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Barriers and strategies for implementing community-based interventions with minority elders: positive minds-strong bodies
- Source :
- Implementation Science Communications, Implementation Science Communications, Vol 1, Iss 1, Pp 1-13 (2020)
- Publication Year :
- 2020
- Publisher :
- BioMed Central, 2020.
-
Abstract
- Background By 2040, one out of three older adults in the USA are expected to belong to a racial/ethnic minority group. This population has an increased risk of mental and physical disability with significant barriers to access care. Community-based organizations (CBOs) often provide programming to serve minority and immigrant elders. Limited resources and other barriers such as lack of trained staff make it difficult to implement evidence-based interventions (EBIs) in CBOs for long-term adoption. Yet little is known about what factors can facilitate adoption of EBIs in CBOs serving minority elders. Methods Positive-Minds–Strong Bodies (PM-SB), an evidence-based intervention offered in four languages, aims to reduce mental and physical disability for minority and immigrant elders through the efforts of community health workers and exercise trainers. The intervention consists of cognitive behavior therapy and exercise training sessions delivered over 6 months. During a recent clinical trial of this intervention, we elicited feedback from CBO staff to determine how best to facilitate the implementation and long-term sustainability of PM-SB within their agencies. We surveyed 30 CBO staff members, held four focus groups, and conducted 20 in-depth interviews to examine staff perspectives and to reveal factors or changes needed to facilitate long-term adoption in prospective CBOs. Results Participants reported that staff motivation and implementation could be improved through the following changes: increasing patient compensation for treatment sessions, decreasing levels of organizational accountability, and reducing staff demands embedded in the intervention. Although most staff perceived that PM-SB improved their agency’s ability to address the health and well-being of elders, capacity-building strategies such as a “train-the-trainer” initiative were identified as priorities to address staff turnover for sustainability. Adapting the intervention to get financial reimbursement also emerged as vital. Conclusions Augmenting financial incentives, streamlining procedures, and simplifying staff accountability were suggested strategies for facilitating the transition from a disability prevention clinical trial in minority and immigrant elders to a scalable implementation in routine services at CBOs. Trial registration ClinicalTrials.gov, NCT02317432.
- Subjects :
- Medicine (General)
Physical disability
Minority group
Racial/ethnic minority elders
Population
Psychological intervention
Anxiety
CHW
Health administration
03 medical and health sciences
R5-920
0302 clinical medicine
Nursing
Immigrants
0501 psychology and cognitive sciences
030212 general & internal medicine
education
Health policy
education.field_of_study
Disability
Depression
Research
05 social sciences
Health services research
Focus group
Psychology
050104 developmental & child psychology
Subjects
Details
- Language :
- English
- ISSN :
- 26622211
- Volume :
- 1
- Database :
- OpenAIRE
- Journal :
- Implementation Science Communications
- Accession number :
- edsair.doi.dedup.....354e774d8a6074fee1855256fbbf7eb8