将利益相关者的反纳入同行提供的初级保健健康计划的设计:一项快速的定性研究
Emily M Johnson1, Kyle Possemato2, Matthew Chinman3,4,5
1VA Center for Integrated Healthcare, Syracuse VA Medical Center, 800 Irving Ave. (116C), Syracuse, NY, 13210, USA. Emily.Johnson1@va.gov.
BMC health services research
|December 7, 2023
概括
初级保健行为健康干预措施可以在同行支持下得到改善. 全身健康STEPS计划根据工作人员的反进行了调整,以更好地将同行支持纳入退伍军人初级保健机构.
科学领域:
- 实施科学 实施科学
- 初级保健 行为健康 行为健康
- 同行支持干预措施 同行支持干预
背景情况:
- 在初级保健中有行为健康问题的人可能会从同行支持中受益,如果他们拒绝正式治疗.
- 整体健康STEPS是退伍军人的一种新干预措施,在初级保健中整合了同行支持和分步护理模式.
- 纳入了利益相关者的反,以提高干预对退伍军人,同行和初级保健环境的适用性.
研究的目的:
- 根据初级保健工作人员 (包括同事) 的定性反,调整整体健康STEPS干预措施.
- 识别和解决实施整体健康STEPS的潜在障碍和促进因素.
- 改进干预的设计,以优化其适应现有的初级保健结构,并最大限度地提高同行支持的有效性.
主要方法:
- 在9个同行计划中,与16名VA工作人员 (8名同行,8名监督员/管理员) 进行了半结构化的定性访谈.
- 采访采用了实施研究综合框架 (CFIR) 的问题,并使用快速定性分析方法进行分析.
- 适应整体健康的STEPS被使用适应和修改增强框架 (FRAME) 编目,VA同行积极参与该过程.
主要成果:
- 关键的反主题包括利用同行导航技能,确保以患者为中心和灵活的设计,并优化效率 (例如,会话长度).
- 确定了与现有职位 (例如,全身健康教练) 的角色冲突,导致修改,以定义全身健康STEPS同行的独特角色.
- 工作人员为推广材料和培训提供了建议,以支持干预的推广.
结论:
- 前线工作人员和同行反对于识别整体健康STEPS的关键修改至关重要.
- 该干预成功地适应了多样化的项目结构,突出了独特的同行贡献,并简化了交付.
- 从整体健康STEPS调整中吸取的经验教训可以为其他医疗保健干预措施的开发和实施提供信息.
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