tailieunhanh - báo cáo khoa học: " Fidelity of implementation: development and testing of a measure"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Fidelity of implementation: development and testing of a measure | Keith et al. Implementation Science 2010 5 99 http content 5 1 99 IMPLEMENTATION SCIENCE Implementation Science RESEARCH ARTICLE Open Access Fidelity of implementation development and testing of a measure Rosalind E Keith1 Faith P Hopp 1 2 Usha Subramanian3 Wyndy Wiitala1 Julie C Lowery1 Abstract Background Along with the increasing prevalence of chronic illness has been an increase in interventions such as nurse case management programs to improve outcomes for patients with chronic illness. Evidence supports the effectiveness of such interventions in reducing patient morbidity mortality and resource utilization but other studies have produced equivocal results. Often little is known about how implementation of an intervention actually occurs in clinical practice. While studies often assume that interventions are used in clinical practice exactly as originally designed this may not be the case. Thus fidelity of an intervention s implementation reflects how an intervention is or is not used in clinical practice and is an important factor in understanding intervention effectiveness and in replicating the intervention in dissemination efforts. The purpose of this paper is to contribute to the understanding of implementation science by a proposing a methodology for measuring fidelity of implementation FOI and b testing the measure by examining the association between FOI and intervention effectiveness. Methods We define and measure FOI based on organizational members level of commitment to using the distinct components that make up an intervention as they were designed. Semistructured interviews were conducted among 18 organizational members in four medical centers and the interviews were analyzed qualitatively to assess three dimensions of commitment to use-satisfaction consistency and quality-and to develop an overall rating of FOI. Mixed methods were used to explore the association between FOI and intervention effectiveness inpatient .