Implementation Research to develop the American College of Rheumatology's Toolkit for Implementation of Rheumatoid Arthritis Outcome Measures in Clinical Practice: a qualitative study.
The authors conducted semi-structured interviews with rheumatologists and practice personnel to identify critical gaps in collecting rheumatoid arthritis (RA) outcome measures. With the findings from these interviews, they developed the RA Measures Toolkit, which featured guidelines, best practices, and educational resources to improve the efficiency of workflows and to enhance patient care.
AHRQ-funded; HS025638.
Citation: Nasrallah C, Schmajuk G, Hamblin A . Leveraging the Consolidated Framework for Implementation Research to develop the American College of Rheumatology's Toolkit for Implementation of Rheumatoid Arthritis Outcome Measures in Clinical Practice: a qualitative study. Arthritis Care Res 2024 Dec; 76(12):1647-56. doi: 10.1002/acr.25410.
Keywords: Arthritis, Chronic Conditions, Implementation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Keenan-Devlin LS, Hughes-Jones JY, Johnson T
Implementation of a clinically integrated breastfeeding peer counselor program.
Researchers described the design and implementation of a clinically integrated breastfeeding peer counseling (ci-BPC) program to address disparities between publicly insured and commercially insured patients. Patient focus groups and surveys informed the program design, and a clinical support team developed workflows integrating breastfeeding peer counseling into the clinic and postpartum unit. This evidence-based, multidisciplinary collaboration resulted in a sustainable ci-BPC program that improved breastfeeding outcomes.
AHRQ-funded; HS027906.
Citation: Keenan-Devlin LS, Hughes-Jones JY, Johnson T . Implementation of a clinically integrated breastfeeding peer counselor program. J Perinatol 2024 Nov; 44(11):1584-90. doi: 10.1038/s41372-024-01995-3.
Keywords: Breast Feeding, Implementation, Newborns/Infants, Health Promotion, Women
Strehlow M, Alvarez A, Blomkalns AL
Precision emergency medicine.
The authors of this article conceptualized precision emergency medicine as an emerging paradigm to identify key drivers of its implementation into current and future clinical practice. Key drivers include the leveraging of new technology and data to advance diagnostic testing, providing access to care, advancing population health, and reimagining provider education and roles.
AHRQ-funded; HS029275.
Citation: Strehlow M, Alvarez A, Blomkalns AL . Precision emergency medicine. Acad Emerg Med 2024 Nov; 31(11):1150-64. doi: 10.1111/acem.14962.
Keywords: Emergency Department, Health Information Technology (HIT), Implementation
Growdon ME, Hunt LJ, Miller MJ
eConsultation for deprescribing among older adults: clinician perspectives on implementation barriers and facilitators.
This study examined clinician perspectives on barriers/facilitators of using eConsults for deprescribing among older adults within a university health network. The authors conducted semi-structured interviews with primary care physicians (PCPs), geriatricians, and pharmacists. The most common barriers and facilitators to deprescribing for PCPs was that they considered deprescribing important but identified myriad barriers (e.g., time constraints, fragmented clinical care, lack of pharmacist integration, and patient/family resistance). Other barriers to the use of eConsults for deprescribing included the limits of contextual information available through electronic health record (vs. face-to-face) to render specific and actionable eConsults (e.g., knowledge of prior deprescribing attempts). Geriatricians and PCPs both highlighted the limits of contextual information available through electronic health record (vs. face-to-face) to render specific and actionable eConsults (e.g., knowledge of prior deprescribing attempts). A targeted process where eConsults could be offered for select patients based on key factors and accepted or declined by PCPs with pithy recommendations in a timely manner created interested by all groups.
AHRQ-funded; HS026383; HS029738.
Citation: Growdon ME, Hunt LJ, Miller MJ . eConsultation for deprescribing among older adults: clinician perspectives on implementation barriers and facilitators. J Gen Intern Med 2024 Oct; 39(13):2461-70. doi: 10.1007/s11606-024-08899-0..
Keywords: Telehealth, Health Information Technology (HIT), Elderly, Implementation, Medication, Primary Care
Franco MI, Staab EM, Zhu M
Implementation of an EHR-integrated web-based depression assessment in primary care: PORTAL-Depression.
This study’s objective was to integrate a computerized adaptive test for depression into the electronic health record (EHR) and establish systems for administering assessments in-clinic and via a patient portal to improve depression care. This health information technology (IT) quality improvement (QI) project was called Patient Outcomes Reporting for Timely Assessment of Life with Depression (PORTAL-Depression). It was conducted in a hospital-based primary care clinic that serves a medically underserved metropolitan community over a 30-month period. Five major health IT innovations were integrated into the EHR by a multi-disciplinary team: (1) use of a computerized adaptive test for depression assessment, (2) 2-way secure communication between cloud-based software and the EHR, (3) improved accessibility of depression assessment results, (4) enhanced awareness and documentation of positive depression results, and (5) sending assessments via the portal. The participating attending and resident physicians were trained in depression assessment workflows through presentations at clinic meetings, self-guided online materials, and individual support. Key implementation strategies were to develop stakeholder relationships, using an evaluative and iterative process, and have ongoing training.
AHRQ-funded; HS026151.
Citation: Franco MI, Staab EM, Zhu M . Implementation of an EHR-integrated web-based depression assessment in primary care: PORTAL-Depression. JAMIA Open 2024 Oct; 7(3):ooae094. doi: 10.1093/jamiaopen/ooae094.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Depression, Primary Care, Behavioral Health, Implementation
Lewis CC, Frank HE, Cruden G
A research agenda to advance the study of implementation mechanisms.
Studying implementation mechanisms is crucial for advancing the field of implementation science. ´óÏóÊÓƵfunded a conference series to develop a research agenda on implementation mechanisms, and disseminate the agenda to research, policy, and practice audiences. This article presented the resulting agenda, including priorities and actions to encourage its execution. Actions included discrete activities, projects, or products, and ways to shift how research is conducted.
AHRQ-funded; HS025632.
Citation: Lewis CC, Frank HE, Cruden G . A research agenda to advance the study of implementation mechanisms. Implement Sci Commun 2024 Sep 16; 5(1):98. doi: 10.1186/s43058-024-00633-5..
Keywords: Implementation, Evidence-Based Practice, Health Services Research (HSR)
Williams FS, Garofalo R, Karnik NS
Universal substance use care for adolescents with chronic medical conditions: a protocol to examine equitable implementation determinants and strategies for SBIRT at a pediatric hospital.
A research protocol explores implementing Screening, Brief Intervention, and Referral to Treatment services for adolescents with chronic medical conditions in pediatric hospitals. The study highlights that these youth face equal or greater substance use risks compared to peers, with notable rates of alcohol and marijuana use. Using implementation science frameworks, the research aims to identify factors affecting program adoption through interviews and focus groups with hospital staff, patients, and caregivers. The study emphasizes health equity considerations in developing implementation strategies.
AHRQ-funded; HS026385.
Citation: Williams FS, Garofalo R, Karnik NS . Universal substance use care for adolescents with chronic medical conditions: a protocol to examine equitable implementation determinants and strategies for SBIRT at a pediatric hospital. Addict Sci Clin Pract 2024 Sep 11; 19(1):67. doi: 10.1186/s13722-024-00492-4..
Keywords: Children/Adolescents, Substance Abuse, Behavioral Health, Chronic Conditions, Hospitals, Implementation
Dukes KC, Hockett Sherlock S, Racila AM
Implementing nasal povidone-iodine decolonization to reduce infections in hemodialysis units: a qualitative assessment.
A qualitative study examined the implementation of nasal povidone-iodine decolonization in outpatient hemodialysis units to prevent bloodstream infections. Through interviews with 66 healthcare personnel across five U.S. academic medical centers, researchers found that while the treatment was generally acceptable and feasible, implementation success varied. Key facilitators included leadership support and patient engagement tools, while barriers included staffing limitations, patient health burdens, and language barriers. The findings suggest potential for successful implementation with appropriate organizational support.
AHRQ-funded; HS026724.
Citation: Dukes KC, Hockett Sherlock S, Racila AM . Implementing nasal povidone-iodine decolonization to reduce infections in hemodialysis units: a qualitative assessment. Infect Control Hosp Epidemiol 2024 Sep; 45(9):104-1109. doi: 10.1017/ice.2024.83..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Hospitals, Implementation
McGuier EA, Kolko DJ, Aarons GA
Teamwork and implementation of innovations in healthcare and human service settings: a systematic review.
This systematic review’s objective was to summarize empirical research examining associations between teamwork and implementation outcomes when evidence-based practices and other innovations are implemented in healthcare and human service settings. Out of 10,489 results identified, 58 articles representing 55 studies were included. Relevant studies increased over time with 71% of articles published after 2016. They were unable to generate estimates of effects for any quantitative associations because of very limited overlap in the reported associations between team variables and implementation outcomes. The following qualitative findings were found with high confidence: 1) Staffing shortages and turnover hinder implementation; 2) Adaptive team functioning (i.e., positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better implementation outcomes; Problems in team functioning (i.e., negative affective states, problematic behavioral processes, lack of shared cognitive states) act as barriers to implementation and are associated with poor implementation outcomes; and 3) Open, ongoing, and effective communication within teams facilitates implementation of new practices; poor communication is a barrier.
AHRQ-funded; HS026862.
Citation: McGuier EA, Kolko DJ, Aarons GA . Teamwork and implementation of innovations in healthcare and human service settings: a systematic review. Implement Sci 2024 Jul 15; 19(1):49. doi: 10.1186/s13012-024-01381-9..
Keywords: Teams, Implementation
Wyles CL, Shea K, Weiss A
A virtual dissemination framework to inform and evaluate a neonatal Project ECHO (NeoECHO).
This paper introduces a novel Virtual Dissemination Evaluation (VDE) framework designed to enhance the spread of up-to-date knowledge and best practices in intensive care units, particularly neonatal care. The framework combines two existing models: the Integrated Promoting Action on Research Implementation in Health Services (iPARIHS) and Moore's Expanded Outcomes frameworks. To demonstrate its application, the researchers implemented the framework in a dissemination strategy called NeoECHO, which aims to prevent, detect, and treat necrotizing enterocolitis in newborns through evidence-based virtual education. The VDE framework was assessed using criteria for practical application, including significance, internal consistency, parsimony, testability, and design fit. The NeoECHO strategy was then evaluated for adherence to the VDE framework, its operationalization, and the feasibility of implementation evaluation. Results showed that the VDE framework met the criteria for practical application and demonstrated feasibility in terms of adherence and consistent operationalization. Healthcare providers actively engaged with the NeoECHO strategy, indicating its effectiveness in disseminating best practices for neonatal care.
AHRQ-funded; HS022908.
Citation: Wyles CL, Shea K, Weiss A . A virtual dissemination framework to inform and evaluate a neonatal Project ECHO (NeoECHO). J Adv Nurs 2024 Jul; 80(7):2977-87. doi: 10.1111/jan.15986.
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Implementation, Evidence-Based Practice
Becker JE, Shebl FM, Losina E
Using simulation modeling to inform intervention and implementation selection in a rapid stakeholder-engaged hybrid effectiveness-implementation randomized trial.
In this article, the authors described the use of a validated dynamic microsimulation model of COVID-19 transmission and disease to determine the most effective strategies to mitigate infections among Massachusetts group home staff and residents with serious mental illness and intellectual/developmental disabilities. The results of the simulation model were presented to multidisciplinary stakeholders and policymakers to inform the "Tailored Best Practice" package for a hybrid effectiveness-implementation trial. Vaccination and decreasing vaccine hesitancy among staff were predicted to have the greatest impact in mitigating COVID-19 risk in vulnerable populations of group home residents and staff. The authors noted that future implementation may benefit from this model approach when rapid deployment is necessary in the absence of data on tailored interventions.
AHRQ-funded; HS000063.
Citation: Becker JE, Shebl FM, Losina E . Using simulation modeling to inform intervention and implementation selection in a rapid stakeholder-engaged hybrid effectiveness-implementation randomized trial. Implement Sci Commun 2024 Jun 24; 5(1):70. doi: 10.1186/s43058-024-00593-w.
Keywords: Evidence-Based Practice, Simulation, Implementation
Ashcraft LE, Goodrich DE, Hero J
A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022.
The authors conducted a systematic review to describe the body of research evidence testing implementation strategies across diverse settings and domains. They described characteristics of studies and frequency of implementation strategies used across study arms and examined common strategy pairings and cooccurrence with significant outcomes. The implementation strategies which most frequently occurred in the experimental arm were Distribute Educational Materials, Conduct Educational Meeting, Audit and Provide Feedback, and External Facilitation; these strategies were often used in combination. The authors also presented recommendations for improving future similar efforts.
AHRQ-funded; HS027210.
Citation: Ashcraft LE, Goodrich DE, Hero J . A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022. Implement Sci 2024 Jun 24; 19(1):43. doi: 10.1186/s13012-024-01369-5.
Keywords: Implementation, Evidence-Based Practice, Outcomes
Kimpel CC, Myer EA, Cupples A A
Identifying barriers and facilitators to Veterans Affairs Whole Health Integration using the updated consolidated framework for implementation research.
This study examined the Veteran Affairs (VA) Whole Health Integration System initiative across VA sites with approaches to implementation varying by site. The authors used the Consolidated Framework for Implementation Research (CFIR) to synthesize systemic barriers and facilitators to Veteran use with the initiative. Advanced fellows from 11 VA Quality Scholars sites performed the initial data collection. The final report included CFIR-organized results from six sites. Cost, complexity, offerings, and accessibility were key innovation findings. They also found inner setting barriers and facilitators including relational connections and communication, compatibility, structure and resources, learning centeredness, and information and knowledge access. Results regarding individuals included innovation deliverers, implementation leaders and team, and individual capability, opportunity, and motivation to implement and deliver whole health care.
AHRQ-funded; HS026122.
Citation: Kimpel CC, Myer EA, Cupples A A . Identifying barriers and facilitators to Veterans Affairs Whole Health Integration using the updated consolidated framework for implementation research. J Healthc Qual 2024 May-Jun; 46(3):137-49. doi: 10.1097/jhq.0000000000000419..
Keywords: Implementation, Quality Improvement, Healthcare Delivery, Quality of Care
Barton HJ, Maru A, Leaf MA
Academic detailing as a health information technology implementation method: supporting the design and implementation of an emergency department-based clinical decision support tool to prevent future falls.
This study investigated the effectiveness of academic detailing, a method involving personalized education sessions with clinicians, in implementing a machine learning-based clinical decision support (CDS) tool designed to prevent future falls in elderly emergency department patients. Through qualitative analysis of interviews with clinicians who had encountered the CDS tool, researchers identified several factors influencing its use, including aspects of the tool's design, clinicians' understanding of the tool and referral process, the fast-paced emergency department environment, clinicians' perception of patient fall risk, and the complexity of the referral process. Academic detailing sessions allowed for real-time clarification of misconceptions and demonstration of the tool's functionality, highlighting its potential as a valuable strategy for supporting the implementation and optimization of health information technologies. Additionally, insights gained from these sessions can inform both immediate adjustments to the implementation process and long-term redesign of the tool to better align with clinicians' needs and workflows.
AHRQ-funded; HS027735.
Citation: Barton HJ, Maru A, Leaf MA . Academic detailing as a health information technology implementation method: supporting the design and implementation of an emergency department-based clinical decision support tool to prevent future falls. JMIR Hum Factors 2024 Apr 18; 11:e52592. doi: 10.2196/52592..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Implementation, Emergency Department, Falls, Prevention
Salwei ME, Hoonakker P, Carayon P
Usability of a human factors-based clinical decision support in the emergency department: lessons learned for design and implementation.
A human-centered design process was followed to assess the usability and adoption of human factors (HF)-based clinical decision support (CDS) in the emergency department (ED). A CDS was developed to aid in pulmonary embolism (PE) diagnosis, showing high usability in testing. However, despite positive perceptions, actual CDS usage remained low due to integration issues with clinician workflow. The findings highlight the need for ongoing refinement of CDS design to align with clinical workflows and enhance usability.
AHRQ-funded; HS026395; HS024558; HS022086. NIH 142099
Citation: Salwei ME, Hoonakker P, Carayon P . Usability of a human factors-based clinical decision support in the emergency department: lessons learned for design and implementation. Hum Factors 2024 Mar; 66(3):647-57. doi: 10.1177/00187208221078625.
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Emergency Department, Implementation
Hernandez SE, Solomon D, Moon J
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Researchers described their fluoroquinolone restriction for the prevention of Clostridioides difficile infection (FIRST) trial, a multisite clinical study which used an electronic health record-based best-practice alert to optimize the use of fluoroquinolone antibiotics in acute care settings. Their goals were to describe the roles and responsibilities of clinical implementation coordinators within antibiotic stewardship teams and to identify facilitators and barriers coordinators experienced within the implementation process. The researchers conducted directed content analysis of semistructured interviews, implementation diaries, and check-in meetings. Their results indicated that clinical implementation coordinators facilitated the implementation process via their roles and responsibilities and acted as strategic partners in the improvement of adoption and sustainability of a fluoroquinolone preauthorization protocol.
AHRQ-funded; HS026226.
Citation: Hernandez SE, Solomon D, Moon J . Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions. Am J Health Syst Pharm 2024 Feb 8; 81(4):120-28. doi: 10.1093/ajhp/zxad272.
Keywords: Evidence-Based Practice, Implementation, COVID-19
Dayao JKO, Duffy CEL, Cristiano AM
Implementation and evaluation of Exercise is Medicine in primary care clinics within a large academic health system.
The objective of this study was to evaluate the feasibility, implementation, and effectiveness of the Exercise is Medicine (EIM) initiative. Researchers used a combination of the Practical Robust Implementation and Sustainability Model (PRISM) and the Learning Evaluation model to implement EIM; data was collected from the EHR, including Physical Activity Vital Sign (PAVS) scores, and also from qualitative surveys and interviews with the patients, clinicians, and staff of 5 primary care clinics within a large academic health system. The results indicated that EIM is feasible for routine primary care practice within a large academic health system. The researchers concluded that EIM is a model to emulate to help primary care providers address healthy lifestyle behaviors more efficiently.
AHRQ-funded; HS026517.
Citation: Dayao JKO, Duffy CEL, Cristiano AM . Implementation and evaluation of Exercise is Medicine in primary care clinics within a large academic health system. Fam Med Community Health 2024 Feb 2; 12(1):e002608. doi: 10.1136/fmch-2023-002608..
Keywords: Primary Care, Lifestyle Changes, Health Promotion, Implementation
Frehn JL, Li JN, Liu KR
Implementation of a universal screening and follow-up care system for pediatric developmental and behavioral health in federally qualified health center sites.
This study assessed the results of implementing an intervention to increase screening of developmental delays in children at six federally qualified health center (FQHC) sites in Northern California from April 2014 to April 2017. The goals of the intervention were to increase (a) standardized developmental screening at recommended intervals and (b) follow-up care and support for early intervention services. The aim was to optimize each site's screening processes, supported by an automated electronic tablet-based system. Social workers were hired to conduct follow-up clinical assessments, provide psychosocial education and treatment, provide referrals, provide case management support, and collaborate with service partners. During the last year of the intervention, when tablet-based screening was adopted, the sites screened an estimated 6,550 children ages 0-18 at 23 intervals in three domains (developmental, autism, and psychosocial/behavioral), compared to a baseline where they screened children ages 0-3 at four intervals in one domain. Screening rates increased from 65.3% to 75.5% after automation was extended from the first to the second site and continued its’ increase to 91.8% after automation was expanded to the remaining sites. Ranges for follow-up visits were between 74% and 88%.
AHRQ-funded; HS000046.
Citation: Frehn JL, Li JN, Liu KR . Implementation of a universal screening and follow-up care system for pediatric developmental and behavioral health in federally qualified health center sites. Fam Syst Health 2023 Dec; 41(4):454-66. doi: 10.1037/fsh0000803..
Keywords: Children/Adolescents, Disabilities, Screening, Implementation
Goldberg DG, Owens-Jasey C, Haghighat S
Implementation strategies for large scale quality improvement initiatives in primary care settings: a qualitative assessment.
This study focused on gaining a comprehensive understanding of perspectives from research participants and research team members on the value of implementation strategies and factors that influenced the AHRQ-funded EvidenceNOW initiative in Virginia. The goal of EvidenceNOW’s Advancing Heart Health in Primary Care initiative is to assist primary care practices in the US in implementing evidence-based practices in cardiovascular care and building capacity for quality improvement. In 2018, the authors conducted 25 focus groups with clinicians and staff at participating practices, including 80 physicians, advanced practice clinicians, practice managers, and other practice staff. They also conducted face-to-face and telephone interviews with 22 research team members, including lead investigators, practice facilitators, physician expert consultants, and evaluators. They used the integrated-Promoting Action on Research Implementation in the Health Services (i-PARIHS) framework in their qualitative data analysis and organization of themes. Implementation strategies that were valued by both practice representatives and research team members included the kick-off event, on-site practice facilitation, and interaction with physician expert consults. Day-to-day activities often overwhelmed clinicians and staff, which hindered their ability to fully participate in the EvidenceNOW initiative.
AHRQ-funded; HS023913.
Citation: Goldberg DG, Owens-Jasey C, Haghighat S . Implementation strategies for large scale quality improvement initiatives in primary care settings: a qualitative assessment. BMC Prim Care 2023 Nov 17; 24(1):242. doi: 10.1186/s12875-023-02200-8..
Keywords: Quality Improvement, Primary Care, Quality of Care, Implementation
Lovero KL, Kemp CG, Wagenaar BH
Application of the Expert Recommendations for Implementing Change (ERIC) compilation of strategies to health intervention implementation in low- and middle-income countries: a systematic review.
The authors conducted a systematic literature review on the use of Expert Recommendations for Implementing Change (ERIC) project strategies for health intervention implementation in low- and middle-income countries (LMICs) in order to identify gaps and to inform future research. The results indicated that ERIC usage in LMICs is rapidly growing, but its application has not been consistently used to test strategy effectiveness. The authors recommended that future LMICs research test strategies need to be better specified, so they may be compared across contexts and their impact on outcomes evaluated.
AHRQ-funded; HS025632.
Citation: Lovero KL, Kemp CG, Wagenaar BH . Application of the Expert Recommendations for Implementing Change (ERIC) compilation of strategies to health intervention implementation in low- and middle-income countries: a systematic review. Implement Sci 2023 Oct 30; 18(1):56. doi: 10.1186/s13012-023-01310-2..
Keywords: Implementation, Evidence-Based Practice

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