المؤلفون: Kappler, Caitlin B., Coffman, Cynthia J., Stechuchak, Karen M., Choate, Ashley, Meyer, Cassie, Zullig, Leah L., Hughes, Jaime M., Drake, Connor, Sperber, Nina R., Kaufman, Brystana G., Van Houtven, Courtney H., Allen, Kelli D., Hastings, Susan N.

المساهمون: Quality Enhancement Research Initiative

المصدر: Implementation Science Communications ; volume 5, issue 1 ; ISSN 2662-2211

مصطلحات موضوعية: General Medicine

الوصف: Background STRIDE is a supervised walking program designed to address the negative consequences of immobility during hospitalization for older adults. In an 8-hospital stepped wedge randomized controlled trial, STRIDE was associated with reduced odds of hospital discharge to skilled nursing facility. STRIDE has the potential to become a system-wide approach to address hospital-associated disability in Veteran’s Affairs; however, critical questions remain about how best to scale and sustain the program. The overall study goal is to compare the impact of two strategies on STRIDE program penetration (primary), fidelity, and adoption implementation outcomes. Methods Replicating Effective Programs will be used as a framework underlying all implementation support activities. In a parallel, cluster randomized trial, we will use stratified blocked randomization to assign hospitals ( n = 32) to either foundational support, comprised of standard, low-touch activities, or enhanced support, which includes the addition of tailored, high-touch activities if hospitals do not meet STRIDE program benchmarks at 6 and 8 months following start date. All hospitals begin with foundational support for 6 months until randomization occurs. The primary outcome is implementation penetration defined as the proportion of eligible hospitalizations with ≥ 1 STRIDE walks at 10 months. Secondary outcomes are fidelity and adoption with all implementation outcomes additionally examined at 13 and 16 months. Fidelity will be assessed for STRIDE hospitalizations as the percentage of eligible hospital days with “full dose” of the program, defined as two or more documented walks or one walk for more than 5 min. Program adoption is a binary outcome defined as ≥ 5 patients with a STRIDE walk or not. Analyses will also include patient-level effectiveness outcomes (e.g., discharge to nursing home, length of stay) and staffing and labor costs. We will employ a convergent mixed-methods approach to explore and understand pre-implementation ...

الإتاحة: https://doi.org/10.1186/s43058-024-00544-5Test

المؤلفون: Kumara, Mahima T., Cleveland, Rebecca J., Kostic, Aleksandra M., Weisner, Serena E., Allen, Kelli D., Golightly, Yvonne M., Welch, Heather, Dale, Melissa, Messier, Stephen P., Hunter, David J., Katz, Jeffrey N., Callahan, Leigh F., Losina, Elena

المساهمون: CDC, National Institute of Arthritis and Musculoskeletal and Skin Diseases

المصدر: Osteoarthritis and Cartilage Open ; volume 6, issue 2, page 100463 ; ISSN 2665-9131

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1016/j.ocarto.2024.100463Test
https://api.elsevier.com/content/article/PII:S266591312400030X?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S266591312400030X?httpAccept=text/plainTest

المؤلفون: Burgess, Diana J, Evans, Roni, Allen, Kelli D, Bangerter, Ann, Bronfort, Gert, Cross, Lee J, Ferguson, John E, Haley, Alex, Campbell, Emily M Hagel, Mahaffey, Mallory R, Matthias, Marianne S, Meis, Laura A, Polusny, Melissa A, Serpa, J Greg, Taylor, Stephanie L, Taylor, Brent C

المصدر: Pain Medicine. 21(Supplement_2)

مصطلحات موضوعية: Health Services and Systems, Health Sciences, Behavioral and Social Science, Depression, Clinical Trials and Supportive Activities, Pain Research, Mental Health, Complementary and Integrative Health, Mind and Body, Clinical Research, Comparative Effectiveness Research, Neurosciences, Chronic Pain, Evaluation of treatments and therapeutic interventions, 6.6 Psychological and behavioural, Good Health and Well Being, Humans, Learning, Mindfulness, Treatment Outcome, Veterans, mindfulness, veteran, chronic pain, Clinical Sciences, Pharmacology and Pharmaceutical Sciences, Public Health and Health Services, Anesthesiology, Clinical sciences, Health services and systems, Clinical and health psychology

الوصف: BackgroundMindfulness-based interventions (MBIs) are evidence-based nonpharmacological treatments for treating chronic pain. However, the predominant MBI, mindfulness-based stress reduction, has features that pose significant implementation barriers.ObjectivesThis study will test two approaches to delivering MBIs for improving Veterans' chronic pain and mental health comorbidities. These two approaches address key implementation barriers.MethodsWe will conduct a four-site, three-arm pragmatic randomized controlled trial, Learning to Apply Mindfulness to Pain (LAMP), to test the effectiveness of two MBIs at improving pain and mental health comorbidities. Mobile+Group LAMP consists of prerecorded modules presented by a mindfulness instructor that are viewed in an online group setting and interspersed with discussions led by a facilitator. Mobile LAMP consists of the same prerecorded modules but does not include a group component. We will test whether either of these MBIs will be more effective than usual care at improving chronic pain and whether the Mobile+Group LAMP will be more effective than Mobile LAMP at improving chronic pain. Comparisons for the primary hypotheses will be conducted with continuous outcomes (Brief Pain Inventory interference score) repeated at 10 weeks, 6 months, and 12 months. The secondary hypotheses are that Mobile+Group LAMP and Mobile LAMP will be more effective than usual care at improving secondary outcomes (e.g., post-traumatic stress disorder, depression). We will also confirm the comparisons for the primary and secondary hypotheses in gender-specific strata.ImplicationsThis trial is expected to result in two approaches for delivering MBIs that will optimize engagement, adherence, and sustainability and be able to reach large numbers of Veterans.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/38s1d9p5Test

المؤلفون: Parsons, Camille M, Gates, Lucy S, Perry, Thomas, Nevitt, Michael, Felson, David, Sanchez-Santos, Maria T, Jones, Graeme, Golightly, Yvonne M, Allen, Kelli D, Callahan, Leigh F, White, Daniel K, Walker-Bone, Karen, Cooper, Cyrus, Arden, Nigel K

المصدر: Osteoarthritis and Cartilage Open. 2(4)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Chronic Pain, Pain Research, Aging, Arthritis, Osteoarthritis, Clinical Research, Aetiology, 2.1 Biological and endogenous factors, Musculoskeletal, Epidemiology, Harmonization, Knee, Occupation, Clinical sciences

الوصف: ObjectiveWith adults working to older ages, occupation is an important, yet less modifiable domain of physical activity to consider in the risk of knee osteoarthritis (OA). This study aimed to investigate the association between predominant lifetime occupation and prevalent knee OA.DesignParticipant-level data were used from five international community-based cohorts: Johnston County Osteoarthritis Project, the Hertfordshire Cohort Study, the Multicenter Osteoarthritis Study, the Tasmanian Cohort Study and Framingham Osteoarthritis Study. Self-reported predominant occupation was categorized into sedentary, light, light manual and heavy manual levels. Cross-sectional associations between predominant lifetime occupation and knee OA outcomes including prevalence of radiographic knee OA (RKOA), symptomatic RKOA and knee pain, were assessed using logistic regression, accounting for cohort clustering.ResultsData for 7391 participants were included. 24.7% reported sedentary lifetime occupation, 30.0% light, 35.9% light manual and 9.4% heavy manual. 43.3% presented with RKOA, 52.1% with knee pain and 29.0% with symptomatic RKOA. There was over a two-fold increase in the odds of having RKOA, knee pain and symptomatic RKOA in those whose with heavy manual compared to sedentary occupations ((odds ratio (OR): 2.14; 95% confidence interval (CI): 1.79, 2.58), (OR: 2.19; 95% CI: 1.78, 2.70), (OR: 2.41; 95% CI: 1.94, 2.99) respectively).ConclusionThis large international multi-cohort study demonstrated an association of heavy manual work with RKOA, symptomatic RKOA and knee pain. Measures that protect workers and are designed to reduce heavy manual related activities remain a priority to reduce the risk of knee OA.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/6bq3m9z9Test

المؤلفون: Allen, Kelli D., Huffman, Katie, Cleveland, Rebecca J., van der Esch, Martin, Abbott, J. Haxby, Abbott, Allan, Bennell, Kim, Bowden, Jocelyn L., Eyles, Jillian, Healey, Emma L., Holden, Melanie A, Jayakumar, Prakash, Koenig, Karl, Lo, Grace, Losina, Elena, Miller, Katie, Østerås, Nina, Pratt, Carin, Quicke, Jonathan G, Sharma, Saurab, Skou, Søren T, Tveter, Anne Therese, Woolf, Anthony, Yu, Shirley P., Hinman, Rana S.

المصدر: Allen , K D , Huffman , K , Cleveland , R J , van der Esch , M , Abbott , J H , Abbott , A , Bennell , K , Bowden , J L , Eyles , J , Healey , E L , Holden , M A , Jayakumar , P , Koenig , K , Lo , G , Losina , E , Miller , K , Østerås , N , Pratt , C , Quicke , J G , Sharma , S , Skou , S T , Tveter , A T , ....

مصطلحات موضوعية: Delphi, Implementation, Osteoarthritis, Outcomes

الوصف: Objective: To develop sets of core and optional recommended domains for describing and evaluating Osteoarthritis Management Programs (OAMPs), with a focus on hip and knee Osteoarthritis (OA). Design: We conducted a 3-round modified Delphi survey involving an international group of researchers, health professionals, health administrators and people with OA. In Round 1, participants ranked the importance of 75 outcome and descriptive domains in five categories: patient impacts, implementation outcomes, and characteristics of the OAMP and its participants and clinicians. Domains ranked as “important” or “essential” by ≥80% of participants were retained, and participants could suggest additional domains. In Round 2, participants rated their level of agreement that each domain was essential for evaluating OAMPs: 0 = strongly disagree to 10 = strongly agree. A domain was retained if ≥80% rated it ≥6. In Round 3, participants rated remaining domains using same scale as in Round 2; a domain was recommended as “core” if ≥80% of participants rated it ≥9 and as “optional” if ≥80% rated it ≥7. Results: A total of 178 individuals from 26 countries participated; 85 completed all survey rounds. Only one domain, “ability to participate in daily activities”, met criteria for a core domain; 25 domains met criteria for an optional recommendation: 8 Patient Impacts, 5 Implementation Outcomes, 5 Participant Characteristics, 3 OAMP Characteristics and 4 Clinician Characteristics. Conclusion: The ability of patients with OA to participate in daily activities should be evaluated in all OAMPs. Teams evaluating OAMPs should consider including domains from the optional recommended set, with representation from all five categories and based on stakeholder priorities in their local context.

وصف الملف: application/pdf

العلاقة: https://portal.findresearcher.sdu.dk/da/publications/e846bb75-641d-4e02-8cb9-96b7c88b428aTest

الإتاحة: https://doi.org/10.1016/j.joca.2023.02.078Test
https://portal.findresearcher.sdu.dk/da/publications/e846bb75-641d-4e02-8cb9-96b7c88b428aTest
https://findresearcher.sdu.dk/ws/files/224957483/OARSI_JEI_manuscript_REVISION.pdfTest

المؤلفون: Sawalha, Amr H., Solomon, Daniel H., Allen, Kelli D., Katz, Patricia, Yelin, Ed

المصدر: ACR Open Rheumatology ; volume 5, issue 6, page 308-309 ; ISSN 2578-5745 2578-5745

الإتاحة: https://doi.org/10.1002/acr2.11547Test

المؤلفون: Solomon, Daniel H., Allen, Kelli D., Katz, Patricia, Sawalha, Amr H., Yelin, Ed

المصدر: ACR Open Rheumatology ; volume 5, issue 6, page 288-289 ; ISSN 2578-5745 2578-5745

الإتاحة: https://doi.org/10.1002/acr2.11538Test

المؤلفون: Decosimo, Kasey, Drake, Connor, Coffman, Cynthia J., Sperber, Nina R., Tucker, Matthew, Hughes, Jaime M., Zullig, Leah L., Chadduck, Trisha, Christensen, Leah, Kaufman, Brystana, Allen, Kelli D., Hastings, S. Nicole, Van Houtven, Courtney H.

المساهمون: Quality Enhancement Research Initiative, U.S. Department of Veterans Affairs

المصدر: Implementation Science Communications ; volume 4, issue 1 ; ISSN 2662-2211

مصطلحات موضوعية: General Medicine

الوصف: Background Family caregiver training decreases caregiver psychological burden and improves caregiver depressive symptoms and health-related quality of life. Caregivers FIRST is an evidence-based group skills training curriculum for family caregivers and was announced for national dissemination in partnership with the Veterans Health Administration (VHA) National Caregiver Support Program (CSP). Previous evaluations of Caregivers FIRST implementation highlighted that varying support was needed to successfully implement the program, ranging from minimal technical assistance to intensive assistance and support. However, we do not know the optimal level of support needed to inform cost-effective national scaling of the program. We describe a protocol for randomizing 24 non-adopting VA medical centers 1:1 to a tailored, high-touch implementation support or a standard, low-touch implementation support to test the primary hypothesis that high-touch support increases Caregivers FIRST penetration, fidelity, and adoption. Additionally, we describe the methods for evaluating the effect of Caregivers FIRST participation on Veteran outcomes using a quasi-experimental design and the methods for a business case analysis to examine cost of delivery differences among sites assigned to a low or high-touch implementation support. Methods We use a type III hybrid implementation-effectiveness study design enrolling VA medical centers that do not meet Caregivers FIRST adoption benchmarks following the announcement of the program as mandated within the CSP. Eligible medical centers will be randomized to receive a standard low-touch implementation support based on Replicating Effective Programs (REP) only or to an enhanced REP (high-touch) implementation support consisting of facilitation and tailored technical assistance. Implementation outcomes include penetration (primary), fidelity, and adoption at 12 months. Mixed methods will explore sites’ perceptions and experiences of the high-touch intensification strategy. ...

الإتاحة: https://doi.org/10.1186/s43058-023-00475-7Test

المؤلفون: Van Houtven, Courtney H., Drake, Connor, Malo, Teri L., Decosimo, Kasey, Tucker, Matthew, Sullivan, Caitlin, D’Adolf, Josh, Hughes, Jaime M., Christensen, Leah, Grubber, Janet M., Coffman, Cynthia J., Sperber, Nina R., Wang, Virginia, Allen, Kelli D., Hastings, S. Nicole, Shea, Christopher M., Zullig, Leah L.

المساهمون: Quality Enhancement Research Initiative, U.S. Department of Veterans Affairs

المصدر: Implementation Science Communications ; volume 4, issue 1 ; ISSN 2662-2211

مصطلحات موضوعية: General Medicine

الوصف: Background Caregivers FIRST is an evidence-based program addressing gaps in caregivers’ skills. In 2020, the Veterans Health Administration Caregiver Support Program (CSP) nationally endorsed Caregivers FIRST, offering credit in leadership performance plans to encourage all VA medical centers (VAMCs) to implement locally. This study examines the association of organizational readiness with VAMC adoption of Caregivers FIRST. Methods In a cohort observational study, we surveyed CSP managers about their facilities’ readiness to implement using the Organizational Readiness for Implementing Change (ORIC) instrument and compared change commitment and change efficacy domains among VAMCs “adopters” defined as delivering Caregivers FIRST within 1 year of the national announcement to those that did not (“non-adopters”). Within “adopters,” we categorized time to adoption based on Rogers’ diffusion of innovation theory including “innovators,” “early adopters,” “early majority,” “late adopters,” and “laggards.” Organizational readiness and site characteristics (facility complexity, staffing levels, volume of applications for caregiver assistance services) were compared between “adopters,” “non-adopters,” and between time to adoption subcategories. Separate logistic regression models were used to assess whether ORIC and site characteristics were associated with early adoption among “adopters.” Results Fifty-one of 63 (81%) VAMCs with CSP manager survey respondents adopted Caregivers FIRST during the first year. ORIC change commitment and efficacy were similar for “adopters” and “non-adopters.” However, sites that adopted earlier (innovators and early adopters) had higher ORIC change commitment and efficacy scores than the rest of the “adopters.” Logistic regression results indicated that higher ORIC change commitment (odds ratio [OR] = 2.57; 95% confidence interval [CI], 1.11–5.95) and ORIC change efficacy (OR = 2.60; 95% CI, 1.12–6.03) scores were associated with increased odds that a VAMC was an early adopter ...

الإتاحة: https://doi.org/10.1186/s43058-023-00447-xTest

المؤلفون: Shayo, Mathew J., Shayo, Pendo, Haukila, Kelvin F., Norman, Katherine, Burke, Colleen, Ngowi, Kennedy, Goode, Adam P., Allen, Kelli D., Wonanji, Vivian Timothy, Mmbaga, Blandina T., Bettger, Janet Prvu

المصدر: Frontiers in Rehabilitation Sciences ; volume 3 ; ISSN 2673-6861

الوصف: Introduction Musculoskeletal (MSK) disorders such as low back pain and osteoarthritis are a leading cause of disability and the leading contributor to the need for rehabilitation services globally. This need has surpassed the availability of trained clinicians; even in urban areas where services and providers are thought to be more abundant, access can be challenged by transportation options and financial costs associated with travel, care and lost time from work. However, continuing standard of fully in-person rehabilitation care for MSK-associated pain and disability may no longer be necessary. With increased ownership or access to even a basic mobile phone device, and evidence for remote management by trained clinicians, some individuals with MSK disorders may be able to continue their rehabilitation regimen predominantly from home after initial evaluation in primary care or an outpatient clinic. Methods This manuscript describes application of a framework we used to culturally and contextually adapt an evidence-based approach for leveraging digital health technology using a mobile phone (mHealth) to expand access to rehabilitation services for MSK-associated pain and disability. We then conducted a multi-level analysis of policies related to the adapted approach for rehabilitation service delivery to identify opportunities to support sustainability. Results Our study was conducted in Tanzania, a lower-middle income country with their first National Rehabilitation Strategic Plan released in 2021. Lessons learned can be applied even to countries with greater infrastructure or fewer barriers. The seven-step adaptation framework used can be applied in other regions to improve the likelihood of local mHealth adoption and implementation. Our practice and policy assessment for Tanzania can be applied in other regions and used collaboratively with government officials in support of building or implementing a national rehabilitation strategic plan. Conclusion The work described, lessons learned and components of the ...

الإتاحة: https://doi.org/10.3389/fresc.2022.982175Test