TY - JOUR
T1 - Factors related to implementation and reach of a pragmatic multisite trial
T2 - The my own health report (MOHR) study
AU - Balasubramanian, Bijal A.
AU - Heurtin-Roberts, Suzanne
AU - Krasny, Sarah
AU - Rohweder, Catherine L.
AU - Fair, Kayla
AU - Olmos-Ochoa, Tanya T.
AU - Stange, Kurt C.
AU - Gorin, Sherri Sheinfeld
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Background: Contextual factors relevant to translating healthcare improvement interventions to different settings are rarely collected systematically. This study articulates a prospective method for assessing and describing contextual factors related to implementation and patient reach of a pragmatic trial in primary care. Methods: In a qualitative case-series, contextual factors were assessed from the My Own Health Report (MOHR) study, focused on systematic health risk assessments and goal setting for unhealthy behaviors and behavioral health in nine primary care practices. Practice staff interviews and observations, guided by a context template were conducted prospectively at three time points. Patient reach was calculated as percentage of patients completing MOHR of those who were offered MOHR and themes describing contextual factors were summarized through an iterative, data immersion process. These included practice members' motivations towards MOHR, practice staff capacity for implementation, practice information system capacity, external resources to support quality improvement, community linkages, and implementation strategy fit with patient populations. Conclusions: Systematically assessing contextual factors prospectively throughout implementation of quality improvement initiatives helps translation to other health care settings. Knowledge of contextual factors is essential for scaling up of effective interventions.
AB - Background: Contextual factors relevant to translating healthcare improvement interventions to different settings are rarely collected systematically. This study articulates a prospective method for assessing and describing contextual factors related to implementation and patient reach of a pragmatic trial in primary care. Methods: In a qualitative case-series, contextual factors were assessed from the My Own Health Report (MOHR) study, focused on systematic health risk assessments and goal setting for unhealthy behaviors and behavioral health in nine primary care practices. Practice staff interviews and observations, guided by a context template were conducted prospectively at three time points. Patient reach was calculated as percentage of patients completing MOHR of those who were offered MOHR and themes describing contextual factors were summarized through an iterative, data immersion process. These included practice members' motivations towards MOHR, practice staff capacity for implementation, practice information system capacity, external resources to support quality improvement, community linkages, and implementation strategy fit with patient populations. Conclusions: Systematically assessing contextual factors prospectively throughout implementation of quality improvement initiatives helps translation to other health care settings. Knowledge of contextual factors is essential for scaling up of effective interventions.
KW - Delivery of health care
KW - Health resources
KW - Patient care team
KW - Primary health care
KW - Quality improvement
UR - http://www.scopus.com/inward/record.url?scp=85019119205&partnerID=8YFLogxK
U2 - 10.3122/jabfm.2017.03.160151
DO - 10.3122/jabfm.2017.03.160151
M3 - Article
C2 - 28484066
AN - SCOPUS:85019119205
SN - 1557-2625
VL - 30
SP - 337
EP - 349
JO - Journal of the American Board of Family Medicine
JF - Journal of the American Board of Family Medicine
IS - 3
ER -