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Background: Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interventions compared with interventions transported without adaptation, there are also examples of interventions which have been extensively adapted, yet have not worked in the new context. Decisions on when, to what extent, and how to adapt interventions therefore are not straightforward, particularly when conceptualising intervention effects as contingent upon contextual interactions in complex systems. No guidance currently addresses these questions comprehensively. To inform development of an overarching guidance on adaptation of complex population health interventions, this systematic review synthesises the content of the existing guidance papers.Methods: We searched for papers published between January 2000 and October 2018 in 7 bibliographic databases. We used citation tracking and contacted authors and experts to locate further papers. We double screened all the identified records. We extracted data into the following categories: descriptive information, key concepts and definitions, rationale for adaptation, aspects of adaptation, process of adaptation, evaluating and reporting adapted interventions. Data extraction was conducted independently by two reviewers, and retrieved data were synthesised thematically within pre-specified and emergent categories.Results: We retrieved 6694 unique records. Thirty-eight papers were included in the review representing 35 sources of guidance. Most papers were developed in the USA in the context of implementing evidence-informed interventions among different population groups within the country, such as minority populations. We found much agreement on how the papers defined key concepts, aims, and procedures of adaptation, including involvement of key stakeholders, but also identified gaps in scope, conceptualisation, and operationalisation in several categories.Conclusions: Our review found limitations that should be addressed in future guidance on adaptation. Specifically, future guidance needs to be reflective of adaptations in the context of transferring interventions across countries, including macro- (e.g. national-) level interventions, better theorise the role of intervention mechanisms and contextual interactions in the replicability of effects and accordingly conceptualise key concepts, such as fidelity to intervention functions, and finally, suggest evidence-informed strategies for adaptation re-evaluation and reporting.Trial Registration: PROSPERO 2018, CRD42018112714. [ABSTRACT FROM AUTHOR]

Background: Since the early 90s, patient navigation programs were introduced in the United States to address inequitable access to cancer care. Programs have since expanded internationally and in scope. The goals of patient navigation programs are to: a) link patients and families to primary care services, specialist care, and community-based health and social services (CBHSS); b) provide more holistic patient-centred care; and, c) identify and resolve patient barriers to care. This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to CBHSS. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies.Methods: This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to CBHSS.Results: Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social care system, although they need to be considered with caution since the majority of studies were descriptive.Conclusions: This study contributes new knowledge that can inform the initiation and maintenance of primary care patient navigation programs that link patients with CBHSS. It also provides directions for future research. [ABSTRACT FROM AUTHOR]

This scoping review provides an overview of cancer interventions implemented with Arab Americans across the cancer control continuum, including an examination of outcomes and implementation processes. The search strategy included database searching and reviewing reference lists and forward citations to identify articles describing interventions with Arab adults living in the US, with no restrictions on date of publication or research methodology. The review included 23 papers describing 12 unique cancer interventions. Most interventions focused on individual-level determinants of breast and cervical cancer screening; used non-quasi-experimental research designs to evaluate intervention effectiveness; and demonstrated improvements in short-term cancer screening knowledge. Implementation processes were less commonly described. Most interventions were culturally and linguistically tailored to communities of focus; were delivered in educational sessions in community settings; engaged with the community mostly for recruitment and implementation; and were funded by foundation grants. Suggestions for research and intervention development are discussed. [ABSTRACT FROM AUTHOR]

Background: Online knowledge translation (KT) approaches are becoming increasingly prevalent within healthcare due to their accessibility and facilitation of international support networks. Online platforms enable timely and far‐reaching dissemination of current evidence and best‐practice recommendations. Although there is potential to improve the uptake of rehabilitation guidelines, it is essential to consider the acceptability of online approaches to healthcare professionals to ensure their successful integration within everyday clinical settings. Aims: To establish the prospective acceptability of a theoretically informed online intervention for speech pathologists, Aphasia Nexus: Connecting Evidence to Practice, that aims to facilitate the implementation of aphasia best practice. Methods & Procedures: A mixed‐methods multinational electronic survey based on the Theoretical Framework of Acceptability (TFA) completed by aphasia researchers and clinicians. Outcomes & Results: A total of 43 participants completed the survey with 91% (n = 39) indicating that they would use Aphasia Nexus. Understanding the intervention and how it works (intervention coherence as per the TFA) was the key factor influencing the likelihood of integration within everyday clinical practice. Participants identified potential areas where the intervention could influence service change and also recommended further design and content changes to improve the intervention. Conclusions & Implications: Aphasia Nexus is an acceptable platform for further feasibility testing in the form of a pilot trial within an Australian‐based health service. The study progresses the theory of TFA as it was a valuable framework facilitating the identification of prominent factors influencing acceptability. The study also informs further intervention refinements in preparation for the next stage of research. WHAT THIS PAPER ADDS: What is already known on the subject: Online strategies have the potential to enhance KT and promote the uptake of rehabilitation guidelines. An online intervention, however, can only be effective if implemented well. For this reason, it is essential to establish the acceptability of online interventions to the intended recipients and therefore increase the likelihood of successful implementation. What this paper adds to existing knowledge: This study used a theoretically based framework to establish the acceptability of an online implementation intervention, Aphasia Nexus, to multinational aphasia clinicians and researchers. It demonstrated the value in identifying the prominent factors influencing acceptability to inform further intervention refinements and warrant continuing research. What are the potential or actual clinical implications of this work?: Speech pathologists should use online platforms to drive the implementation of best practice on an international scale. It is important for clinicians to have an in‐depth understanding of online interventions and how they work to enhance their successful uptake into routine clinical practice. Aphasia Nexus is an acceptable online platform for implementing best practice in aphasia. [ABSTRACT FROM AUTHOR]

Background: A lack of knowledge exists on real world hospital strategies that seek to improve quality, while reducing or containing costs. The aim of this study is to identify hospitals that have implemented such strategies and determine factors influencing the implementation. Methods: We searched PubMed, EMBASE, Web of Science, Cochrane Library and EconLit for case studies on hospitalwide strategies aiming to increase quality and reduce costs. Additionally, grey literature databases, Google and selected websites were searched. We used inductive coding to identify factors relating to implementation of the strategies. Results: The literature search identified 4198 papers, of which our included 17 papers describe 19 case studies from five countries, mostly from the United States. To accomplish their goals, hospitals use different management strategies, such as continuous quality improvement (CQI), clinical pathways, Lean, Six Sigma and value-based healthcare (VBHC). Reported effects on both quality and costs are predominantly positive. Factors identified to be relevant for implementation were categorized in eleven themes: (1) strategy, (2) leadership, (3) engagement, (4) reorganization, (5) finances, (6) data and information technology (IT), (7) projects, (8) support, (9) skill development, (10) culture, and (11) communication. Recurring barriers for implementation are a lack of physician engagement, insufficient financial support, and poor data collection. Conclusion: Hospital strategies that explicitly aim to provide high quality care at low costs may be a promising option to bend the cost curve while improving quality. We found a limited amount of studies, and varying contexts across case studies. This underlines the importance of integrated evaluation research. When implementing a quality enhancing, cost reducing strategy, we recommend considering eleven conditions for successful implementation that we were able to derive from the literature. [ABSTRACT FROM AUTHOR]

Point of care ultrasound (POCUS) use in the emergency department is associated with improved patient outcomes and increased patient satisfaction. When used for procedural guidance, it has been shown to increase first pass success and decrease complications. As of 2012, ultrasound has been identified as a core skill required for graduating emergency medicine (EM) residents. Despite this, only a minority of EM faculty who trained prior to 2008 are credentialed in POCUS. Half of all EM training programs in the United States have less than 50% of their faculty credentialed to perform and teach POCUS to learners. As the use of POCUS continues to grow in medicine, it is especially important to have a pathway for faculty to attain competence and become credentialed in POCUS. The goal of this paper was to outline an implementation process of a curriculum designed to credential EM faculty in POCUS. [ABSTRACT FROM AUTHOR]

The United States (U.S.) has a plan to end the HIV epidemic by 2030. The plan's first pillar prioritizes HIV testing. Social Network Strategy (SNS) is an intervention to reach persons not routinely testing for HIV. We conducted a systematic review of SNS to understand its implementation to optimize HIV testing in the U.S. among key populations. The eligibility criteria included peer-reviewed papers based in the U.S. and focused on HIV testing. We identified and thematically analyzed 14 articles to explore factors associated with successful implementation. Key themes included: (1) social network and recruiter characteristics; (2) strategies for and effectiveness of recruiting key populations; (3) use of and types of incentives; (4) trust, confidentiality, and stigma concerns; and (5) implementation plans and real-world guidance. Cohort studies indicated that SNS detects more incident HIV cases. Partnerships with health departments are critical to confirm new diagnoses, as are developing plans that support recruiters and staff. SNS is a promising strategy to optimize HIV testing among key populations. [ABSTRACT FROM AUTHOR]

Shiftwork leads to myriad negative health and safety outcomes. Lighting countermeasures can benefit shiftworkers via physiological effects of light (e.g. alerting, circadian adjustment), and short-wavelength light is the most potent for eliciting those responses; however, limited work indicates it may not be required for alerting. We developed similar-appearing light boxes (correlated color temperature: 3000–3375 K; photopic illuminance: 260–296 lux), enriched (SW+, melanopic EDI: 294 lux) or attenuated (SW-, melanopic EDI: 103 lux) in short-wavelength energy, and implemented them on a high-security watchfloor. Efficacy and feasibility of these two novel lighting interventions were assessed in personnel working 12-hour night shifts (n  = 47) in this within-participants, crossover study. For each intervention condition, light boxes were arranged across the front of the watchfloor and illuminated the entire shift; blue-blocking glasses were worn post-shift and before sleep; and sleep masks were used while sleeping. Comparisons between baseline and intervention conditions included alertness, sleep, mood, quality of life (QOL), and implementation measures. On-shift alertness (Karolinska Sleepiness Scale) increased in SW− compared to baseline, while changes in SW+ were more limited. Under SW+, both mood and sleep improved. Psychomotor vigilance task performance did not vary by condition; however, perceived performance and QOL were higher, and reported caffeine consumption and sleep onset latency were lower, under SW−. For both interventions, satisfaction and comfort were high, and fewer symptoms and negative feelings were reported. The addition of spectrally engineered lights to this unique work environment improved sleep, alertness, and mood without compromising visual comfort and satisfaction. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection. [ABSTRACT FROM AUTHOR]

Background: Process data, data generated by a user's interaction with a web‐based application, is an emerging tool in educational research. The current study explores using process data as a measure of implementation fidelity to a randomized control trial (RCT) of the Read It Again Mobile (RIA‐M) curricular supplement. Objectives: To determine the extent to which teachers implemented RIA‐M and to assess the utility of using process data in the assessment of fidelity. Methods: The RCT involved 30 pre‐kindergarten classrooms with a sample of n = 216 students. RIA‐M provides a curricular supplement which teachers may incorporate into classroom instruction and is delivered via a tablet computer. Pre and post literacy assessments are used to determine treatment effect. Process data, produced from teacher interactions with the tablet, and classroom observations are used to assess fidelity. Results and Conclusions: Our findings indicate no difference between treatment and control students in the RCT. Yet, we find that process data provides unique fidelity information concerning treatment exposure, adherence, and quality of program delivery. Specifically, process data indicated that teachers did not demonstrate the same level of fidelity that was captured in classroom observations. This finding provides some evidence for the absence of an intervention effect. Major Takeaways: The current study improves our understanding of how web‐based interventions may be assessed for implementation fidelity using process data. Further, process data offers a potentially reliable and scalable measure of fidelity for other web‐based educational interventions. Lay Description: What we know about the topic: Mobile technology‐based interventions are on the rise in many educational settings.Fidelity to educational interventions can be difficult to reliably assess.Teachers may be resistant to implementing technology in classrooms. What this paper adds: Examines a pilot study of a mobile technology‐based curricular intervention for teachers designed to improve early reading and literacy.Examines a new method for assessing fidelity of mobile technology‐based interventions.Compares the new method to traditional methods of assessing fidelity to educational interventions. Implications for practice and/or policy: The presence of technology in the classroom does not assure that the technology will be used effectively.Mobile technology‐based interventions may require additional monitoring and coaching to assure use as intended.Process data, generated in the use of technology‐based interventions, may provide a unique way to measure fidelity to the intervention. [ABSTRACT FROM AUTHOR]

Purpose: The use of patient-reported outcome (PRO) measures in clinical practice is increasing. Following the creation of a 'User's Guide to Implementing PRO Assessment in Clinical Practice' by the International Society for Quality of Life Research (ISOQOL), volunteers from ISOQOL sought to create a Companion Guide to assist health care providers with the scientific and practical considerations involved in implementing and using PRO measures in clinical care by using information from real-world case studies. This paper summarizes the key issues presented in the Companion Guide.Methods: Ten respondents, who were members of the ISOQOL's CP-SIG and worked in various clinical areas, participated in a survey or telephone interview. Participants were from Canada (n = 2), Denmark (n = 1), England (n = 2), Holland (n = 1), and the United States (n = 4).Results: Based on the information provided by respondents, a Companion Guide was produced, organized according to the nine questions presented in the User's Guide. An additional section for key take-home messages was also provided. This guide provides examples of issues and considerations related to the implementation of PRO measures in clinical practice.Conclusions: Respondents provided insight into their experiences and emphasized that PRO initiatives were likely to be more successful if there is purposeful, designed integration into clinical practice, meaningful substantive engagement with all stakeholders and access to necessary organizational resources. The ability to leverage existing technology as well as realistic and stakeholder consensus-driven expectations for planning and timing were also key to the successful implementation of PRO measures. [ABSTRACT FROM AUTHOR]

There is an abundance of literature describing the current status of corrections around the world, particularly in the United States with its overcrowded prisons, high recidivism rates, and policy evaluations. Efforts to implement best practices and reduce institutional populations by shifting offender sentencing and resources to community programs are also prevalent. What is less documented are efforts to translate evidence-based practices across international borders through cross-national collaborations. Intuitively, best practices should translate across human-defined borders because intervening in human behavior should not change based on different legal codes. This paper summarizes the efforts of the University of Cincinnati Corrections Institute (UCCI) and Alberta's Correctional Services Division to shift an agency's paradigm of working with offenders, redesign provincial probation operations to establish adherence to the principles of effective intervention, and to cross nationally train and coach probation officers in the Effective Practices in Community Supervision (EPICS) model. Successes and challenges of implementing the model and of the collaboration are presented so that corrections professionals and researchers have a point of reference for future cross-national collaborations, implementation efforts, and training initiatives. [ABSTRACT FROM AUTHOR]

This qualitative systematic review examined the context‐specific factors that influence the implementation of youth participatory action research (YPAR) projects in high schools within the United States. Thematic synthesis was conducted to identify and analyze the YPAR implementation factors that were present in 38 peer‐reviewed studies. Results indicate the following two analytic themes concerning YPAR implementation in high schools: (a) pedagogical strategies and (b) stakeholder dynamics and needs. The themes provide support for existing ecological frameworks of implementation factors and demonstrate that adult researchers' project‐specific decisions are nested within educational power structures. This paper will discuss the implications of these YPAR implementation themes in executing YPAR projects in high schools. Highlights: Review of 38 studies of YPAR in U.S. high schools and factors that affect implementation.Two analytic themes emerged: pedagogical strategies, and stakeholder dynamics and needs.Adult researchers make pedagogy choices related to time, course, curriculum, and youth needs.Stakeholder dynamics and needs in schools create added power dynamics influencing implementation. [ABSTRACT FROM AUTHOR]

Beginning in 2009, the United States (US) federal government spearheaded a nationwide teacher evaluation reform effort, encouraging states to change their process of evaluating teachers. School principals, the primary evaluators of teacher performance, act as middle leaders in the sense they must attempt to balance messages from federal, state, and local level policymakers and the teachers they evaluate about how this process will play out in practice. In this paper I ask: (1) In what ways do US school principals act as middle leaders when learning and implementing new teacher evaluation systems?; and (2) In what ways do principals' actions as middle leaders influence how teacher evaluation systems work in schools? Data for analysis comes from nine K-8 public school principals in the US state of Michigan and includes interviews with principals and teachers (n=36), observations of principals interactions with teachers during the evaluation process (n=18), and additional teacher evaluation artefacts. The results of this work suggest principals act as middle leaders by trying to balance messages received from their superiors and the teachers they evaluate. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is twofold: first, to identify the types of adaptations made by service providers (i.e. practitioners) during a large-scale US statewide implementation of SafeCare®, an evidence-based intervention to reduce child neglect; and second, to place adaptations within a taxonomy of types of adaptations. Design/methodology/approach: Semi-structured interviews and focus groups were conducted with 138 SafeCare providers and supervisors. Grounded theory methods were used to identify themes, specific types of adaptations and factors associated with adaptation. Findings: Adaptations were made to both peripheral and core elements of the evidence-based practice (EBP). The taxonomy of adaptations included two broad categories of process and content. Process adaptations included presentation of materials, dosage/intensity of sessions, order of presentation, addressing urgent concerns before focusing on the EBP and supplementing information to model materials. Content adaptations included excluding parts of the EBP and overemphasizing certain aspects of the EBP. Adaptations were motivated by client factors such as the age of the target child, provider factors such as a providers' level of self-efficacy with the EBP and concerns over client/provider rapport. Client factors were paramount in motivating adaptations of all kinds. Research limitations/implications: The present findings highlight the need to examine ways in which adaptations affect EBP implementation and sustainment, client engagement in treatment, and client outcomes. Practical implications: Implementers and EBP developers and trainers should build flexibility into their models while safeguarding core intervention elements that drive positive client outcomes. Originality/value: This study is unique in examining and enumerating both process and content types of adaptations in a large-scale child neglect implementation study. In addition, such adaptations may be generalizable to other types of EBPs. [ABSTRACT FROM AUTHOR]

Background: The goal of Lean Enterprise Transformation (LET) is to go beyond simply using Lean tools and instead embed Lean principles and practices in the system so that it becomes a fundamental, collective mindset of the entire enterprise. The Veterans Engineering Resource Center (VERC) launched the Veterans Affairs (VA) LET pilot program to improve quality, safety, and the Veteran's experience. A national evaluation will examine the pilot program sites' implementation processes, outcomes and impacts, and abilities to improve LET adoption and sustainment. This paper describes the evaluation design for the VA LET national evaluation and describes development of a conceptual framework to evaluate LET specifically in healthcare settings.Methods: A targeted literature review of Lean evaluation frameworks was performed to inform the development of the conceptual framework. Key domains were identified by a multidisciplinary expert group and then validated with key stakeholders. The national evaluation design will examine LET implementation using qualitative, survey, and quantitative methods at ten VA facilities. Qualitative data include site visits, interviews, and field observation notes. Survey data include an employee engagement survey to be administered to front-line staff at all pilot sites. Quantitative data include site-level quality improvement metrics collected by the Veterans Services Support Center. Qualitative, quantitative, and mixed-methods analyses will be conducted to examine implementation of LET strategic initiatives and variations in implementation success across sites.Discussion: This national evaluation of a large-scale LET implementation effort will provide insights helpful to other systems interested in embarking on a Lean journey. Additionally, we created a multi-faceted conceptual framework to capture the specific features of a Lean healthcare organization. This framework will guide this evaluation and may be useful as an assessment tool for other organizations interested in implementing Lean principles at an enterprise level. [ABSTRACT FROM AUTHOR]

Objectives: To examine: (1) what elements of patient-centered medical homes (PCMHs) are typically provided to low-income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low-income groups.Data Sources/study Setting: Existing literature on PCMH utilization among health care organizations serving low-income populations.Study Design: Systematic review and meta-analysis.Data Collection/extraction Methods: We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low-income populations. A total of 434 studies were reviewed. Thirty-three articles met eligibility criteria.Principal Findings: Patient-centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range -0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = -0.248), but there were apparent limitations in study quality.Conclusions: Evidence shows that the PCMH model can increase health outcomes among low-income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed. [ABSTRACT FROM AUTHOR]

Purpose The increased need for, and maintenance of, infrastructure creates challenges for all agencies that manage infrastructure assets. To assist with these challenges, agencies implement asset management systems. The purpose of this paper is to investigate and compare the importance of barriers faced by agencies establishing transportation asset management systems in the USA and Libya to contrast a case of a developed and developing country.Design/methodology/approach A literature review identified 28 potential barriers for implementing an asset management system. Practitioners who participate in decision-making processes in each country were asked to rate the importance of each barrier in an online survey questionnaire. Descriptive statistics, Kendall Concordance W., and Mann-Whitney are used to analyze the collected data.Findings Through an analysis of 61 completed questionnaires, 14 barriers were identified as important by both the US and Libyan practitioners. A total of 11 additional barriers, primarily in the areas of political and regulatory obstacles, were determined to be important only for Libya. These 11 barriers provide reasonable insights into asset management systems’ barriers for developing countries.Practical implications The list of barriers identified from this research will assist decision makers to address and overcome these barriers when implementing asset management systems in their specific organizational and country conditions.Originality/value The research identified standard barriers to implementing asset management systems and identified barriers that were specific to the country context, such as political and regulatory barriers in Libya. When viewed with the asset management literature, the results show broad applicability of some asset management barriers and the need to contextualize to country context (e.g. developing countries) for other barriers. [ABSTRACT FROM AUTHOR]

This commentary uses the lens of curricular implementation to consider issues and opportunities afforded by the papers in this special edition. While it is interesting to envision innovative approaches to physical education, actually implementing changes in the complex institutional school environment is exceptionally challenging. These authors have done an excellent job presenting viable solutions and fore grounding challenges. Yet, without a concerted effort to invite teachers to engage with us in this process, our implementation initiatives may not enhance the meaningful and educative process that these scholars envision for physical education. [ABSTRACT FROM PUBLISHER]

Translating evidence-based HIV/STD prevention interventions and research findings into applicable HIV prevention practice has become an important challenge for the fields of community psychology and public health due to evidence-based interventions and evidence-based practice being given higher priority and endorsement by federal, state, and local health department funders. The Interactive Systems Framework (ISF) for Dissemination and Implementation and the Division of HIV/AIDS Prevention (DHAP) Research-to-Practice model both address this challenge. The DHAP model and the ISF are each presented with a brief history and an introduction of their features from synthesis of research findings through translation into intervention materials to implementation by prevention providers. This paper describes why the ISF and the DHAP model were developed and the similarities and differences between them. Specific examples of the use of the models to translate research to practice and the subsequent implications for support of each model are provided. The paper concludes that the ISF and the DHAP model are truly complementary with some unique differences, while both contribute substantially to addressing the gap between identifying effective programs and ensuring their widespread adoption in the field. [ABSTRACT FROM AUTHOR]

Although transportation agencies in the United States have been developing asset management systems (AMS) as decision-support tools for specific types of infrastructure assets, there are several barriers to the implementation of AMS. In particular, implementation and development costs are critical issues. Without evidence of AMS benefits, further implementation and development of AMS may be constrained. This paper documents the development of a generic methodology for quantifying the benefits derived from implementation of AMS and justifying investment in AMS implementation. The generic methodology involves three analysis methods: descriptive analysis, regression analysis, and benefit-cost analysis. These methods draw on basic principles of engineering economic analysis and apply to two types of evaluations: an ex post facto evaluation and an ex ante evaluation depending on the time frame and the availability of time series data. While the concepts are relatively simple, the challenge lies in identifying data to support the application of the methodology. This paper demonstrates how the methodology can be applied to evaluate the implementation of a pavement management system in terms of efficacy, effectiveness, and efficiency (three Es). [ABSTRACT FROM AUTHOR]

Dissemination of evidence-based programs and policies is a critical final step in reducing the burden of cancer in the general public. Yet, we have not been fully successful to date in improving clinical or public health practice by disseminating programs found to be effective in research. Therefore, research is needed into the dissemination process and outcomes to enable better efforts in the future. This paper explores the definitions and models used for dissemination, the designs of dissemination studies, and possible research questions in dissemination research, all focused on cancer prevention and control. We hope that this paper will encourage dissemination research in our field. [ABSTRACT FROM AUTHOR]

The Common Rule originally issued in 1991 and last amended in 2005 is scheduled to be replaced on January 19, 2018 by a revised Common Rule (the final rule). The goal of the revisions is to modernize and improve applicability of the rule to a research landscape that has dramatically changed since 1991. Translating these changes into action will require comprehensive understanding of the final rule and detailed implementation planning by Human Research Protection Programs. This paper presents select changes that require substantial attention; including for example: expansion of the exempt category, changes to continuing review requirements, changes to the informed consent form and the use of single IRBs for domestic multi-site research. In addition, myriad policies, procedures and workflows will have to be developed, drastically rewritten, or just mildly tweaked. [ABSTRACT FROM PUBLISHER]

This article introduces readers to four invited articles comprising a special section on implementing the Grand Challenges for Social Work Initiative. We highlight key contributions made by the authors of each article, which collectively explore implications of the grand challenges initiative for social work education, science, campus leadership, and campus-community collaboration. We describe how substantive points raised in the special section connect to the rapidly growing interdisciplinary literature on the implementation of grand challenges. [ABSTRACT FROM AUTHOR]

In the HIV Translating Initiatives for Depression into Effective Solutions project, we conducted a randomized controlled effectiveness and implementation trial comparing depression collaborative care with enhanced usual care in Veterans Health Administration HIV clinics in the US. An offsite HIV depression care team including a psychiatrist, a depression care manager (DCM), and a clinical pharmacist provided collaborative care using a stepped-care model of treatment and made recommendations to providers through the electronic health record system. The DCM delivered care management to HIV patients through phone calls, performing routine assessments and providing counseling in self-management and problem-solving. The DCM documented all calls in each patient’s electronic medical record. In this paper we present results from interviews conducted with patients and clinical staff in a multi-stage formative evaluation (FE). We conducted semi-structured FE interviews with 26 HIV patients and 30 clinical staff at the three participating sites during and after the trial period to gather their experiences and perspectives concerning the intervention components. Interviews were transcribed verbatim and analyzed using rapid content analysis techniques. Patients reported high satisfaction with the depression care manager (DCM) phone calls. Both HIV and mental health providers reported that the DCM’s chart notes in the electronic health record were very helpful, and most felt that a dedicated DCM for HIV patients is ideal to meet patient needs. Sites encountered barriers to achieving and maintaining universal depression screening, but had greater success when such screening was incorporated into routine intake processes. FE results demonstrated that depression care management via telehealth from an offsite team is acceptable and helpful to both HIV patients and their providers. Given that a centralized offsite depression care team can deliver effective, cost-effective, cost-saving services for multiple HIV clinics in different locations with high patient and provider satisfaction, broad implementation should be considered. [ABSTRACT FROM PUBLISHER]

This paper describes the frustrating reality of sustainability implementation in the USA and New Zealand (NZ), an early adopter of sustainability mandates. Local government has a key role in implementation, but has been slow to uptake sustainable practices. We surveyed senior planners in small to medium-sized local government agencies in both countries to identifywhichfeatures of local government support (or hinder) sustainability in practice. Environmentally sustainable practices are not well entrenched in either country. In the USA, the framing of sustainability and public support are significant predictors of implementation. However, sustainability is rarely a priority. In NZ, local government capacity is the main driver of implementation. We recommend that planners promote sustainability values, reconcile economic development goals with sustainability (e.g., green economy model), and translate public support for sustainability into institutional priorities. NZ localities also need increased capacity and US localities need continued Federal and State support. [ABSTRACT FROM PUBLISHER]

People with disabilities (PWDs) are often excluded from health-promoting activities in their communities. Inclusive policy, systems, and environmental (PSE) changes can promote access to healthy lifestyle choices for PWDs. However, implementation of inclusive PSEs in community-based settings is challenging and we lack an understanding of what factors impact implementation of inclusive PSEs. The purpose of this study was to examine barriers and facilitators experienced by community coaches while planning and implementing inclusive PSEs. Semi-structured interviews (n = 10) were conducted with coaches as part of the Reaching People with Disabilities through Healthy Communities project. Interviews were coded using directed content analysis guided by the Theoretical Domains Framework and were categorized into barriers and facilitators within the COM-B framework (which identifies Capability, Opportunity, and Motivations as components that can impact Behavior). The opportunities domain, consisting of social influences and environmental context and resources, most impacted disability-inclusive PSE implementation. Within this domain, facilitators included community support, strong partnerships, technical assistance from experts, and alignment with ongoing initiatives. Barriers included the community's lack of knowledge about disability, fear regarding resources needed for inclusive changes, and lack of resources (time, staff, funding). Supports addressing the opportunities domain should be considered to facilitate the implementation of disability-inclusive PSEs to build healthy, accessible communities for all. [ABSTRACT FROM AUTHOR]

Background: One practice in healthcare implementation is patient engagement in quality improvement and systems redesign. Implementers in healthcare systems include clinical leadership, middle managers, quality improvement personnel, and others facilitating changes or adoption of new interventions. Patients provide input into different aspects of health research. However, there is little attention to involve patients in implementing interventions, especially in the United States (U.S.), and this might be essential to reduce inequities. Implementers need clear strategies to overcome challenges, and might be able to learn from countries outside the U.S. Methods: We wanted to understand existing work about how patients are being included in implementation activities in real world U.S. healthcare settings. We conducted an environmental scan of three data sources: webinars, published articles, and interviews with implementers who engaged patients in implementation activities in U.S. healthcare settings. We extracted, categorized, and triangulated from data sources the key activities, recurring challenges, and promising solutions using a coding template. Results: We found 27 examples of patient engagement in U.S. healthcare implementation across four webinars, 11 published articles, and seven interviews, mostly arranging patient engagement through groups and arranging processes for patients that changed how engaged they were able to be. Participants rarely specified if they were engaging a population experiencing healthcare inequities. Participants described eight recurring challenges; the two most frequently identified were: (1) recruiting patients representative of those served in the healthcare system; and (2) ensuring processes for equitable communication among all. We matched recurring challenges to promising solutions, such as logistic solutions on how to arrange meetings to enhance engagement or training in inclusivity and power-sharing. Conclusion: We clarified how some U.S. implementers are engaging patients in healthcare implementation activities using less and more intensive engagement. It was unclear whether reducing inequities was a goal. Patient engagement in redesigning U.S. healthcare service delivery appears similar to or less intense than in countries with more robust infrastructure for this, such as Canada and the United Kingdom. Challenges were common across jurisdictions, including retaining patients in the design/delivery of implementation activities. Implementers in any region can learn from those in other places. [ABSTRACT FROM AUTHOR]

This paper discusses the fundamental importance of achieving quality implementation when assessing the impact of social and emotional learning interventions. Recent findings in implementation science are reviewed that include a definition of implementation, its relation to programme outcomes, current research on the factors that affect implementation, and a framework for understanding the steps, actions and challenges involved in achieving quality implementation. Examples from the social and emotional learning literature are used to illustrate different issues. [ABSTRACT FROM AUTHOR]

Background: A 2-day consensus working meeting, hosted by the United States National Institutes of Health and the Veterans Administration, focused on issues related to dissemination and implementation (D&I) research in measurement and reporting. Meeting participants included 23 researchers, practitioners, and decision makers from the USA and Canada who concluded that the field would greatly benefit from measurement resources to enhance the ease, harmonization, and rigor of D&I evaluation efforts. This paper describes the findings from an environmental scan and literature review of resources for D&I measures.Findings: We identified a total of 17 resources, including four web-based repositories and 12 static reviews or tools that attempted to synthesize and evaluate existing measures for D&I research. Thirteen resources came from the health discipline, and 11 were populated from database reviews. Ten focused on quantitative measures, and all were generated as a resource for researchers. Fourteen were organized according to an established D&I theory or framework, with the number of constructs and measures ranging from 1 to more than 450. Measure metadata was quite variable with only six providing information on the psychometric properties of measures.Conclusions: Additional guidance on the development and use of measures are needed. A number of approaches, resources, and critical areas for future work are discussed. Researchers and stakeholders are encouraged to take advantage of a number of funding mechanisms supporting this type of work. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine how US school leaders make sense of external mandates, and the way in which their understanding of state and district accountability policies affects their work. It is posited that school leaders' responses to external accountability are likely to reflect a complex interaction between their perception of the accountability policies, the state and district contexts in which those policies are situated and their own leadership beliefs and practices. Design/methodology/approach – The authors use both principal and teacher survey data to explore the question of how perceptions of external policy are associated with instructional leadership behaviors. Cases of seven principals are employed to flesh out the findings from the survey analysis. Findings – It is concluded that external accountability policy may have a positive impact on instructional leadership – where they see those policies as aligned with their own values and preferences, and where they see their district leaders as supportive of school-driven accountability initiatives. In these cases, school leaders internalize the external accountability policies and shape them to the particular needs that they see as priorities in their own school. Where one or the other of these factors is weak or missing, on the other hand, leaders demonstrate more negative attitudes to external accountability and weaker instructional leadership. Originality/value – This analysis draws on a unique, large-scale data base and uses a mixed methods approach to answer the question. [ABSTRACT FROM AUTHOR]

Evidence-based treatments (EBTs) for childhood disruptive behavior disorders, such as Parent-Child Interaction Therapy (PCIT), have limited availability in community settings. Recent research highlights the importance of implementation support models to ensure full adoption and sustainability of an EBT. Although other EBT protocols have been disseminated using the learning collaborative (LC) model, these methods are only now being applied to PCIT. This paper will describe the first PCIT learning collaborative conducted in the US. Community clinicians successfully completing the program demonstrated high levels of treatment fidelity and coding reliability, and families who completed treatment through the program reported significant improvements in child internalizing and externalizing behaviors and parenting behaviors and stress. These preliminary results suggest community clinicians are successful in implementing PCIT with the support of the LC. • Community clinicians learning PCIT show high levels of fidelity and reliability. • Children exhibit improved internalizing and externalizing behavior problems. • Parents show improved interactions with children and reduced parenting stress. • Training completion varied with clinician comfort with EBTs and coaching parents. • Treatment completion did not vary by client or community characteristics. [ABSTRACT FROM AUTHOR]

Local climate protection initiatives are receiving increased attention and support. However, most of the current understanding about their content, motivation, and impact is based on qualitative studies, whose findings cannot be generalised, or quantitative studies, which consider superficial measures of policy adoption. There is a lack of information about the type and extent of greenhouse gas (GHG)-reducing actions that 'typical' cities have implemented, whether or not they are explicitly framed as part of a broader climate protection strategy. In an effort to address this gap, this paper examines original data collected from a nation-wide sample of US cities on their implementation of a comprehensive list of GHG-mitigating activities. An assessment of the data reveals considerable variation in the frequency with which the different activities are implemented, particularly when considered across policy instrument type and target population. Further analysis suggests that cities utilise three broad 'types' of climate protection strategies, based on the number and nature of the relevant actions that they have implemented. [ABSTRACT FROM AUTHOR]

health purchaser's willingness-to-pay (WTP) for health is defined as the amount of money the health purchaser (e.g. a health maximizing public agency or a profit maximizing health insurer) is willing to spend for an additional unit of health. In this paper, we propose a game-theoretic framework for estimating a health purchaser's WTP for health in markets where the health purchaser offers a menu of medical interventions, and each individual in the population selects the intervention that maximizes her prospect. We discuss how the WTP for health can be employed to determine medical guidelines, and to price new medical technologies, such that the health purchaser is willing to implement them. The framework further introduces a measure for WTP for expansion, defined as the amount of money the health purchaser is willing to pay per person in the population served by the health provider to increase the consumption level of the intervention by one percent without changing the intervention price. This measure can be employed to find how much to invest in expanding a medical program through opening new facilities, advertising, etc. Applying the proposed framework to colorectal cancer screening tests, we estimate the WTP for health and the WTP for expansion of colorectal cancer screening tests for the 2005 US population. [ABSTRACT FROM AUTHOR]

One of the important research issues in the emerging area of research on dissemination of prevention programs relates to the type and extent of training needed by program providers to prepare them to implement effective programs with fidelity. The present paper describes the immediate outcomes of a dissemination and implementation trial of Project Toward No Drug Abuse, an evidence-based prevention program for high school students. A total of 65 high schools in 14 school districts across the USA were recruited and randomly assigned to one of three experimental conditions: comprehensive implementation support for teachers, regular workshop training only, or standard care control. The comprehensive intervention was comprised of on-site coaching, web-based support, and technical assistance, in addition to the regular workshop. Students ( n = 2,983) completed self-report surveys before and immediately after program implementation. Fidelity of implementation was assessed with a classroom observation procedure that focused on program process. Results indicated that relative to the controls, both intervention conditions produced effects on hypothesized program mediators, including greater gains in program-related knowledge; greater reductions in cigarette, marijuana and hard drug use intentions; and more positive changes in drug-related beliefs. There were stronger effects on implementation fidelity in the comprehensive, relative to the regular, training condition. However, seven of the ten immediate student outcome measures showed no significant differences between the two training conditions. The implications of these findings for dissemination research and practice are discussed. [ABSTRACT FROM AUTHOR]

The Transitional Case Management (TCM) study, one of the projects of the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative, was a multi-site randomized test of whether a strengths-based case management intervention provided during an inmate’s transition from incarceration to the community increases participation in community substance abuse treatment, enhances access to needed social services, and improves drug use and crime outcomes. As in many intervention studies, TCM experienced a relatively large percentage of treatment-group participants who attended few or no scheduled sessions. The paper discusses issues with regard to participation in community case management sessions, examines patterns of session attendance among TCM participants, and analyzes client and case manager characteristics that are associated with number of sessions attended and with patterns of attendance. The average number of sessions (out of 12) attended was 5.7. Few client or case manager characteristics were found to be significantly related to session attendance. Clinical and research implications of the findings and of adherence in case management generally are discussed. [ABSTRACT FROM AUTHOR]