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    ENGAGE Workshop - 6 month(s) ago

    NHLBI presents the Enhancing Implementation of Guidelines and Evidence-based Care in Clinical and Community Settings (ENGAGE) Workshop

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    • .@NIH: ENGAGE workshop, October 16-17, will explore factors in successful approaches for #guideline development, #implementation #dissemination and identification of priority areas! #ImpSci @ImplementSci #NHLBI #ENGAGE @Fogarty_NIH @Brian_Mittman @TCI_ca https://t.co/HBXUrKIMMC https://t.co/JGc4RTvHfR

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    Background Despite the evidence-based guidelines promoted by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), the overuse of prescription drugs to manage COPD, particularly inhaled corticosteroids (ICS), remains a persistent challenge. In this real-world study, we evaluated how patients with COPD were divided into ABCD groups based on the 2017 GOLD guidelines, determined the rate of adherence to the GOLD treatment recommendations, described the rate of ICS usage, and determined the rate of triple therapy (TT) prescription. Methods The charts of 2291 patients diagnosed with COPD were retrospectively analyzed, of which 1438 matched the eligibility criteria. Results The average patient age was 69.6 ± 10.9 years; 52% of patients were female. The average COPD assessment test (CAT) score was 18.3 ± 9.1. The ABCD breakdown was as follows: group A 19.5%, group B 64.1%, group C 1.8%, and group D 14.6%. All groups, except group D, showed discordance in COPD treatment relative t

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    • Gap between #Guideline recommendations of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and real-world clinical practice in #COPD care. Need for #Implementation #ImpSci #DIRH @NIH. #Overuse of inhaled #corticosteroids; #underuse of EBIs https://t.co/Apc3ZiaJ3C https://t.co/FzwiQpm9Bh

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    Edited by: Michelle H. Moniz: University of Michigan, USA Rebecca Hamm: University of Pennsylvania, USA Jennifer Callaghan Koru: University of Arkansas for Medical Sciences, USA Image credit: © Valenty / stock.adobe.com

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    • .@ImplementSci & #Implementation Science Communications issue call for papers on Implementation of #Evidence-Based Practices for Improving #Maternal & #Neonatal Health. #ImpSci @NICHD_NIH @Fogarty_NIH @NIH_ORWH @ACOGPregnancy @AWHONN @NeoToday @WomenNeo https://t.co/fLsrFvODAy https://t.co/Q6hsiAuxmp

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    Background As the focus has grown in recent years on both engaged research and dissemination and implementation (D&I) research, so too has federal funding to support these areas. The purpose of this analysis is to provide an overall perspective about the range of practices and approaches being used to engage partners in D&I research, with special attention to disparities-relevant research, and to identify gaps and opportunities in research funded by the US National Institutes of Health (NIH) in this space. Methods This analysis examined a portfolio of active D&I research grants funded in fiscal years 2020 and 2021 across the NIH. Grant applications were deductively coded and summary statistics were calculated. Cross-tabulations were used to identify trends by engagement and disparities foci. Results There were 103 grants included in the portfolio, of which 87% contained some form of community or partner engagement, and 50% of engaged grants were relevant to health disparities. Engageme

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    • .@ImplementSci: Article outlines several gaps in the @NIH #implementation science portfolio and describes opportunities for increasing engagement to improve the #quality of D&I research and application to advancing #HealthEquity. #ImpSci @NIHfunding Read: https://t.co/CTc85zAcIZ https://t.co/81szSjwGb3

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    Background Hypertension is the leading cause of death and disability. Clinical care for patients with hypertension in Kenya leverages referral networks to provide basic and specialized healthcare services. However, referrals are characterized by non-adherence and delays in completion. An integrated health information technology (HIT) and peer-based support strategy to improve adherence to referrals and blood pressure control was proposed. A formative assessment gathered perspectives on barriers to referral completion and garnered thoughts on the proposed intervention. Methods We conducted a qualitative study in Kitale, Webuye, Kocholya, Turbo, Mosoriot and Burnt Forest areas of Western Kenya. We utilized the PRECEDE-PROCEED framework to understand the behavioral, environmental and ecological factors that would influence uptake and success of our intervention. We conducted four mabaraza (customary heterogenous community assemblies), eighteen key informant interviews, and twelve focus gr

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    • .@NIH_NHLBI-funded #HyTREC: Local realities & patients’ experiences are critical to development and #implementation of sustainable strategies to improve effectiveness of #hypertension referral networks. #Kenya @RVedanthan @AMPATHKenya #ImpSci #CTRIS Read: https://t.co/IqCpisvxM9 https://t.co/rPcUZRtVVf

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    This cohort study investigates whether US state-level telepharmacy policy is associated with pharmacy deserts and access to pharmacy services.

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    • .@JAMANetworkOpen: Within a year of #policy #implementation, states that adopted or updated telepharmacy statutes and regulations experienced a 2-fold benefit: a⬇️in the number of #pharmacy deserts and the percentage of patients in them. #ImpSci Read: https://t.co/OkQU0xBQ4T https://t.co/NAWjIDLtfB

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    Background Audit and feedback (A&F) is an implementation strategy that can facilitate implementation tailoring by identifying gaps between desired and actual clinical care. While there are several theory-based propositions on which A&F components lead to better implementation outcomes, many have not been empirically investigated, and there is limited guidance for stakeholders when applying A&F in practice. The current study aims to illustrate A&F procedures in six community mental health clinics, with an emphasis on reporting A&F components that are relevant to theories of how feedback elicits behavior change. Methods Six clinics from a larger trial using a tailored approach to implement measurement-based care (MBC) were analyzed for feedback content, delivery mechanisms, barriers to feedback, and outcomes of feedback using archival data. Pattern analysis was conducted to examine relations between A&F components and changes in MBC use. Results Several sites utilized both aggregate and

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    • .@ImplementSci: @CaraCLewis, Mira Snyder, @MeredithRBoyd, Madison Walker, and @Byron_Powell illustrate the use of #Audit & #Feedback to guide tailored #implementation of measurement-based care in community #MentalHealth. @wustl_impsci @cmhsr_wustl Read: https://t.co/AIJ00CeOtM

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    Heart failure (HF) is a leading cause of death and disability in older adults. Despite decades of high-quality evidence to support their use, guidelin…

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    • We review #implementation strategies proven effective in RCTs, recognizing irony that even they havent been widely implemented We propose a #conceptualframework for implementation Even #phase3 trials can follow this framework for early implementation https://t.co/uTc6iJ9VkV 5/ https://t.co/f0rhYOfcI8

    • Implementation trials should be robustly designed #Cluster designs help avoid contamination Trial execution requires alignment - regulatory - public - institution - infrastructure Fidelity should be measured Outcomes should be meaningful https://t.co/uTc6iJ9VkV 4/ https://t.co/vQ6YIbaXgt

    • #ImpSci: study of strategies that ⬆️ systemic uptake of evidence Guided by #conceptualframeworks, implementation research should -be #embedded in health systems -engage the right stakeholders -be tailored to barriers, facilitators, regional context https://t.co/uTc6iJ9VkV 3/ https://t.co/DldyxajmwH

    • There are #barriers to implementation at multiple levels - trial design - healthcare system - intervention - institution - clinician These must be addressed when we plan #implementation or #deimplementation Important processes to consider👇🏽 https://t.co/uTc6iJ9VkV 2/ https://t.co/Bs1pWIcvY8

    • #Implementation lags years behind #evidence How might we design #trials, engage #stakeholders, & align #healthcare systems for better implementation? We offer strategies & propose a conceptual framework to bridge the evidence-care gap @JACCJournals https://t.co/uTc6iJ9VkV 1/ https://t.co/lOEAaSZ4OK

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    Background Although sustainability remains a recognised challenge for Quality Improvement (QI) initiatives, most available research continues to investigate sustainability at the end of implementation. As a result, the learning and continuous adjustments that shape sustainability outcomes are lost. With little understanding of the actions and processes that influence sustainability within QI initiatives, there is limited practical guidance and direction on how to enhance the sustainability of QI initiatives. This study aims to unpack the ‘process of sustaining’, by exploring threats to sustainability encountered throughout the implementation of QI Initiatives and identifying strategies used by QI teams to address these threats over time. Methods A longitudinal multiple case study design was employed to follow 4 QI initiatives over a 3-year period. A standardised sustainability tool was used quarterly to collect perceptions of sustainability threats and actions throughout implementation

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    • .@ImplementSci: Paper unpacks process of sustaining, by describing 5 common #sustainability threats encountered throughout the #implementation of 4 QI initiative case studies and identifies 12 strategies used to address these threats. #ImpSci @NIH_NHLBI https://t.co/aWHgL1BPkc https://t.co/JxVPqUoLev