Using a stakeholder-engaged, iterative, and systematic approach to adapting collaborative decision skills training for implementation in VA psychosocial rehabilitation and recovery centers

BMC Health Services Research

Research Article

Yuliana Gallegos-Rodriguez¹  Eric Granholm¹  Dimitri Perivoliotis¹  William D. Spaulding²  David Oakes³  Robert Mercado³  Erin Cisneros³  Gregory A. Light⁴  Elijah Sosa⁴  Emily B. H. Treichler⁴  Borsika Rabin⁵ 

[1] Department of Psychiatry, UC San Diego, 9500 Gillman Drive, 92037, La Jolla, CA, USA;Center of Recovery Education, VA San Diego, 3500 La Jolla Village Drive, 92161, San Diego, CA, USA;Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, 68588, Lincoln, NE, USA;Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA San Diego, 3500 La Jolla Village Drive, 92161, San Diego, CA, USA;Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA San Diego, 3500 La Jolla Village Drive, 92161, San Diego, CA, USA;Department of Psychiatry, UC San Diego, 9500 Gillman Drive, 92037, La Jolla, CA, USA;Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gillman Drive, 92037, La Jolla, CA, USA;Clinical and Translational Research Center Dissemination and Implementation Science Center, UC San Diego Altman, UC San Diego, 9500 Gillman Drive, 92037, La Jolla, CA, USA;

关键词: Adaptation;    Stakeholder engagement;    Implementation;    VHA;    Collaborative decision making;    Serious mental illness;   

DOI  :  10.1186/s12913-022-08833-2

 received in 2022-07-05, accepted in 2022-11-05,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundAdaptation of interventions is inevitable during translation to new populations or settings. Systematic approach to adaptation can ensure that fidelity to core functions of the intervention are preserved while optimizing implementation feasibility and effectiveness for the local context. In this study, we used an iterative, mixed methods, and stakeholder-engaged process to systematically adapt Collaborative Decision Skills Training for Veterans with psychosis currently participating in VA Psychosocial Rehabilitation and Recovery Centers.MethodsA modified approach to Intervention Mapping (IM-Adapt) guided the adaptation process. An Adaptation Resource Team of five Veterans, two VA clinicians, and four researchers was formed. The Adaptation Resource Team engaged in an iterative process of identifying and completing adaptations including individual qualitative interviews, group meetings, and post-meeting surveys. Qualitative interviews were analyzed using rapid matrix analysis. We used the modified, RE-AIM enriched expanded Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME) to document adaptations. Additional constructs included adaptation size and scope; implementation of planned adaptation (yes–no); rationale for non-implementation; and tailoring of adaptation for a specific population (e.g., Veterans).ResultsRapid matrix analysis of individual qualitative interviews resulted in 510 qualitative codes. Veterans and clinicians reported that the intervention was a generally good fit for VA Psychosocial Rehabilitation and Recovery Centers and for Veterans. Following group meetings to reach adaptation consensus, 158 adaptations were completed. Most commonly, adaptations added or extended a component; were small in size and scope; intended to improve the effectiveness of the intervention, and based on experience as a patient or working with patients. Few adaptations were targeted towards a specific group, including Veterans. Veteran and clinician stakeholders reported that these adaptations were important and would benefit Veterans, and that they felt heard and understood during the adaptation process.ConclusionsA stakeholder-engaged, iterative, and mixed methods approach was successful for adapting Collaborative Decision Skills Training for immediate clinical application to Veterans in a psychosocial rehabilitation center. The ongoing interactions among multiple stakeholders resulted in high quality, tailored adaptations which are likely to be generalizable to other populations or settings. We recommend the use of this stakeholder-engaged, iterative approach to guide adaptations.

【 授权许可】

CC BY   
© The Author(s) 2022

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