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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

3013 — Use of Implementation Science Principles to Implement a Gender Sensitivity Curriculum in a Practice-Based Research Network

Yee EF, New Mexico VAHCS; DiLeone B, VA Boston HCS; Yano EM, VA Greater Los Angeles HCS; Frayne S, VA Palo Alto HCS; Bean-Mayberry B, VA Greater Los Angeles HCS; Sadler A, Iowa City VAHCS; Bastian L, Durham VAMC; Carney D, VA Palo Alto HCS; Vogt D, VA Boston HCS;

Women Veterans (WV) have historically made up a small proportion of VA patients. Therefore, some VA providers may be unfamiliar with their unique healthcare needs and preferences. A web-based, interactive gender awareness curriculum called Caring for Women Veterans (CWV) has been shown to be effective for enhancing provider and staff gender sensitivity and knowledge. In this study, we used an evidence-based quality improvement (EBQI) approach to implement gender awareness training at geographically diverse sites to inform future national roll-out.

Multidisciplinary stakeholder panels were conducted at two sites in the Women’s Health Practice-Based Research Network. Participants completed a Program Design Preference Questionnaire to assess preferences for implementation approaches and design elements for locally-tailored gender awareness programs (e.g., identification of local training strategies, responsible entities, supplemental organizational resources, prioritization of target clinical workgroups, and identification of local barriers).

While common elements emerged, key stakeholders identified different implementation approaches across sites (e.g., action plans were embraced at one site but rated as unhelpful at another). Leadership endorsement and buy-in was universally rated as important, though the approach to leadership involvement varied. One site chose to rely on a single “go to” leader while another tapped an existing group to “own” the program, and decided to generate a leadership “public service announcement” DVD to precede the training. Integration of local WV “voices” was noted as key in one site, resulting in facility conduct of its own focus groups regarding their experiences, while another site suggested training incorporation into ongoing initiatives (e.g., Patient Aligned Care Teams). Barriers included: time, availability to participate in meetings/calls, and competing PACT implementation. Both sites raised concern that there could be perception of special treatment of women Veterans.

Stakeholders identified site-specific approaches to implementing gender sensitivity curricula. Involving stakeholders in implementation design helps to identify strategies that take local organizational culture, priorities, and leadership engagement into account.

Stakeholder engagement will facilitate local tailoring of the CWV training intervention, as well as integration of organizational supports for implementation/monitoring and proactive amelioration of potential barriers and competing demands.

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