Browsing by Author "Graham, Ian D."

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    Applying the Knowledge-to-Action Framework to Implement Gait and Balance Assessments in Inpatient Stroke Rehabilitation
    (Elsevier, 2020-11) Moore, Jennifer L.; Virva, Roberta; Henderson, Chris; Lenca, Lauren; Butzer, John F.; Lovell, Linda; Roth, Elliot; Graham, Ian D.; Hornby, T. George; Physical Medicine and Rehabilitation, School of Medicine
    Objectives The overall objectives of this project were to implement and sustain use of a gait assessment battery (GAB) that included the Berg Balance Scale, 10-meter walk test, and 6-minute walk test during inpatient stroke rehabilitation. The study objective was to assess the effect of the study intervention on clinician adherence to the recommendations and its effect on clinician perceptions and the organization. Design Pre- and post-training intervention study. Setting Subacute inpatient rehabilitation facility. Participants Physical therapists (N=6) and physical therapist assistants (N=2). Intervention The intervention comprised a bundle of activities, including codeveloping and executing the plan with clinicians and leaders. The multicomponent implementation plan was based on the Knowledge-to-Action Framework and included implementation facilitation, implementation leadership, and a bundle of knowledge translation interventions that targeted barriers. Implementation was an iterative process in which results from one implementation phase informed planning of the next phase. Main Outcome Measures Clinician administration adherence, surveys of perceptions, and organizational outcomes. Results Initial adherence to the GAB was 46% and increased to more than 85% after 6 months. These adherence levels remained consistent 48 months after implementation. Clinician perceptions of measure use were initially high (>63%), with significant improvements in knowledge and use of one measure after implementation. Conclusions We successfully implemented the assessment battery with high levels of adherence to recommendations, likely because of using the bundle of knowledge translation activities, facilitation, and use of a framework to codevelop the plan. These changes in practice were sustainable, as determined by a 4-year follow-up.
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    Protocol for the development of guidance for stakeholder engagement in health and healthcare guideline development and implementation
    (BMC, 2020-02-01) Petkovic, Jennifer; Riddle, Alison; Akl, Elie A.; Khabsa, Joanne; Lytvyn, Lyubov; Atwere, Pearl; Campbell, Pauline; Chalkidou, Kalipso; Chang, Stephanie M.; Crowe, Sally; Dans, Leonila; Jardali, Fadi El; Ghersi, Davina; Graham, Ian D.; Grant, Sean; Greer-Smith, Regina; Guise, Jeanne-Marie; Hazlewood, Glen; Janet, Janet; Katikireddi, S. Vittal; Langlois, Etienne V.; Lyddiatt, Anne; Maxwell, Lara; Morley, Richard; Mustafa, Reem A.; Nonino, Francesco; Pardo, Jordi Pardo; Pollock, Alex; Kevin, Kevin; Riva, John; Schünemann, Holger; Simeon, Rosiane; Smith, Maureen; Stein, Airton T.; Synnot, Anneliese; Tufte, Janice; White, Howard; Welch, Vivian; Concannon, Thomas W.; Tugwell, Peter; Social and Behavioral Sciences, School of Public Health
    Stakeholder engagement has become widely accepted as a necessary component of guideline development and implementation. While frameworks for developing guidelines express the need for those potentially affected by guideline recommendations to be involved in their development, there is a lack of consensus on how this should be done in practice. Further, there is a lack of guidance on how to equitably and meaningfully engage multiple stakeholders. We aim to develop guidance for the meaningful and equitable engagement of multiple stakeholders in guideline development and implementation. METHODS: This will be a multi-stage project. The first stage is to conduct a series of four systematic reviews. These will (1) describe existing guidance and methods for stakeholder engagement in guideline development and implementation, (2) characterize barriers and facilitators to stakeholder engagement in guideline development and implementation, (3) explore the impact of stakeholder engagement on guideline development and implementation, and (4) identify issues related to conflicts of interest when engaging multiple stakeholders in guideline development and implementation. DISCUSSION: We will collaborate with our multiple and diverse stakeholders to develop guidance for multi-stakeholder engagement in guideline development and implementation. We will use the results of the systematic reviews to develop a candidate list of draft guidance recommendations and will seek broad feedback on the draft guidance via an online survey of guideline developers and external stakeholders. An invited group of representatives from all stakeholder groups will discuss the results of the survey at a consensus meeting which will inform the development of the final guidance papers. Our overall goal is to improve the development of guidelines through meaningful and equitable multi-stakeholder engagement, and subsequently to improve health outcomes and reduce inequities in health.
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    PROTOCOL: Guidance for stakeholder engagement in guideline development: A systematic review
    (Wiley, 2022-05-11) Petkovic, Jennifer; Riddle, Alison; Lytvyn, Lyubov; Khabsa, Joanne; Akl, Elie A.; Welch, Vivian; Magwood, Olivia; Atwere, Pearl; Graham, Ian D.; Grant, Sean; John, Denny; Vittal Katikireddi, Srinivasa; Langlois, Etienne; Mustafa, Reem A.; Todhunter‐Brown, Alex; Schünemann, Holger; Smith, Maureen; Stein, Airton T.; Concannon, Tom; Tugwell, Peter; Epidemiology, Richard M. Fairbanks School of Public Health
    This is the protocol for a Campbell systematic review. The objectives are as follows: to identify, describe, and summarize existing guidance and methods for multistakeholder engagement throughout the health guideline development process.