Chronic Disease Clinical Trial
Official title:
Formative Evaluation in Implementation Research: Guideline Development
The Veterans Administration (VA) has embraced the use of implementation research as a critical way to improve care by facilitating the adoption of proven medical practices. Yet implementation science still remains rudimentary. Challenges exist in judging the success of an implementation project. Rather than relying solely on hard outcomes, an investigator must also assess how effectively an intervention is put into place at a site. This assessment comes via a formative evaluation (FE) plan. The FE plan can contain such diverse data elements as the number of fliers distributed about the intervention, how often an intervention advocate speaks to participants, the content derived from team meeting notes, and themes extracted from focus groups. The diversity of such data elements can appear foreign to investigators trained in traditional health services research. The FE plan can also lead to confusion about what to measure, when, and how to integrate the various measures into a unified whole. Complicating matters is the fact that FE is often qualitative--such as interviews, focus groups, and meeting notes which can make data difficult for investigators to interpret. Thus, there is a pressing need to provide clarity on how FE is to be used in implementation studies. This Short Term Project proposal offers a three-part approach toward specifying the best FE practices: first, a systematic review of the literature; second, qualitative interviews with VA implementation investigators; and third, a panel discussion of national experts, funded through a VA Implementation Collaborative Award. The panel discussion will outline FE guidelines based on the researchers expertise, the systematic review, and the qualitative interviews.
Objectives: The Veterans Administration (VA) has embraced the use of implementation research
as a critical way to improve care by facilitating the adoption of proven medical practices.
Yet implementation science still remains rudimentary. Challenges exist in judging the
success of an implementation project. Rather than relying solely on hard outcomes, an
investigator must also assess how effectively an intervention is put into place at a site.
This assessment comes via a formative evaluation (FE) plan. The FE plan can contain such
diverse data elements as the number of fliers distributed about the intervention, how often
an intervention advocate speaks to participants, the content derived from team meeting
notes, and themes extracted from focus groups. The diversity of such data elements can
appear foreign to investigators trained in traditional health services research. The FE plan
can also lead to confusion about what to measure, when, and how to integrate the various
measures into a unified whole. Complicating matters is the fact that FE is often
qualitative-- such as interviews, focus groups, and meeting notes which can make data
difficult for investigators to interpret. Thus, there is a pressing need to provide clarity
on how FE is to be used in implementation studies. This Short Term Project proposal offers a
three-part approach toward specifying the best FE practices: first, a systematic review of
the literature; second, qualitative interviews with VA implementation investigators; and
third, a panel discussion of national experts, funded through a VA Implementation
Collaborative Award. The panel discussion will outline FE guidelines based on the
researchers expertise, the systematic review, and the qualitative interviews. The specific
aims for this proposal include the following: Specific Aim 1: Conduct a systematic review of
VA funded implementation projects to classify the specific types of FE procedures employed.
Specific Aim 2: Conduct in-depth telephone interviews with investigators of VA-funded
implementation projects to establish which FE methods were used and which were considered
most/least successful.
Specific Aim 3: Using the national experts gathered together under the umbrella of the
Center for Health Equity Research and Promotions (CHERP) Implementation Research
Collaborative, develop a set of guidelines outlining best FE practices in VA implementation
research. Relevance to the VA, Anticipated Results, and Future Directions: This Short Term
Project is designed to provide rapid results for developing the best approach toward the use
of FE in VA implementation science. As such this proposal is responsive to the VA Health
Services Research & Development (HSR&D) priority topics for both implementation and
management and research methodology. The systematic review, the qualitative report, and the
FE guidelines that will emerge from the project will have wide-spread applications within
the VA implementation community, thereby supporting the HSR&D research mission. The study
will also serve as needed pilot data for a future Merit Review award application designed to
provide the theoretical and practical approaches toward FE use within the VA.
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