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Evaluating Dissemination of AHRQ CER Products

Evaluating Dissemination of AHRQ CER Products. Darren Mays, PhD, MPH Department of Oncology Georgetown University Medical Center Lombardi Comprehensive Cancer Center Washington, DC. Research to Practice Gap. Bernhardt, Mays, & Kreuter, 2011. How will iADAPT help?.

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Evaluating Dissemination of AHRQ CER Products

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  1. Evaluating Dissemination of AHRQ CER Products Darren Mays, PhD, MPH Department of Oncology Georgetown University Medical Center Lombardi Comprehensive Cancer Center Washington, DC

  2. Research to Practice Gap Bernhardt, Mays, & Kreuter, 2011

  3. How will iADAPT help? • Poised to make progress • What approaches work? For whom? In what settings/conditions? • Presents an evaluation challenge • Creative methods/approaches • Diverse populations • Different clinical areas • Need for a flexible evaluation framework

  4. What is RE-AIM? • Evaluate public health impact • Focus on dissemination • Barriers include design, setting, approach • Impact assessed on multiple domains • RE-AIM domains: • Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance Glasgow, Vogt, & Boles, 1999; Glasgow, Lichtenstein, & Marcus, 2003

  5. RE-AIM Domains • Reach • Did the CER products reach the intended population(s)? • Participation rate(s), characteristics, baseline “risk” • Efficacy/effectiveness • What is the impact on intended outcomes? • Clinical outcomes, CER product utilization, occurrence of harms/unintended consequences Refer to RE-AIM domains handout; Glasgow et al., 2006

  6. RE-AIM Domains • Adoption • Did the intended units use the CER product(s)? • Participation and characteristics of setting(s), delivery agents, barriers to adoption • Implementation • Were the CER products implemented as intended? • Adherence, fidelity, technical success • Maintenance • What is the long-term impact of CER products? • Long-term efficacy/effectiveness, sustained implementation, barriers to long-term use Refer to RE-AIM domains handout; Glasgow et al., 2006

  7. Determining Impact • Quantitatively determining impact • Original application • Reach x Efficacy = Impact • RE-AIM overall impact • Product of all 5 domains • Requires quantifiable measures Glasgow, Vogt, Boles, 1999; Glasgow et al. 2006

  8. Application to iADAPT? Adapted from Glasgow et al., 2001

  9. A Closer Look Clinic Kiosk Web Portal R: n = 1,000 patientsPoor diabetes control E: Medium effect size2,500 CERSGs (~2.5/pt.) A: 100% of clinics I: 75% completion rate Few technical problems M: Minimal maintenanceLow-cost to direct patients • R: n = 200 patientsWell-controlled diabetes • E: Small effect size200 CERSGs (~1/pt.) • A: 75% of clinics • I: 50% completion rate Technical problems • M: Few support resourcesLimited patient interest

  10. Conclusions • A flexible evaluation framework • Multi-domain evaluation approach • Identify facilitators, barriers, and future directions • Creative approaches may be needed!

  11. RE-AIM Resources • NCI DCCPS web site for RE-AIM • http://cancercontrol.cancer.gov/IS/REAIM • Resources include: • Figures/graphics illustrating key concepts • Checklists and planning tools • Example measures • Publications, presentation

  12. References Bernhardt, JM, Mays, D, & Kreuter, MW. (2011). Dissemination 2.0: Closing the gap between knowledge and practice with new media. J Health Comm, 16(S1), 32-44 Glasgow, RE, Vogt, TM, & Boles, SM. (1999). Evaluating the public health impact of health promotion interventions: The RE-AIM framework. AJPH, 89(9), 1322-1327 Glasgow, RE, et al. (2001). The RE-AIM framework for evaluating interventions: What can it tell us about approaches to chronic illness management. Patient Ed. & Counsel., 44, 119-127. Glasgow, RE, Lichtenstein, E, & Marcus, AC. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. AJPH, 93(8), 1261-1267 Glasgow, RE, et al. (2006). Using RE-AIM metrics to evaluate diabetes self-management support interventions. AJPM, 30(1), 67-73

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