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RE- AIM Plus To Evaluate Effective Dissemination of AHRQ CER Products

RE- AIM Plus To Evaluate Effective Dissemination of AHRQ CER Products. Michele Heisler, MD, MPA September, 2011. Web-Based Tool to Facilitate Diabetes Medications Decision-making (AHRQ R18, Heisler). i Decide

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RE- AIM Plus To Evaluate Effective Dissemination of AHRQ CER Products

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  1. RE-AIMPlus To Evaluate Effective Dissemination of AHRQ CER Products Michele Heisler, MD, MPA September, 2011

  2. Web-Based Tool to Facilitate Diabetes Medications Decision-making(AHRQ R18, Heisler) iDecide • Assessing the use of a web-based, interactive, tailored decision tool in improving diabetes health outcomes Decido • Evaluando el uso de un herramienta de decisión en mejorar los resultados de la salud en pacientes con diabetes

  3. Definition of Tailoring • assess an individual’s characteristics relevant to the behavior • Use assessment data to generate messages relevant to that individual’s specific needs • Deliver these messages in a clear, vivid—and interactive--format

  4. iDecide • Project description • Community health worker (CHW)-delivered intervention to improve knowledge of diabetes medications among low-literacy, low-income adults (Latinos and African Americans) with poor glycemic control/reported medication problems • 2 arms (n=210) • Control group: reviews the static, paper AHRQ patient guide with a CHW • Intervention group: reviews the tailored, web-based program with a CHW

  5. Goals of the study Aim 1: (Work together to)Build an interactive, tailored diabetes medication decision aid to help people: • Assess their treatment goals • Identify personal preferences and concerns • Understand options for improving their diabetes care (when appropriate)

  6. Goals of the study Aim 2: Compare the tailored tool with the print AHRQ CER guides on participant: • Knowledge of medications • Satisfaction with information • Decisional conflict

  7. Goals of the study Aim 3: Look at how the tool affects: • Participant changes to medication • Self-reported medication adherence • Participant beliefs about medication • A1c levels

  8. What do qualitative methods add to implementation evaluation? • Use open-ended techniques, e.g., interviews, observation • Goal is understanding, rather than measurement • Get into the “black box” • Uncover the whys and hows behind quantitative measures • Identify and understand implementation processes, how influenced by context and how affect implementation success

  9. Development of RE-AIM Plus • Systematically review each RE-AIM dimension and create open-ended questions • Add information sources and data analyses to address

  10. RE-AIM Plus: Reach

  11. RE-AIM Plus: Effectiveness

  12. RE-AIM Plus: Implementation

  13. RE-AIM Plus: Maintenance

  14. Methods: Effective procedures and instruments to systematically collect data Multiple data sources Data management system to facilitate data retrieval Including real time Important Methods Considerations

  15. Concluding Thoughts RE-AIM Plus: • Useful in generating context-specific and generalizable information on implementation • Allows understanding of implementation mechanisms behind both process and outcome measures • May improve ways to adapt implementation in real time and increase likelihood of success when interventions are disseminated

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