SLIDE 1 The I mplementation & Sustainment Facilitation (I SF) Strategy: Effectiveness results from a 39-site cluster randomized trial
*Bryan R. Garner; Stephen J. Tueller, Michael Bradshaw,
Steve Martino, Kate Speck, Denna Vandersloot, Heather J. Gotham, Michael Chaple, Liz Ball, Alyssa Wolfe, Mat Roosa, and Jay Ford
Funding provided by the National Institute on Drug Abuse (NIDA; R01-DA038146; PI: Garner)
*Presented by: Bryan R. Garner, PhD Senior Implementation Research Scientist RTI International 3040 E. Cornwallis Rd. Research Triangle Park, NC 27709-2194 Phone: (919) 597-5159 Email: bgarner@rti.org
SLIDE 2
The Substance Abuse Treatment to HI V Care (SAT2HI V) Project (R01-DA038146)
SLIDE 3
The Substance Abuse Treatment to HI V Care (SAT2HI V) Project (R01-DA038146)
SLIDE 4
The Substance Abuse Treatment to HI V Care (SAT2HI V) Project (R01-DA038146)
Focus of this presentation
SLIDE 5
I mplementation Effectiveness
(Klein & Sorra, 1996; Klein, Conn, & Sorra, 2001)
“Implementation effectiveness refers to the consistency and quality of targeted organizational members’ use of a specific innovation.”
Klein & Sorra, 1996
SLIDE 6
I mplementation Effectiveness
(Klein, Conn, & Sorra, 2001, p. 812)
SLIDE 7
Participant Flow Chart
SLIDE 8
Participant Flow Chart
SLIDE 9
Participant Flow Chart
SLIDE 10 Naming, Defining, and Specifying the I mplementation Strategies
- 1. Name it
- 2. Define it
- 3. Specify it
a) The Actor b) The Action c) Action Target d) Temporality e) Dose f) Implementation Outcome g) Justification
SLIDE 11 Addiction Technology Transfer Center (ATTC) implementation strategy
assistance
materials
quality monitoring systems
quality monitoring
- E. Distribute educational
materials
meetings
dynamic
feedback
consultation
collaborative
SLIDE 12 I mplementation & Sustainment Facilitation (I SF) strategy
- K. Use an improvement and
implementation advisor
- L. Develop tools for quality
improvement
- M. Organize implementation
team meetings
champions
- O. Assess for readiness and
identify barriers
- P. Conduct local consensus
discussions
- Q. Conduct cyclical small tests
- f change
SLIDE 13
Addiction Technology Transfer Center (ATTC) implementation strategy
SLIDE 14
I mplementation & Sustainment Facilitation (I SF) strategy
SLIDE 15
Strategy dose during preparation phase
SLIDE 16
Strategy dose during implementation phase
SLIDE 17
Strategy dose during sustainment phase
SLIDE 18
Participant Flow Chart
SLIDE 19
The Substance Abuse Treatment to HI V Care (SAT2HI V) Project (R01-DA038146)
Focus of this presentation
?
SLIDE 20 Methods
Sample
- 78 staff from 39 AIDS Service Organizations (ASOs; 2 staff per ASO).
- 38 staff and 19 ASOs randomized to ATTC condition.
- 40 staff from 20 ASOs randomized to ATTC+ISF condition.
Outcome
- Implementation Effectiveness – A continuous staff measure representing
the sum of the standardized cumulative number of MIBIs delivered by BI staff (i.e., consistency) and the cumulative fidelity score of their delivery of the MIBI (i.e., quality).
Analysis
- Mplus was used to conduct an adjusted multilevel regression analysis
focused on the relationship between condition assignment (ATTC = 0; ATTC+ISF = 1) and implementation effectiveness.
SLIDE 21 Hypothesized Model
Assigned to ATTC+ISF condition (relative to ATTC) Implementation Effectiveness Staff-level covariates
1. Age 2. Gender 3. Race 4. Ethnicity 5. Education level 6. Years of experience 7. Average hours worked per week 8. MI Experience 9. Innovation-values fit
+
SLIDE 22 Results
Assigned to ATTC+ISF condition (relative to ATTC)
β = .43, p = .002
Implementation Effectiveness Staff-level covariates
1. Age 2. Gender 3. Race 4. Ethnicity 5. Education level 6. Years of experience 7. Average hours worked per week 8. MI Experience 9. Innovation-values fit
SLIDE 23 Conclusions
- As part of the SAT2HIV Project, our team was able to
advance 39 ASOs across the EPIS continuum.
- Results of this cluster-randomized trial support the
effectiveness of the Implementation & Sustainment Facilitation (ISF) intervention as an adjunct to the ATTC strategy, at least for implementation effectiveness.
- Future research will need to examine the extent to which
the current findings can be replicated, improved upon, and generalized to other contexts and EBPs.
SLIDE 24
Thank you!
Bryan R. Garner, PhD Senior Implementation Research Scientist RTI International 3040 E. Cornwallis Rd. Research Triangle Park, NC 27709-2194 Phone: (919) 597-5159 Email: bgarner@rti.org
