Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness

Abstract Background Clinical interventions often need to be adapted from their original design when they are applied to new settings. There is a growing literature describing frameworks and approaches to deploying and documenting adaptations of evidence-based practices in healthcare. Still, interven...

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Main Authors: Virginia Wang, Joshua D’Adolf, Kasey Decosimo, Katina Robinson, Ashley Choate, Rebecca Bruening, Nina Sperber, Elizabeth Mahanna, Courtney H. Van Houtven, Kelli D. Allen, Cathleen Colón-Emeric, Teresa M. Damush, Susan N. Hastings
Format: Article
Language:English
Published: BMC 2022-07-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-022-08270-1
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author Virginia Wang
Joshua D’Adolf
Kasey Decosimo
Katina Robinson
Ashley Choate
Rebecca Bruening
Nina Sperber
Elizabeth Mahanna
Courtney H. Van Houtven
Kelli D. Allen
Cathleen Colón-Emeric
Teresa M. Damush
Susan N. Hastings
author_facet Virginia Wang
Joshua D’Adolf
Kasey Decosimo
Katina Robinson
Ashley Choate
Rebecca Bruening
Nina Sperber
Elizabeth Mahanna
Courtney H. Van Houtven
Kelli D. Allen
Cathleen Colón-Emeric
Teresa M. Damush
Susan N. Hastings
author_sort Virginia Wang
collection DOAJ
description Abstract Background Clinical interventions often need to be adapted from their original design when they are applied to new settings. There is a growing literature describing frameworks and approaches to deploying and documenting adaptations of evidence-based practices in healthcare. Still, intervention modifications are often limited in detail and justification, which may prevent rigorous evaluation of interventions and intervention adaptation effectiveness in new contexts. We describe our approach in a case study, combining two complementary intervention adaptation frameworks to modify CONNECT for Quality, a provider-facing team building and communication intervention designed to facilitate implementation of a new clinical program. Methods This process of intervention adaptation involved the use of the Planned Adaptation Framework and the Framework for Reporting Adaptations and Modifications, for systematically identifying key drivers, core and non-core components of interventions for documenting planned and unplanned changes to intervention design. Results The CONNECT intervention’s original context and setting is first described and then compared with its new application. This lays the groundwork for the intentional modifications to intervention design, which are developed before intervention delivery to participating providers. The unpredictable nature of implementation in real-world practice required unplanned adaptations, which were also considered and documented. Attendance and participation rates were examined and qualitative assessment of reported participant experience supported the feasibility and acceptability of adaptations of the original CONNECT intervention in a new clinical context. Conclusion This approach may serve as a useful guide for intervention implementation efforts applied in diverse clinical contexts and subsequent evaluations of intervention effectiveness. Trial registration The study was registered at ClinicalTrials.gov ( NCT03300336 ) on September 28, 2017.
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spelling doaj.art-b1dc6c96de404e7aa22036fb800538c42022-12-22T02:07:01ZengBMCBMC Health Services Research1472-69632022-07-0122111110.1186/s12913-022-08270-1Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readinessVirginia Wang0Joshua D’Adolf1Kasey Decosimo2Katina Robinson3Ashley Choate4Rebecca Bruening5Nina Sperber6Elizabeth Mahanna7Courtney H. Van Houtven8Kelli D. Allen9Cathleen Colón-Emeric10Teresa M. Damush11Susan N. Hastings12Health Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemHealth Services Research and Development Center for Health Information and Communication, Richard L. Roudebush VAMCHealth Services Research and Development Center of Innovation, Durham VA Health Care SystemAbstract Background Clinical interventions often need to be adapted from their original design when they are applied to new settings. There is a growing literature describing frameworks and approaches to deploying and documenting adaptations of evidence-based practices in healthcare. Still, intervention modifications are often limited in detail and justification, which may prevent rigorous evaluation of interventions and intervention adaptation effectiveness in new contexts. We describe our approach in a case study, combining two complementary intervention adaptation frameworks to modify CONNECT for Quality, a provider-facing team building and communication intervention designed to facilitate implementation of a new clinical program. Methods This process of intervention adaptation involved the use of the Planned Adaptation Framework and the Framework for Reporting Adaptations and Modifications, for systematically identifying key drivers, core and non-core components of interventions for documenting planned and unplanned changes to intervention design. Results The CONNECT intervention’s original context and setting is first described and then compared with its new application. This lays the groundwork for the intentional modifications to intervention design, which are developed before intervention delivery to participating providers. The unpredictable nature of implementation in real-world practice required unplanned adaptations, which were also considered and documented. Attendance and participation rates were examined and qualitative assessment of reported participant experience supported the feasibility and acceptability of adaptations of the original CONNECT intervention in a new clinical context. Conclusion This approach may serve as a useful guide for intervention implementation efforts applied in diverse clinical contexts and subsequent evaluations of intervention effectiveness. Trial registration The study was registered at ClinicalTrials.gov ( NCT03300336 ) on September 28, 2017.https://doi.org/10.1186/s12913-022-08270-1AdaptationComplexity scienceTeamsMobilityImplementationIntervention design
spellingShingle Virginia Wang
Joshua D’Adolf
Kasey Decosimo
Katina Robinson
Ashley Choate
Rebecca Bruening
Nina Sperber
Elizabeth Mahanna
Courtney H. Van Houtven
Kelli D. Allen
Cathleen Colón-Emeric
Teresa M. Damush
Susan N. Hastings
Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness
BMC Health Services Research
Adaptation
Complexity science
Teams
Mobility
Implementation
Intervention design
title Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness
title_full Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness
title_fullStr Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness
title_full_unstemmed Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness
title_short Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness
title_sort adapting to connect modifying a nursing home based team building intervention to improve hospital care team interactions functioning and implementation readiness
topic Adaptation
Complexity science
Teams
Mobility
Implementation
Intervention design
url https://doi.org/10.1186/s12913-022-08270-1
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