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2023 HSR&D/QUERI National Conference Abstract

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4132 — Utilizing implementation science to design, disseminate, implement, and sustain evidence-based programs

Lead/Presenter: Catherine Battaglia,  COIN - Seattle/Denver
All Authors: Battaglia C (Seattle Denver Center of Innovation, Eastern Colorado Health Care System), Sjoberg, H (Seattle Denver Center of Innovation, Eastern Colorado Health Care System) McCreight, M (Seattle Denver Center of Innovation, Eastern Colorado Health Care System) Ayele, R (Seattle Denver Center of Innovation, Eastern Colorado Health Care System) Hernandez-Lujan, D (Seattle Denver Center of Innovation, Eastern Colorado Health Care System) McCarthy, Michaela S (Seattle Denver Center of Innovation, Eastern Colorado Health Care System)

Objectives:
As pressure mounts to accelerate the translation of evidence-based findings into practice to improve uptake, we designed a training program for Veterans Health Administration (VA) researchers, practitioners, and operations partners based on the Designing for Dissemination and Implementation (D4DandI) implementation strategy. Implementation strategies are methods to enhance the adoption, implementation, sustainment, and scale-up of an innovation and are designed to reduce the gap between research and practice by improving the translation process. D4DandI targets the adoption, implementation, sustainment, and scale-up and spread of programs.

Methods:
We developed a curriculum that followed the Quality Enhancement Research Initiative (QUERI) Implementation Roadmap utilizing four discrete methods of the D4DandI implementation strategy: 1) Pre-implementation assessment for proactive planning and multilevel context assessment (Weeks 1-2) Multi-level partner engagement to learn what is important to end-users and obtain buy-in (Weeks 3-8), 3) Implementation and adaptations guided by the pre-implementation assessment while retaining program fidelity (Weeks 9-10), and 4) Program evaluation using RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) to define sustainment elements (Weeks 11-12). In week 13, we asked participants to present their research plan with their lessons learned from the D4DandI Training Hub. We utilized a virtual e-learning platform, expert trainers, mentorship, and a Virtual Learning Collaborative (VLC) to support the D4DandI participants’ growth and success. Participants completed mid and post-course evaluations to understand the most impactful lessons and take-aways from the course.

Results:
Two cohorts of participants completed the D4DandI virtual Training Hub. The first cohort consisted of two groups for a total of nine participants working on two care coordination projects, while the second cohort was comprised of six individuals with six diverse and independent projects. The first cohort received 13 weeks of training containing six modules each followed by six VLCs with the 13th session consisting of a presentation utilizing lessons learned from the training by each group. This was followed by three monthly VLCs. Based on evaluations, we further adapted the curriculum to meet the needs of more novice learners. The next cohort received nine weeks of training including six weekly modules with VLCs at weeks four and eight, followed by presentations in week nine. We continued to follow-up with participants for three monthly VLCs. Content in all six modules was well received by participants. The most impactful lessons and take-aways from both cohorts included: interview guides for pre-implementation assessment, tools/skills to engage partners throughout project design, dissemination, and implementation as well as learning how to track and interpret adaptations based on local context.

Implications:
We trained VA practitioners, researchers, and operational partners in the D4DandI implementation strategy. The D4DandI Training Hub provided a forum for participants to learn and conceptualize how to apply this knowledge and skills to deliver effective evidence-based programs in real-world settings across the VA.

Impacts:
The D4DandI implementation strategy can help VA leadership, practitioners, or researchers design, disseminate, implement, and sustain evidence-based programs in the face of organizational barriers and constraints.