Article

A Guide for applying a revised version of the PARIHS framework for implementation

Independent Consultant, Amherst, Massachusetts, USA. .
Implementation Science (Impact Factor: 3.47). 08/2011; 6:99. DOI: 10.1186/1748-5908-6-99
Source: PubMed

ABSTRACT ABSTRACT:
Based on a critical synthesis of literature on use of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, revisions and a companion Guide were developed by a group of researchers independent of the original PARIHS team. The purpose of the Guide is to enhance and optimize efforts of researchers using PARIHS in implementation trials and evaluations.
Authors used a planned, structured process to organize and synthesize critiques, discussions, and potential recommendations for refinements of the PARIHS framework arising from a systematic review. Using a templated form, each author independently recorded key components for each reviewed paper; that is, study definitions, perceived strengths/limitations of PARIHS, other observations regarding key issues and recommendations regarding needed refinements. After reaching consensus on these key components, the authors summarized the information and developed the Guide.
A number of revisions, perceived as consistent with the PARIHS framework's general nature and intent, are proposed. The related Guide is composed of a set of reference tools, provided in Additional files. Its core content is built upon the basic elements of PARIHS and current implementation science.
We invite researchers using PARIHS for targeted evidence-based practice (EBP) implementations with a strong task-orientation to use this Guide as a companion and to apply the revised framework prospectively and comprehensively. Researchers also are encouraged to evaluate its use relative to perceived strengths and issues. Such evaluations and critical reflections regarding PARIHS and our Guide could thereby promote the framework's continued evolution.

Download full-text

Full-text

Available from: Hildi J Hagedorn, Jul 07, 2015
1 Follower
 · 
235 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives. Persons with mental disorders experience functional impairments and premature mortality. Limited continuity of care may contribute to disparities in this group. We describe the replication of an evidence-based outreach program (Re-Engage) to reconnect Veterans with mental disorders into care who have dropped out of services. Methods. Using the Enhanced Replicating Effective Programs framework, population-based registries were used to identify Veterans lost-to-care, and providers used this information to determine Veteran disposition and need for care. Providers recorded Veteran preferences, health status, and care utilization, and formative process data was collected to document implementation efforts. Results. Among Veterans who dropped out of care (n = 126), the mean age was 49 years, 10% were women, and 29% were African-American. Providers determined that 39% of Veterans identified for re-engagement were deceased, hospitalized, or ineligible for care. Of the remaining 68 Veterans, outreach efforts resulted in contact with 20, with 7 returning to care. Providers averaged 14.2 hours over 4 months conducting re-engagement services and reported that gaining facility leadership support and having service agreements for referrals were essential for program implementation. Conclusions. Population-level, panel management strategies to re-engage Veterans with mental disorders are potentially feasible if practices are identified to facilitate national rollout.
    Depression research and treatment 09/2012; 2012:325249. DOI:10.1155/2012/325249
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective. There is limited theory regarding the real-world implementation of mental health care in the primary care setting: a type of organizational coordination intervention. The purpose of this study was to develop a theory to conceptualize the potential causes of barriers and facilitators to how local sites responded to this mandated intervention to achieve coordinated mental health care. Methods. Data from 65 primary care and mental health staff interviews across 16 sites were analyzed to identify how coordination was perceived one year after an organizational mandate to provide integrated mental health care in the primary care setting. Results. Standardized referral procedures and communication practices between primary care and mental health were influenced by the organizational factors of resources, training, and work design, as well as provider-experienced organizational boundaries between primary care and mental health, time pressures, and staff participation. Organizational factors and provider experiences were in turn influenced by leadership. Conclusions. Our emergent theory describes how leadership, organizational factors, and provider experiences affect the implementation of a mandated mental health coordination intervention. This framework provides a nuanced understanding of the potential barriers and facilitators to implementing interventions designed to improve coordination between professional groups.
    Depression research and treatment 07/2012; 2012:597157. DOI:10.1155/2012/597157
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A survey was administered anonymously to 45 mental health providers who delivered smoking cessation treatment integrated into posttraumatic stress disorder care (integrated care) as part of a multisite clinical trial. Survey items assessed key factors associated with successful implementation of research-based practices from the perspective of treating providers. Factors assessed included prior experiences with cessation treatment, compatibility of integrated care with current practices, feasibility of adopting integrated care into regular practice, and adequacy of training. More than half of respondents reported that integrated care delivery was feasible, and they would be considerably or extremely likely to continue delivery in routine practice. Positive prestudy beliefs and more experience delivering cessation care were associated with stronger endorsement of delivering integrated care after the study. The most frequently cited obstacle to delivering integrated care involved time limitations. Future efforts should focus on developing treatment adaptations that address provider-identified barriers and identifying clinic- and administrative-level supports that facilitate delivery of integrated care and assist providers who incorporate integrated care into clinical practice. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Psychology of Addictive Behaviors 05/2012; 27(1). DOI:10.1037/a0028484 · 2.09 Impact Factor