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Mental Health in the Community > Week 5: Implementation Outcomes > Flashcards

Week 5: Implementation Outcomes Flashcards

1
Q

A framework that categorizes implementation outcomes into different types (e.g., adoption, implementation, fidelity, sustainability).

A

Proctor’s Taxonomy

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2
Q

Deliberate and purposive actions to implement new treatments, practices and services.

A

Implementation Outcomes

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3
Q

3 Functions of Implementation Outcomes

A

1) Serve as indicators of implementation success
2) Proximal indicators of implementation processes
3) Key intermediate outcomes

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4
Q

Also referred to as the Implementation Outcomes Framework.

Aims to bring consistency and comparability to the field.

A

Proctor’s Taxonomy of Implementation Outcomes

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5
Q

Proctor’s 8 Taxonomy of Implementation Outcomes

A

1) Acceptability
2) Adoption
3) Appropriateness
4) Feasibility
5) Fidelity
6) Implementation Costs
7) Coverage/Reach
8) Sustainability

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6
Q

Perception amongst stakeholders that new intervention is agreeable.

A

Acceptability

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7
Q

Intention to apply or the application of a new intervention.

A

Adoption

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8
Q

Extent to which an intervention can be applied.

A

Feasibility

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8
Q

Perceived relevance of intervention to a setting, audience, or problem.

A

Appropriateness

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9
Q

Extent to which an intervention gets applied as originally designed/intended.

A

Fidelity

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10
Q

Costs of the delivery strategy, including the costs of the intervention itself.

A

Implementation Costs

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11
Q

Extent to which eligible patients/population actually receive intervention.

A

Coverage/Reach

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12
Q

Extent to which a new intervention becomes routinely available/is maintained post-introduction.

A

Sustainability

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13
Q

3 Types of Outcomes

A

1) Implementation outcomes: The “how” of the intervention
2) Service outcomes: The “quality” of the intervention
3) Patient/Client outcomes: The “impact” of the intervention

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14
Q

Focus on the process of implementing a new intervention, such as its adoption, fidelity, and sustainability.

A

Implementation Outcomes

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15
Q

Relate to the quality and efficiency of the intervention’s delivery, including factors like timeliness, safety, and equity.

A

Service Outcomes

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16
Q

Aims to understand and/or explain influences on implementation outcomes.

It assesses 39 constructs over five domains. The five domains include intervention characteristics, outer setting, inner setting, characteristics of individuals, and the process of implementation.

A

Consolidated Framework of Implementation Research (CFIR)

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17
Q

Measure the impact of the intervention on individuals, such as changes in their health, behavior, or well-being.

A

Patient/Client Outcomes

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18
Q

5 Domains in the Consolidated Framework for Implementation Research (CFIR)

A
  • Intervention characteristics (i.e., adaptability or complexity)
  • Outer setting (i.e., policy, regulations)
  • Inner construct (i.e., readiness for implementation)
  • Characteristics of individuals (i.e., staffattitudes, skills)
  • Process of implementation
19
Q

Aims to encourage greater attention to intervention elements that can improve the sustainable adoption and implementation of evidence-based interventions.

A

RE-AIM

20
Q

5 Dimensions Across Individual, Organizational, and Community Level (RE-AIM)

A

Reach
Effectiveness
Adoption
Implementation (i.e., fidelity)
Maintenance

21
Q

Key Considerations in Measuring Implementation Outcomes

A

Researcher Experience: The familiarity of researchers with different methods can influence their choice.

Available Resources: Time, budget, and expertise can constrain the options.

22
Q

How do we measure Implementation Outcomes?

A

1) Qualitative Interviews or Focus Groups
2) Surveys or Questionnaires
3) Observation
4) Routinely Collected Data

23
Q

Depth: Ideal for exploring in-depth perspectives from various stakeholders.
Resource-Intensive: Requires time, expertise, and analysis skills.

A

Qualitative Interviews or Focus Groups

24
Q

Efficiency: Can collect data from a larger sample.
Less Depth: Provides less detailed information than qualitative methods.

A

Surveys or Questionnaires

25
Q

Direct Assessment: Directly observes implementation practices.
Time-Consuming: Requires careful planning and observation.

A

Observation

26
Q

Efficiency: Leverages existing data sources.
Limitations: May not capture all relevant aspects of implementation.

A

Routinely Collected Data

26
Q

Key Considerations in Analyzing Implementation Outcomes

A

1) Level of Analysis
2) Implementation Stage
3) Measuring at Multiple Stages
4) Selecting measurement Tools

27
Q

Why do we validate implementation outcome instruments?

A
  • Lack of Consensus on which instruments used for measuring the same outcome
  • Inconsistencies in the outcomes reported
  • Variability in the quality of instruments
  • Optimal instrument uncertainty
  • Evidence-based hindrance
28
Q

This is the ability of a measure to detect change in an individual over time.

A

Responsiveness

29
Q

Refers to the consistency and dependability of a measurement tool.

A reliable instrument produces similar results when used repeatedly under the same conditions. In other words, it is free from random error.

A

Reliability

30
Q

Refers to the accuracy of a measurement tool. A valid instrument measures what it is intended to measure. In other words, it is free from systematic error.

A
30
Q

Is a type of error that occurs due to chance or unpredictable factors. It can cause a measurement to deviate from the true value in either a positive or negative direction.

A

Random Error

31
Q

Is a type of error that occurs consistently in the same direction. It causes measurements to deviate from the true value in a predictable way. Systematic errors are often caused by:

A

Systematic Error

32
Q

Consistency of scores over time.

A

Test-Retest Reliability

33
Q

Consistency of items within a questionnaire.

A

Internal Consistency

34
Q

The extent to which the instrument measures the intended construct.

A

Content Validity

35
Q

The extent to which the instrument measures the theoretical construct.

A

Construct Validity

36
Q

The correlation between the instrument and a criterion measure.

A

Criterion Validity

37
Q

Key Points on Reliability and Validity

A

Reliability Precedes Validity: A measure must be reliable before it can be valid.

Focus on Validity: Researchers often prioritize assessing validity over reliability.

Reliability is Necessary but Not Sufficient: A measure must be reliable (consistent) before it can be valid.

Reliability Does Not Imply Validity: A reliable measure may not necessarily be valid.

38
Q

The process of ensuring that a measurement instrument is appropriate and valid across different cultural groups.

A

Cross-cultural Validation

39
Q

Choose instruments that are practical, feasible, and appropriate for your research context.

A

Pragmatism

40
Q

Crowd-Sourced: Instrument developers add their own instruments.
No Validation Requirement: Any measure can be added, regardless of validation.

A

Grid Enabled Measures (GEM) Database

40
Q

Population: Mental health instruments.
Coverage: Includes instruments for all 39 CFIR constructs.
Access: Fee-paying members only (but instruments listed in open-access publications).

A

Society of Implementation Research Collaboration (SIRC)

41
Q

Is a comprehensive checklist designed to evaluate the methodological quality of psychometric studies. These studies examine the reliability and validity of measurement instruments, such as questionnaires, surveys, or tests.

A

ConPsy (Construct Psychology)

41
Q

Focus: Physical health instruments.
Features: Search by implementation outcome, view instrument summary, methodological quality assessment, ConPsy checklist, usability rating, and access to psychometric studies and instruments (where permitted).

A

Focus: Physical health instruments.
Features: Search by implementation outcome, view instrument summary, methodological quality assessment, ConPsy checklist, usability rating, and access to psychometric studies and instruments (where permitted).

Mental Health in the Community (22 decks)

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