%0 Journal Article
%T From Intervention to Innovation: Applying a Formal Implementation Strategy in Community Primary Care
%A Andrea S. Wallace
%A Andrew L. Sussman
%A Mark Anthoney
%A Edith A. Parker
%J Nursing Research and Practice
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/605757
%X Objective. To describe a comprehensive strategy for implementing an effective diabetes self-management support intervention incorporating goal-setting and followup support in community health clinics (CHCs) serving vulnerable patients. Methods. The Replicating Effective Programs (REP) framework was applied to develop an intervention strategy. In order to create a strategy consistent with the REP framework, four CHCs engaged in an iterative process involving key-informant interviews with clinic staff, ongoing involvement of clinic staff facilitating translational efforts, feedback from national experts, and an instructional designer. Results. Moving through the REP process resulted in an implementation strategy that aims to facilitate commitment, communication, and change at the clinic level, as well as means of providing interactive, time-limited education about patient behavior change and support to health care providers. Conclusion. The REP offered a useful framework for providing guidance toward the development of a strategy to implement a diabetes self-management intervention in CHCs serving medically underserved and underrepresented patient populations. 1. Introduction Effective patient self-management has been demonstrated to prevent adverse clinical outcomes from diabetes [1, 2]. While research has examined factors that influence patient receptivity and use of self-management skills, there has been less attention to the delivery of diabetes education and support in primary care settings, where most patients receive this counseling [3¨C5]. In fact, the quality of diabetes self-management support delivered in primary care falls short of that demonstrated to improve outcomes. Delivering even basic diabetes education is challenging to busy primary health clinics, much less providing ongoing support which addresses the many factors influencing patientsĄŻ ability to make significant lifestyle changes and integrate complex tasks into their daily lives such as problem-solving, collaboration, psychosocial issues, and behavior change skills [3, 4, 6]. Collaborative goal-setting between health care providers and patients has been proposed as a strategy for providing diabetes-related self-management support in busy primary care settings [7, 8]. Because research suggests that goal-setting increases patientsĄŻ self-efficacy and motivation to continue developing and maintaining self-management behaviors [9¨C11], goal-setting is now a common strategy in the more comprehensive Diabetes Self-Management Education curricula reimbursed by the Centers for Medicare and
%U http://www.hindawi.com/journals/nrp/2013/605757/