Difference-Making Conditions for the Successful Implementation of IDEAS: A Provider Stigma-Reduction Training for and...

Area of Science:

• Health Services Research
• Occupational Therapy
• Implementation Science

Background:

• Identity Development Evolution and Sharing (IDEAS) is an evidence-supported occupational therapy intervention designed to reduce provider stigma and enhance health care equity.
• Effective implementation of IDEAS is critical for its success in promoting fair and inclusive healthcare practices.
• Identifying key factors that influence IDEAS implementation is essential for optimizing its impact.

Purpose of the Study:

• To identify critical conditions that determine the successful implementation of the IDEAS intervention within occupational therapy settings.
• To examine the relationship between implementation facilitators and the effectiveness of IDEAS in reducing provider stigma.

Main Methods:

• The study involved nine occupational therapy clinical sites, with data collected from 58 participants including facilitators, staff, and managers.
• Data sources included interviews (using the Consolidated Framework for Implementation Research), validated scales (AIM, IAM, FIM), and the Acceptance and Action Questionnaire-Stigma.
• Coincidence analysis was employed to pinpoint key difference-makers directly influencing implementation success and intervention effectiveness.

Main Results:

• Two primary difference-makers for successful IDEAS implementation were identified: the quality of design and packaging of the intervention, and the impact of external facilitation.
• Successful implementation was achieved when sites had either strong design quality and packaging, or a combination of lower design quality with strong external facilitation.
• Positive perceptions of the IDEAS program and a receptive workplace culture were also associated with better intervention outcomes.

Conclusions:

• Beyond selecting effective interventions, careful consideration of implementation factors is vital for occupational therapy practitioners to improve clinical practice and client outcomes.
• Optimizing the design and packaging of interventions, alongside providing robust external facilitation, can significantly enhance the successful adoption of evidence-based practices like IDEAS.
• These findings underscore the importance of implementation science in bridging the gap between evidence-based interventions and real-world healthcare settings to achieve health equity.