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Barriers and facilitators to implementing pharmacist-driven mobile health clinics: Identification of implementation
Background:
Pharmacist-driven mobile health clinics (MHCs) offer an innovative solution to increasing health care access, yet limited information exists on barriers, facilitators, and strategies for their successful implementation.
Objectives:
To use implementation science methodology to identify strategies for implementing pharmacist-driven mobile-health clinics using the Consolidated Framework for Implementation Research (CFIR), Expert Recommendations for Implementing Change (ERIC) taxonomy, and CFIR-ERIC strategy matching tool.
Methods:
A secondary analysis was conducted on semi-structured interviews involving 16 participants from 10 pharmacist-driven MHCs. A mixed deductive strategy was applied where barrier and facilitator codes were inductively tagged, extracted, and mapped to CFIR constructs. Identified barriers mapped to CFIR constructs were matched into the CFIR-ERIC Strategy Matching Tool, which was based on expert consensus. Facilitators were mapped directly to ERIC strategies. A team consensus discussion was held to prioritize, select, and rank strategies to integrate into a pharmacist-driven MHC model.
Results:
The top 5 CFIR-ERIC matched strategies to address barriers were: 1) identify and prepare champions; 2) assess readiness and identify barriers and facilitators; 3) promote adaptability; 4) capture and share local knowledge; and 5) conduct local consensus discussions. The top 5 directly mapped ERIC strategies for facilitators included: 1) tailor strategies; 2) assess readiness and identify barriers and facilitators; 3) identify and prepare champions; 4) promote network weaving; and 5) work with educational institutions. After consensus discussion, 11 strategies were selected for our model incorporation and ranked based on team prioritization.
Conclusions:
Implementation science methodology provides a systematic approach to mitigate barriers, leverage facilitators, and select evidence-based strategies to enhance the implementation of pharmacist-driven MHCs. The findings of this project will be integrated into a pharmacist-driven MHC model to improve access to care and management of chronic disease in rural South Dakota.
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