A change in STRIDE: site-reported adaptations of an evidence-based inpatient mobility program
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Published on: January 29, 2016
Leah L Zullig1,2, Connor Drake1,2, Jaime M Hughes1,3
1Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, United States.
Background:
Hospital-based inactivity among older adults leads to functional decline. Mobility programs like STRIDE (assiSTed eaRly mobIlity for hospitalizeD older vEterans) are effective. Implementation in clinical settings and whether site-initiated adaptations are possible remain understudied.
Purpose:
To report adaptations to STRIDE across Veterans Affairs Medical Centers during implementation, using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME).
Methods:
Site-level contacts completed forms at pre-implementation, six months, and ten months, documenting adaptations. Adaptations were analyzed using collaborative coding to determine fidelity.
Results:
The adaptations were classified per FRAME criteria including timing, planning status, decision makers, modification type, delivery level, and fidelity consistency. All sites reported at least one adaptation. The largest number of adaptations per site was seven. This study demonstrates that hospitals can adapt an evidence-based program and maintain fidelity.
Conclusions:
We found in a large, nationwide implementation trial, site-initiated adaptations are possible. Promoting adaptability among implementing teams and designing interventions for adaptability is feasible.
Clinical Trials Registration:
ClinicalTrials.gov identifier NCT04868656; registered 1 June 2021.
