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Yee EF, DiLeone B, Yano EM, Frayne SM, Bean-Mayberry B, Sadler A, Bastian L, Carney DV, Klap R, Pomernacki A, Blakeney J, Erschens H, Barrett T, Vogt D. Use of Implementation Science Principles to Implement a Gender Sensitivity Curriculum in a VA Practice Based Research Network. Poster session presented at: Agency for Healthcare Research and Quality Practice-Based Research Network Annual Meeting; 2012 Jun 22; Bethesda, MD.
Objectives: Women Veterans (WV) have historically comprised a small proportion of VA patients. VA providers may therefore be unfamiliar with their unique healthcare needs and preferences. A web-based, interactive gender awareness curriculum, "Caring for Women Veterans" (CWV), has demonstrated effectiveness for enhancing gender sensitivity and knowledge. In this study, we used an evidence-based quality improvement (EBQI) approach to implement this training at geographically diverse sites to inform future national roll-out. Methods: Multidisciplinary stakeholder panels were conducted at four sites in the VA Women's Health Practice Based Research Network. Participants completed a questionnaire to assess preferences for implementation approaches and design elements for locally tailored gender awareness programs (e.g., identification of responsible entities, local training strategies and barriers, and prioritization of target clinical workgroups). Results: While common elements emerged, key stakeholders identified different implementation approaches across sites (e.g., action plans were embraced at one site but considered unhelpful at another). Leadership endorsement and buy-in was universally rated as important, though the approach to leadership involvement varied. One site chose a single "go-to" leader; another tapped an existing group to "own" the program. Integration of local WV "voices" and "stories" was noted as key at several sites with one facility conducting its own focus groups regarding WV experiences. Other suggested approaches included incorporating training into ongoing initiatives (e.g., Patient Aligned Care Teams) and creating a toolbox of learning opportunities. Barriers included time, availability to participate in meetings/calls, and competing PACT implementation. All sites raised the concern that there could be perception of special treatment for women veterans. Implications: Stakeholders identified site-specific approaches to implementing gender sensitivity curricula. Involving stakeholders in implementation design helps identify strategies that account for local organizational culture, prioritize leadership engagement to facilitate the training intervention, integrate organizational support for implementation/monitoring, and proactively ameliorate potential barriers and competing demands.