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2019 HSR&D/QUERI National Conference Abstract

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4042 — Team Science Methods to Engage Stakeholders in Intervention Development and Implementation: Applied Rapid Qualitative Analysis

Lead/Presenter: Allison Lewinski,  COIN - Durham
All Authors: Lewinski AA (Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC), Crowley, MJ (Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Duke University School of Medicine, Durham, NC), Miller, C (VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA) Bosworth, HB (Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC; Department of Population Health Sciences, Duke University School of Medicine, Durham NC; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC; School of Nursing, Duke University, Durham, NC) Jackson, GL (Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC; Department of Population Health Sciences, Duke University School of Medicine, Durham NC; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC) Steinhauser, K (Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC; Department of Population Health Sciences, Duke University School of Medicine, Durham NC; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC) White-Clark, C (Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC) Zullig, LL (Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC; Department of Population Health Sciences, Duke University School of Medicine, Durham NC)

Objectives:
To increase the likelihood of implementation, intervention development necessitates engaging multidisciplinary stakeholders as early as possible to ensure that the intervention is contextually appropriate. In the context of the VA Mission Act, we collaborated with the Office of Rural Health to address the challenges of suboptimal coordination between VHA and community providers. The development of our intervention, Telehealth-based Coordination of Non-VHA (TECNO) Care, includes two phases: (1) the identification of challenges rural Veterans and the VHA face with the Mission Act; and (2) the testing of an intervention to address these challenges. In phase 1 of this ongoing project, our team is using a rapid qualitative analysis approach that has facilitated near real-time data analysis. We describe the use of a team approach to engage in rapid qualitative data collection and analysis.

Methods:
We created a team consisting of an interviewer and 1-2 note-taker(s). The interviewer followed a structured qualitative interview guide with the note-taker(s) simultaneously taking notes in a structured format. The team debriefed immediately after each interview. We discussed emerging themes at biweekly meetings to ensure validity, rigor, and relevance to the study purpose.

Results:
This process is enabling us to identify thematic saturation earlier than with traditional qualitative methods. We are interviewing key stakeholders to identify how to best deliver TECNO Care. We have thus far conducted interviews with 7 stakeholders and will interview 8 additional stakeholders. Methodological process results indicate the formation of a team can inform near real-time intervention development and ensure relevant content creation, while simultaneously obtaining stakeholder buy-in.

Implications:
Rapid qualitative analysis enables rapid intervention development, builds stakeholder buy-in, and supports implementation efforts. Creating a collaborative team of multidisciplinary researchers facilitates the development and adaptation of both the interview guide and a sustainable intervention.

Impacts:
Developing VA's capacity as a Learning Healthcare Community requires novel methods for rapidly analyzing data on programs and practices. The VA is therefore an ideal venue for completing team-based rapid qualitative analysis to inform real-time development and implementation of systems interventions. Our project lays an important foundation for developing rigorous rapid qualitative methods and adapting them for VA-specific intervention development.