chal 3 final 2.5
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Challenge 3: Developing a D&I Template for Sustainability Across Settings
Mary Daly England, Kelli Gora, Jose Daniel Navarro, Jill Weinstein
NURS 738 – Group 8College of Nursing, University of Arizona
November 11, 2013
Translational Research Template
Problem
Evidence
DevelopmentImplementation
Evaluation
Factors affecting adoption
• Innovations penetrate homophilous groups more readily
Homophilous verses heterophilous groups
• Active dissemination is more effective
Passive dissemination verses active dissemination
• Relative advantage and compatibility
Characteristics of the intervention or innovation
• Norms and attitudes, organizational structure and process, resources
Contextual factors
Methods to measure penetration and adoption
•Individual provider/consumer
•Service providers’ acceptance of EBP aimed at reducing child neglect
SurveysInterviews
Administrative data
•Individual provider
•Organization or setting
SurveysInterviews
Administrative dataObservation
•RE-AIM/Reach
Case audits Checklists
•Change in knowledge, attitude, behavior, quality of life
•Change in organizational policies and practice
Outcome Indicators
sample
POWER TO REDUCE TYPE I
& TYPE II ERRORS
SIGNIFICANCE
LEVEL OF CONFIDENCE
EFFECT SIZEMARGIN OF
RANDOM ERROR
COST
Variability
Factors to be Considered in Determining Sample Size
(Fox, Hunn & Mathers, 2009;Bacchetti, McCullouch & Segal, 2008)
SAMPLE SIZE IS CRITICAL AND SHOULD BE REPRESENTITIVE AND GERNERALIZABLE TO THE WIDER WORLD.
Organization population size 1000Confidence interval 5%Confidence level 95%
n=286
(Israel, 2009)
Criteria for Determining Effectiveness of the Translational Intervention(s)
EFFECTIVENESS
APPROPRIATENESS
Practicability (focus groups)
ADOPTION
Uptake (survey)
ACCEPTABILITYSatisfaction
of the innovation (survey)
FEASIBILITY
Suitable for everyday use
(survey)
FIDELITY
Adherence (check-lists)
SUSTAINABILITY
Continuation (interviews)
PENETRATION
Level of utilization (case audit)
Taxonomy of implementation outcomes (Proctor et al., 2011)
Organizational Sustainability
Sustainability
Culture
Effectiveness
Stakeholders/ Champions
Integration
Dynamic Sustainability Framework
Ecological System
Practice Setting
Intervention
• Other Practice Settings• Policy• Regulations• Market Forces• Population Charateristics
• Staffing• Org Culture• Models• Education
• Components• Practitioners• Outcomes• Delivery Platform
FIT
FIT
FIT
Adapted from Chambers et al, DSF Model (2013)
Sustainability Strategies
SUSTAINABILITY STRATEGIES
Initial Planning
Key Participants
Integration with
Established Systems
ResourcesFinancial
Time Human
Ongoing Evaluation
Integration With EDSS
(Chambers et al., 2013; Shediac-Rizkallah & Bone, 1998; Scheirer, 2005)
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