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2019 HSR&D/QUERI National Conference Abstract

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1134 — Addressing the Next Implementation Challenge: Transferring Implementation Science Knowledge and Skills

Lead/Presenter: JoAnn Kirchner,  COIN - North Little Rock
All Authors: Kirchner JE (VA Behavioral Health QUERI; CAVHS, North Little Rock, AR; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR;), Smith, JL (VA Behavioral Health QUERI; CAVHS, North Little Rock, AR; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR), Dollar, KM (VA Center for Integrated Healthcare, Syracuse, NY) Martin, LA (VISN 16 & 17 South Central Mental Illness Research, Educational, and Clinical Center (MIRECC); Baylor College of Medicine, Houston, TX) Fletcher TL (VISN 16 & 17 South Central Mental Illness Research, Educational, and Clinical Center (MIRECC); Baylor College of Medicine, Houston, TX)

Objectives:
Guided by the i-PARIHS framework, we have developed substantial experience and expertise in testing impact of implementation facilitation (IF) strategies to support implementation of clinical innovations. Determining how best to transfer these skills is a critical question for implementation scientists. We developed a two-day IF training program and manual to transfer IF knowledge/skills by training operations leaders, researchers and implementation practitioners to apply facilitation in clinical and research initiatives. In 2015, we initiated an independent mixed-methods evaluation to assess training outcomes, and inform ongoing refinements/adaptations to the training program to increase its impact and better meet trainees' needs.

Methods:
Trainees complete pre-/post- surveys approximately 2 weeks before and 2 weeks and 6 months after each training. Surveys collect demographic information and assess IF training domains. At 6 months, trainees also participate in a semi-structured qualitative interview. To analyze training effectiveness, mean self-reported IF knowledge of and confidence in applying IF skills were compared at baseline and follow-up (using nonparametric Wilcoxon signed rank tests).

Results:
Thus far, 65 (81% response rate) trainees have completed both pre-/post- surveys; and 32 (response rate 84%) 6-month follow-up surveys and interviews. Trainees report significantly increased knowledge of factors influencing adoption of clinical innovations, roles/activities of external and internal facilitators and site champions, and providing facilitation through virtual platforms. Participants also report significantly increased knowledge of and confidence in applying IF skills. These findings were sustained at 6-months. There were no significant differences in knowledge change scores between in-person trainees and those participating virtually (i.e., by V-Tel), indicating that IF training can successfully be provided to at least one remote site without loss of knowledge transfer.

Implications:
This evaluation shows significant improvements in IF knowledge/skills and informs ongoing refinements/adaptations to the training program to increase reach and impact for subsequent training cohorts. Further, initial results indicate similar training outcomes for in-person participants and those participating virtually, which are sustained at six-months.

Impacts:
Scholars increasingly call for implementation scientists to handoff evidence-based strategies to front line managers, policymakers and providers. This IF training program provides an example through which scale-up and spread of evidence-based strategies has been accomplished.