Implementing Community-Created Self-Management Support Tools in Primary Care Practices: Multimethod Analysis From the...

Area of Science:

• Primary Care Research
• Health Services Research
• Implementation Science

Background:

• Over half of Americans are projected to have chronic conditions, necessitating improved patient self-management support (SMS).
• Implementing routine SMS in primary care is challenging, with limited understanding of the necessary practice conditions for success.

Purpose of the Study:

• To identify practice conditions essential for the successful implementation of patient-centered self-management support (SMS) tools in primary care settings.
• To explore the factors influencing the adoption and integration of new SMS interventions within existing healthcare workflows.

Main Methods:

• Employed a boot camp translation process involving 16 primary care practices across four practice-based research networks (PBRNs).
• Utilized qualitative case comparison and qualitative comparative analysis, guided by the Consolidated Framework for Implementation Research.
• Data collection involved patients, clinicians, and care managers from each participating practice over a 2-month period.

Main Results:

• Four key practice conditions influenced SMS tool implementation: functional organization, enabling systems for change, a visible champion, and synergy with other work.
• An enabling system, a visible champion, and synergy were identified as necessary for minimal implementation.
• Sufficiency testing did not consistently explain the conditions required for successful new SMS tool implementation.

Conclusions:

• Minimum necessary conditions for rapid implementation of tailored SMS tools include an enabling system, a visible champion, and synergy with other work.
• While these conditions are necessary, they are not sufficient on their own to guarantee successful implementation of SMS tools.
• Further research is needed to fully elucidate the complex factors ensuring robust implementation of patient self-management support interventions.