68 research outputs found

    Disseminating early years research: an illustrative case study

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    Purpose – This paper aims to outline a knowledge translation (KT) case study undertaken as part of a multi-component research programme aimed at evaluating new parenting supports in the earliest years. The study aimed to: explore the influencing factors relating to research use in an early years context; and to use the findings, at least in part, to execute an integrated KT plan – to promote stakeholder engagement, greater research visibility and to enhance the understanding of findings emerging from the research programme. Design/methodology/approach – A mixed-methods study was embedded within a large-scale, longitudinal research programme. In the present study, a national survey (n = 162) was administered to stakeholders working with children and families throughout Ireland. A series of oneto- one interviews were also undertaken (n = 37) to amplify the survey findings. Also, one focus group was carried out with parents (n = 8) and one with members of the research team (n = 3). Several dissemination strategies were concurrently developed, executed and evaluated, based partly on survey and interview findings and guided by the knowledge translation planning template (Barwick, 2008; 2013; 2019). Findings – The main factors influencing the dissemination of evidence, as identified by the stakeholders – were: a lack of resources; an under-developed understanding of research use and dissemination; insufficient collaboration and communication; and conflicting stakeholder priorities. Despite these challenges, the research programme was found to benefit from a multi-component KT plan to achieve the outlined dissemination goals. Practical implications – The KT planning process allowed the research team to be more accountable, introspective and to work more efficiently. This helped increase the likelihood of more targeted and successful dissemination of the research findings, delivering a better return on research investment. Originality/value – This is the first study of its kind (to our knowledge) to provide important insights for stakeholders in Ireland and elsewhere about how to improve the dissemination process. Effective KT planning can ultimately help to bridge the research-policy-practice gap and enable the effective translation of high-quality evidence in the early years’ sector to enhance outcomes for families in the shorter and longer-term

    The Implementation Playbook: Study protocol for the development and feasibility evaluation of a digital tool for effective implementation of evidence-based innovations

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    BACKGROUND: Evidence-based innovations can improve health outcomes, but only if successfully implemented. Implementation can be complex, highly susceptible to failure, costly and resource intensive. Internationally, there is an urgent need to improve the implementation of effective innovations. Successful implementation is best guided by implementation science, but organizations lack implementation know-how and have difficulty applying it. Implementation support is typically shared in static, non-interactive, overly academic guides and is rarely evaluated. In-person implementation facilitation is often soft-funded, costly, and scarce. This study seeks to improve effective implementation by (1) developing a first-in-kind digital tool to guide pragmatic, empirically based and self-directed implementation planning in real-time; and (2) exploring the tool\u27s feasibility in six health organizations implementing different innovations. METHODS: Ideation emerged from a paper-based resource, The Implementation Game©, and a revision called The Implementation Roadmap©; both integrate core implementation components from evidence, models and frameworks to guide structured, explicit, and pragmatic planning. Prior funding also generated user personas and high-level product requirements. This study will design, develop, and evaluate the feasibility of a digital tool called The Implementation Playbook©. In Phase 1, user-centred design and usability testing will inform tool content, visual interface, and functions to produce a minimum viable product. Phase 2 will explore the Playbook\u27s feasibility in six purposefully selected health organizations sampled for maximum variation. Organizations will use the Playbook for up to 24 months to implement an innovation of their choosing. Mixed methods will gather: (i) field notes from implementation team check-in meetings; (ii) interviews with implementation teams about their experience using the tool; (iii) user free-form content entered into the tool as teams work through implementation planning; (iv) Organizational Readiness for Implementing Change questionnaire; (v) System Usability Scale; and (vi) tool metrics on how users progressed through activities and the time required to do so. DISCUSSION: Effective implementation of evidence-based innovations is essential for optimal health. We seek to develop a prototype digital tool and demonstrate its feasibility and usefulness across organizations implementing different innovations. This technology could fill a significant need globally, be highly scalable, and potentially valid for diverse organizations implementing various innovations

    Knowledge Translation and Strategic Communications: Unpacking Differences and Similarities for Scholarly and Research Communications

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    Knowledge translation (KT) involves communication of research evidence. Within research-relevant organizations there is considerable overlap in the roles and activities associated with KT and strategic communications (SC), which calls for greater role clarity. We untangle the differences and similarities between KT and SC, bringing clarity that may benefit organizations employing both types of workers. As KT practitioners (KTPs) take hold in organizations that have long had SC personnel, there is tension but also opportunities for defining roles and exploring synergies. What follows is a description of how we have explored this duality within our networks and an analysis of how SC and KT roles are similar and divergent

    The Society for Implementation Research Collaboration Instrument Review Project: A methodology to promote rigorous evaluation

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    Abstract Background Identification of psychometrically strong instruments for the field of implementation science is a high priority underscored in a recent National Institutes of Health working meeting (October 2013). Existing instrument reviews are limited in scope, methods, and findings. The Society for Implementation Research Collaboration Instrument Review Project’s objectives address these limitations by identifying and applying a unique methodology to conduct a systematic and comprehensive review of quantitative instruments assessing constructs delineated in two of the field’s most widely used frameworks, adopt a systematic search process (using standard search strings), and engage an international team of experts to assess the full range of psychometric criteria (reliability, construct and criterion validity). Although this work focuses on implementation of psychosocial interventions in mental health and health-care settings, the methodology and results will likely be useful across a broad spectrum of settings. This effort has culminated in a centralized online open-access repository of instruments depicting graphical head-to-head comparisons of their psychometric properties. This article describes the methodology and preliminary outcomes. Methods The seven stages of the review, synthesis, and evaluation methodology include (1) setting the scope for the review, (2) identifying frameworks to organize and complete the review, (3) generating a search protocol for the literature review of constructs, (4) literature review of specific instruments, (5) development of an evidence-based assessment rating criteria, (6) data extraction and rating instrument quality by a task force of implementation experts to inform knowledge synthesis, and (7) the creation of a website repository. Results To date, this multi-faceted and collaborative search and synthesis methodology has identified over 420 instruments related to 34 constructs (total 48 including subconstructs) that are relevant to implementation science. Despite numerous constructs having greater than 20 available instruments, which implies saturation, preliminary results suggest that few instruments stem from gold standard development procedures. We anticipate identifying few high-quality, psychometrically sound instruments once our evidence-based assessment rating criteria have been applied. Conclusions The results of this methodology may enhance the rigor of implementation science evaluations by systematically facilitating access to psychometrically validated instruments and identifying where further instrument development is needed

    Predicting patterns of service utilization within children\u27s mental health agencies

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    Background: Some children with mental health (MH) problems have been found to receive ongoing care, either continuously or episodically. We sought to replicate patterns of MH service use over extended time periods, and test predictors of these patterns. Methods: Latent class analyses were applied to 4 years of visit data from five MH agencies and nearly 6000 children, 4-to 13-years-old at their first visit. Results: Five patterns of service use were identified, replicating previous findings. Overall, 14% of cases had two or more episodes of care and 23% were involved for more than 2 years. Most children (53%) were seen for just a few visits within a few months. Two patterns represented cases with two or more episodes of care spanning multiple years. In the two remaining patterns, children tended to have just one episode of care, but the number of sessions and length of involvement varied. Using discriminant function analyses, we were able to predict with just over 50% accuracy children\u27s pattern of service use. Severe externalizing behaviors, high impairment, and high family burden predicted service use patterns with long durations of involvement and frequent visits. Conclusions: Optimal treatment approaches for children seen for repeated episodes of care or for care lasting multiple years need to be developed. Children with the highest level of need (severe pathology, impairment, and burden) are probably best served by providing high intensity services at the start of care

    Toward criteria for pragmatic measurement in implementation research and practice: a stakeholder-driven approach using concept mapping

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    Background: Advancing implementation research and practice requires valid and reliable measures of implementation determinants, mechanisms, processes, strategies, and outcomes. However, researchers and implementation stakeholders are unlikely to use measures if they are not also pragmatic. The purpose of this study was to establish a stakeholder-driven conceptualization of the domains that comprise the pragmatic measure construct. It built upon a systematic review of the literature and semi-structured stakeholder interviews that generated 47 criteria for pragmatic measures, and aimed to further refine that set of criteria by identifying conceptually distinct categories of the pragmatic measure construct and providing quantitative ratings of the criteria’s clarity and importance. Methods: Twenty-four stakeholders with expertise in implementation practice completed a concept mapping activity wherein they organized the initial list of 47 criteria into conceptually distinct categories and rated their clarity and importance. Multidimensional scaling, hierarchical cluster analysis, and descriptive statistics were used to analyze the data. Findings: The 47 criteria were meaningfully grouped into four distinct categories: (1) acceptable, (2) compatible, (3) easy, and (4) useful. Average ratings of clarity and importance at the category and individual criteria level will be presented. Conclusions: This study advances the field of implementation science and practice by providing clear and conceptually distinct domains of the pragmatic measure construct. Next steps will include a Delphi process to develop consensus on the most important criteria and the development of quantifiable pragmatic rating criteria that can be used to assess measures

    Cross-Sectoral Data Linkage: Tracking Mental Health Service Utilization from Childhood into Adulthood

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    Introduction Of the 15-18% of children and youth in Canada with a mental health disorder, some receive specialized mental health (MH) services and need additional treatment as young adults. Lack of a shared database across child and adult sectors has prevented examining predictors of future MH health service use. Objectives and Approach We examined predictors of mental health service utilization in adulthood, and compared a sample of youth who received specialized MH treatment and age-, sex-, and region- matched controls. Patient-level administrative data from five MH agencies funded by the Ministry of Children and Youth Services (MCYS) in Ontario, with population health sector datasets held at the Institute for Clinical Evaluative Sciences (ICES). We expanded previous definitions of coding a MH visit by including codes specific to long-lasting childhood MH diagnoses (e.g., Attention Deficit-Hyperactivity Disorder). Results Our match rate for linking the MCYS treated youth with their population health data was 77%. Youth who received MH treatment (N= 2957) were twice as likely as matched controls (N= 8891) to have a MH visit in the medical system in adulthood (i.e., after age 18). The most common diagnostic codes for the first visit were anxiety, depressive disorders, and ADHD. The median survival time (when 50% had a visit) from age 18 to first MH visit was 3.3 years. In adjusted Cox regressions, significant predictors of having an adult MH visit included service use history in both medical and MH systems during childhood and adolescence (e.g., ongoing pattern of children’s MH service use). Conclusion/Implications This study represents the first longitudinal, case-control cohort study in Canada to examine MH service utilization in the medical sector by youth treated for MH problems. The linkage of information from multiple datasets allowed for a broader understanding of MH service utilization across sectors of care, specific to children and youth
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