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Item Alpha test results for a Housing First eLearning strategy: the value of multiple qualitative methods for intervention design(BMC, 2017-10-31) Ahonen, Emily Q.; Watson, Dennis P.; Adams, Erin L.; McGuire, Alan; Health Policy and Management, School of Public HealthBackground Detailed descriptions of implementation strategies are lacking, and there is a corresponding dearth of information regarding methods employed in implementation strategy development. This paper describes methods and findings related to the alpha testing of eLearning modules developed as part of the Housing First Technical Assistance and Training (HFTAT) program’s development. Alpha testing is an approach for improving the quality of a product prior to beta (i.e., real world) testing with potential applications for intervention development. Methods Ten participants in two cities tested the modules. We collected data through (1) a structured log where participants were asked to record their experiences as they worked through the modules; (2) a brief online questionnaire delivered at the end of each module; and (3) focus groups. Results The alpha test provided useful data related to the acceptability and feasibility of eLearning as an implementation strategy, as well as identifying a number of technical issues and bugs. Each of the qualitative methods used provided unique and valuable information. In particular, logs were the most useful for identifying technical issues, and focus groups provided high quality data regarding how the intervention could best be used as an implementation strategy. Conclusions Alpha testing was a valuable step in intervention development, providing us an understanding of issues that would have been more difficult to address at a later stage of the study. As a result, we were able to improve the modules prior to pilot testing of the entire HFTAT. Researchers wishing to alpha test interventions prior to piloting should balance the unique benefits of different data collection approaches with the need to minimize burdens for themselves and participants. Electronic supplementary material The online version of this article (10.1186/s40814-017-0187-y) contains supplementary material, which is available to authorized users.Item Do the benefits continue? Long term impacts of the Anatomy Education Research Institute (AERI) 2017(BMC, 2022-11-24) Husmann, Polly R.; Brokaw, James J.; O’Loughlin, Valerie Dean; Anatomy, Cell Biology and Physiology, School of MedicineBackground: The Anatomy Education Research Institute (AERI) was held in Bloomington, Indiana in July of 2017. Previous research has shown that AERI was successful in meeting Kirkpatrick's first two levels of evaluation via positive initial reactions and learning gains identified at the end of AERI. This manuscript demonstrates continued success in Kirkpatrick levels two and three via six-month and thirty-month follow-up surveys and nine-month follow-up focus groups and interviews. Methods: Quantitative analyses were completed using Microsoft Excel (2019) and SPSS version 26 while qualitative analyses were completed for both survey responses and focus groups/interviews using thematic analyses. Results: Results demonstrate that the learning gains seen immediately post-AERI 2017 were sustained for all participants (accepted applicants and invited speakers). Qualitative results continued to demonstrate positive reactions to AERI 2017. Both quantitative and qualitative results demonstrated that the main obstacle to educational research for most participants is time, while collaboration, IRB, institutional roadblocks, and devaluing of educational research were also identified as obstacles. Conclusions: The research presented here indicates positive outcomes to Kirkpatrick Levels 1, 2, & 3 of evaluation following AERI 2017. However, substantial obstacles still exist for researchers in medical education. The need for a sustained community of practice for educational researchers was suggested as a potential buffer against these obstacles and multiple options for providing that community are discussed.Item The housing first technical assistance and training (HFTAT) implementation strategy: outcomes from a mixed methods study of three programs(Biomed Central, 2018-09-21) Watson, Dennis P.; Ahonen, Emily Q.; Shuman, Valery; Brown, Molly; Tsemberis, Sam; Huynh, Philip; Ouyang, Fangqian; Xu, Huiping; Social and Behavioral Sciences, School of Public HealthBACKGROUND: This paper discusses the initial testing of the Housing First Training and Technical Assistance (HFTAT) Program, a multifaceted, distance-based strategy for the implementation of the Housing First (HF) supportive housing model. HF is a complex housing intervention for serving people living with serious mental illness and a substance use disorder that requires significant individual- and structural-level changes to implement. As such, the HFTAT employs a combined training and consultation approach to target different levels of the organization. Training delivered to all organizational staff focuses on building individual knowledge and uses narrative storytelling to overcome attitudinal implementation barriers. Consultation seeks to build skills through technical assistance and fidelity audit and feedback. METHOD: We employed a mixed method design to understand both individual-level (e.g., satisfaction with the HFTAT, HF knowledge acquisition and retention, and HF acceptability and appropriateness) and structural-level (e.g., fidelity) outcomes. Quantitative data were collected at various time points, and qualitative data were collected at the end of HFTAT activities. Staff and administrators (n = 113) from three programs across three states participated in the study. RESULTS: Satisfaction with both training and consultation was high, and discussions demonstrated both activities were necessary. Flexibility of training modality and narrative storytelling were particular strengths, while digital badging and the community of practice were perceived as less valuable because of incompatibilities with the work context. HF knowledge was high post training and retained after 3-month follow-up. Participants reported training helped them better understand the model. Attitudes toward evidence-based interventions improved over 6 months, with qualitative data supporting this but demonstrating some minor concerns related to acceptability and appropriateness. Fidelity scores for all programs improved over 9 months. CONCLUSION: The HFTAT was a well-liked and generally useful implementation strategy. Results support prior research pointing to the value of both (a) multifaceted strategies and (b) combined training and consultation approaches. The study also provides evidence for narrative storytelling as an approach for changing attitudinal implementation barriers. The need for compatibility between specific elements of an implementation strategy and the work environment was also observed.Item Seeding Structures for a Community of Practice Focused on Transient Ischemic Attack (TIA): Implementing Across Disciplines and Waves(Springer, 2021-02) Penney, Lauren S.; Homoya, Barbara J.; Damush, Teresa M.; Rattray, Nicholas A.; Miech, Edward J.; Myers, Laura J.; Baird, Sean; Cheatham, Ariel; Bravata, Dawn M.; Medicine, School of MedicineBackground: The Community of Practice (CoP) model represents one approach to address knowledge management to support effective implementation of best practices. Objective: We sought to identify CoP developmental strategies within the context of a national quality improvement project focused on improving the quality for patients receiving acute transient ischemic attack (TIA) care. Design: Stepped wedge trial. Participants: Multidisciplinary staff at six Veterans Affairs medical facilities. Interventions: To encourage site implementation of a multi-component quality improvement intervention, the trial included strategies to improve the development of a CoP: site kickoff meetings, CoP conference calls, and an interactive website (the "Hub"). Approach: Mixed-methods evaluation included data collected through a CoP attendance log; semi-structured interviews with site participants at 6 months (n = 32) and 12 months (n = 30), and CoP call facilitators (n = 2); and 22 CoP call debriefings. Key results: The critical seeding structures that supported the cultivation of the CoP were the kickoffs which fostered relationships (key to the community element of CoPs) and provided the evidence base relevant to TIA care (key to the domain element of CoPs). The Hub provided the forum for sharing quality improvement plans and other tools which were further highlighted during the CoP calls (key to the practice element of CoPs). CoP calls were curated to create a positive context around participants' work by recognizing team successes. In addition to improving care at their local facilities, the community created a shared set of tools which built on their collective knowledge and could be shared within and outside the group. Conclusions: The PREVENT CoP advanced the mission of the learning healthcare system by successfully providing a forum for shared learning. The CoP was grown through seeding structures that included kickoffs, CoP calls, and the Hub. A CoP expands upon the learning collaborative implementation strategy as an effective implementation practice.