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Implementing Community-Created Self-Management Support Tools in Primary Care Practices: Multimethod Analysis From the INSTTEPP Study.
Fernald, Douglas H; Simpson, Matthew J; Nease, Donald E; Hahn, David L; Hoffmann, Amanda E; Michaels, LeAnn C; Fagnan, Lyle J; Daly, Jeanette M; Levy, Barcey T.
Afiliação
  • Fernald DH; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO.
  • Simpson MJ; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO.
  • Nease DE; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO.
  • Hahn DL; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Hoffmann AE; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Michaels LC; Department of Family Medicine, Oregon Health & Science University, Portland, OR.
  • Fagnan LJ; Department of Family Medicine, Oregon Health & Science University, Portland, OR.
  • Daly JM; Department of Family Medicine, University of Iowa, Iowa City, IA.
  • Levy BT; Department of Family Medicine, University of Iowa, Iowa City, IA.
J Patient Cent Res Rev ; 5(4): 267-275, 2018.
Article em En | MEDLINE | ID: mdl-31414012
PURPOSE: With one-half of Americans projected to be living with at least one chronic condition before 2020, enhancing patient self-management support (SMS) may improve health-related behaviors and clinical outcomes. Routine SMS implementation in primary care settings is difficult. Little is known about the practice conditions required for successful implementation of SMS tools. METHODS: Four primary care practice-based research networks (PBRNs) recruited 16 practices to participate in a boot camp translation process to adapt patient-centered SMS tools. Boot camp translation sessions were held over a 2-month period with 2 patients, a clinician, and a care manager from each practice. Qualitative case comparison and qualitative comparative analysis were used to examine practice conditions needed to implement SMS tools. The Consolidated Framework for Implementation Research guided data collection and analysis. RESULTS: Four different practice conditions affected the implementation of new SMS tools: functional practice organization; system that enables innovation and change; presence of a visible, activated champion; and synergy and alignment of SMS changes with other work. Qualitative comparative analysis suggested that it was necessary to have an enabling system, a visible champion, and synergy for a practice to at least minimally implement the SMS tools. Sufficiency testing, however, failed to show robust consistency to satisfactorily explain conditions required to implement new SMS tools. CONCLUSIONS: To implement tailored self-management support tools relatively rapidly, the minimum necessary conditions include a system that enables innovation and change, presence of a visible champion, and alignment of SMS changes with other work; yet, these alone are insufficient to ensure successful implementation.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Qualitative_research Aspecto: Patient_preference Idioma: En Revista: J Patient Cent Res Rev Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Qualitative_research Aspecto: Patient_preference Idioma: En Revista: J Patient Cent Res Rev Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos