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A large national technical assistance (TA) centre in the US provides TA to Head Start regions to help strengthen their use of implementation science frameworks. In administration of TA to regions, the centre has used a 'co-creation' model. Aims and objectives: This paper describes the co-creative TA approach, including level of dosage (frequency and duration) provided, and interim outcomes achieved. Methods: The descriptive paper relies on secondary data analyses of information gathered in the course of delivering the technical assistance. The information gathered included observations of events, surveys, and listening sessions with TA participants. Findings: Analyses revealed that the TA providers were successful in the provision of co-created TA and that interim outcomes of trust, mutual accountability, and some integration of implementation science concepts into ongoing regional work were achieved. Discussion and conclusions: The TA providers succeeded in delivering TA that was perceived by both observers and participants as involving participants and being tailored to their settings and needs. Limitations include a small sample that was selected based on interest and readiness for engaging in TA and descriptive analyses that did not allow for claims of causality. The promising co-creation approach deserves additional exploration and may provide guidance to others designing technical assistance.

Purpose: Quality improvement (QI) processes provide a framework for systematically examining target outcomes and what changes can be made to result in improvement and ensure equity. We present a case study of how QI processes were used as a means of partnership building to enhance equity in designing materials for a Medicaid pilot program, North Carolina Integrated Care for Kids (NC InCK). Description: The NC InCK model addresses social determinants of health by providing structured care integration across core child health and social service areas and using an alternative payment model to incentivize high quality child outcomes. During the two-year planning period prior to the NC InCK model launch, we used Plan-Do-Study-Act (PDSA) cycles to conduct usability testing as a QI strategy for a component of the NC InCK model: the Shared Action Plan (SAP). Assessment: We conducted usability testing with four Family Council members, nine care managers, and one physician. Participants reviewed the SAP and provided feedback via a survey. After reviewing feedback with InCK leadership and the Family Council, we implemented recommendations that led to a SAP that uses clear and accessible language, that highlights family strengths and family-identified goals, and that is distinct from other care management plans. Conclusion: Usability testing forced refinement of materials before NC InCK launched, created opportunities for building and enhancing community partnerships and promoted equity within the NC InCK team and Family Council by considering multiple perspectives when deciding on SAP revisions. Significance: What is Already Known on this Subject?: Plan-Do-Study-Act (PDSA) cycles are a tool for collecting feedback and improving program components. When conducting usability testing, PDSA cycles can be used to collect feedback from a variety of audiences. What this Study adds?: This case study demonstrates how PDSA cycles can be used to conduct usability testing during the planning period of a large-scale health systems change model. Usability testing created opportunities to refine materials, build and enhance community partnerships, and promote equity among key stakeholders prior to the model launch. [ABSTRACT FROM AUTHOR]

This study aims to understand the role implementation support practitioners can have in supporting the use of research-supported practices, policies, and programs in human service sectors. Through a survey design, the authors: 1) confirm and refine principles and competencies used by professionals to provide implementation support in human service systems; 2) increase understanding of the conditions under which implementation support practitioners can be more or less effective; and 3) describe the usefulness of competencies for professionals providing implementation support. Additional findings are presented on the role of context and trusting relationships in implementation support practice. Areas for further research are discussed. [ABSTRACT FROM AUTHOR]

The immediate postpartum period is a favorable, safe, and effective time to provide long-acting reversible contraceptives, yet it is not available widely. We describe an innovative hospital-based approach to immediate postpartum long-acting reversible contraceptives that includes (1) an emphasis on multidisciplinary teambuilding and identification of champions, (2) a focus on the use of implementation science at every stage of the process to develop a systematic and replicable strategy, and (3) an imperative to apply a reproductive justice framework to immediate postpartum long-acting reversible contraceptive implementation. Our model was developed with the use of implementation science best practices. Implementation teams comprised of diverse stakeholders were formed and included champions to promote progress. Our team assessed the implementation context for immediate postpartum long-acting reversible contraceptives and used the findings to develop a readiness assessment for hospitals. A stage-based implementation checklist was then developed to outline necessary infrastructure to support an immediate postpartum long-acting reversible contraceptive initiative. A reproductive justice lens guided planning and implementation. The 3 innovative aspects of our implementation process resulted in a systematic, multidisciplinary, and culturally appropriate model for immediate postpartum long-acting reversible contraceptives that can be replicated across hospitals. Implementation teams and champions moved the work forward at each hospital, and 3 of the 5 participating hospitals moved beyond the exploration stage of implementation during the engagement. Patient education materials and provider training incorporated person-centered and reproductive justice frameworks. Our hope is to continue to partner with stakeholders to better understand how our efforts to support hospital provision of immediate postpartum long-acting reversible contraceptives can increase reproductive health equity rather than perpetuate disparity. [ABSTRACT FROM AUTHOR]