Replicating an effective VA program to train and support family caregivers: a hybrid type III effectiveness-implementation design

BMC Health Services Research

J. Dadolf¹  A. Choate¹  E. P. Mahanna¹  K. P. Decosimo¹  S. N. Hastings²  K. A. Allen³  L. L. Zullig⁴  N. R. Sperber⁴  M. Shepherd-Banigan⁴  V. Wang⁵  C. H. Van Houtven⁶  N. A. Boucher⁷ 

[1] Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street (Mailcode 152), 27705, Durham, NC, USA;Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street (Mailcode 152), 27705, Durham, NC, USA;Center for the Study of Aging and Human Development, Duke University School of Medicine, 27710, Durham, NC, USA;Department of Medicine, Duke University Medical Center, 300 Morris Street, 27701, Durham, NC, USA;Geriatrics Research, Education, and Clinical Center, Durham VA Health Care System, 27705, Durham, NC, USA;Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street (Mailcode 152), 27705, Durham, NC, USA;Department of Medicine & Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street (Mailcode 152), 27705, Durham, NC, USA;Department of Population Health Sciences, School of Medicine, Duke University, 215 Morris Street, 27701, Durham, NC, USA;Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street (Mailcode 152), 27705, Durham, NC, USA;Department of Population Health Sciences, School of Medicine, Duke University, 215 Morris Street, 27701, Durham, NC, USA;Department of Medicine, Duke University Medical Center, 300 Morris Street, 27701, Durham, NC, USA;Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street (Mailcode 152), 27705, Durham, NC, USA;Department of Population Health Sciences, School of Medicine, Duke University, 215 Morris Street, 27701, Durham, NC, USA;Duke-Margolis Center for Health Policy, Duke University, 27710, Durham, NC, USA;Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street (Mailcode 152), 27705, Durham, NC, USA;Department of Population Health Sciences, School of Medicine, Duke University, 215 Morris Street, 27701, Durham, NC, USA;Sanford School of Public Policy, Duke University, 27710, Durham, NC, USA;Duke-Margolis Center for Health Policy, Duke University, 27710, Durham, NC, USA;Center for the Study of Aging and Human Development, Duke University School of Medicine, 27710, Durham, NC, USA;

关键词: Caregiving;    Aging;    Implementation research;    Health services research;    Long term care;   

DOI  :  10.1186/s12913-021-06448-7

来源: Springer

【 摘 要 】

BackgroundCaring for a growing aging population using existing long-term care resources while simultaneously supporting and educating family caregivers, is a public health challenge.We describe the application of the Replicating Effective Programs (REP) framework, developed by the Centers for Disease Control Prevention and used in public health program implementation, to scale up an evidence-based family caregiver training intervention in the Veterans Affairs (VA) healthcare system.MethodsFrom 2018 to 2020, clinicians at eight VA medical centers received REP-guided implementation including facilitation, technical assistance, and implementation tools to deliver the training program. The project team used the REP framework to develop activities across four distinct phases – (1) pre-conditions, (2) pre-implementation, (3) implementation, and (4) maintenance and evolution – and systematically tracked implementation facilitators, barriers, and adaptations.ResultsWithin the REP framework, results describe how each medical center adapted implementation approaches to fit local needs. We highlight examples of how sites balanced adaptations and intervention fidelity.ConclusionsThe REP framework shows promise for national expansion of the caregiver training intervention, including to non-VA systems of care, because it allows sites to adapt while maintaining intervention fidelity.Trial registrationNCT03474380. Date registered: March 22, 2018.

【 授权许可】

CC BY