Evaluating Dissemination of AHRQ CER Products (Text Version)

Slide Presentation from the AHRQ 2011 Annual Conference

Slide presentation from the AHRQ 2011 conference.

Evaluating Dissemination of AHRQ CER Products

Slide Presentation from the AHRQ 2011 Annual Conference

On September 19, 2011, Darren Mays made this presentation at the 2011 Annual Conference. Select to access the PowerPoint® presentation (400 KB). Plugin Software Help.

Slide 1

Text Description is below the image.

Evaluating Dissemination of AHRQ Comparative Effectiveness Research (CER) Products

Darren Mays, PhD, MPH

Department of Oncology
Georgetown University Medical Center
Lombardi Comprehensive Cancer Center
Washington, DC

Slide 2

An image of Research to Practice Gap.

Research to Practice Gap

Image: A rope-bridge over water is shown.

Slide 3

Text Description is below the image.

How will iADAPT help?

  • Poised to make progress:
    • What approaches work? For whom? In what settings/conditions?
  • Presents an evaluation challenge:
    • Creative methods/approaches.
    • Diverse populations.
    • Different clinical areas.
  • Need for a flexible evaluation framework.

Slide 4

Text Description is below the image.

What is RE-AIM?

  • Evaluate public health impact.
  • Focus on dissemination.
  • Barriers include design, setting, approach.
  • Impact assessed on multiple domains.
  • RE-AIM domains:
    • Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance.

Glasgow, Vogt, & Boles, 1999; Glasgow, Lichtenstein, & Marcus, 2003.

Slide 5

Text Description is below the image.

RE-AIM Domains

  • Reach:
    • Did the CER products reach the intended population(s)?
      • Participation rate(s), characteristics, baseline "risk"
  • Efficacy/effectiveness:
    • What is the impact on intended outcomes?
      • Clinical outcomes, CER product utilization, occurrence of harms/unintended consequences.

Refer to RE-AIM domains handout; Glasgow et al., 2006.

Slide 6

Text Description is below the image.

RE-AIM Domains

  • Adoption:
    • Did the intended units use the CER product(s)?
      • Participation and characteristics of setting(s), delivery agents, barriers to adoption.
  • Implementation:
    • Were the CER products implemented as intended?
      • Adherence, fidelity, technical success.
  • Maintenance:
    • What is the long-term impact of CER products?
      • Long-term efficacy/effectiveness, sustained implementation, barriers to long-term use.

Refer to RE-AIM domains handout; Glasgow et al., 2006.

Slide 7

Text Description is below the image.

Determining Impact

  • Quantitatively determining impact.
  • Original application:
    • Reach x Efficacy = Impact.
  • RE-AIM overall impact:
    • Product of all 5 domains.
    • Requires quantifiable measures.

Glasgow, Vogt, Boles, 1999; Glasgow et al. 2006.

Slide 8

Text Description is below the image.

Application to iADAPT?

 REAIMAudience(s)Clinical Area(s)

In Person
CHW Outreach
Acad. Detailing

Med
Med		Med
Med		Low
Low		Low
Low		Low
Med		Patient
Provider		Diabetes
Diabetes

Group
CER Training
School
Group Therapy

Med
High
Low		Low
Low
Med		Med
Med
Med		Med
Low
Low		Med
Low
Med		Policy
Patient
Patient		Multiple
Heart Disease
Diabetes

eHealth
Clinic Kiosk
Web Patient Portal

Med
Med		Med
Med		Low
Med		High
High		Med
High		Patient
Patient &
Provider		Diabetes
Diabetes

Print/Media
Targeted Video

MedMedMedMedMedPatientHeart Disease

Slide 9

Text Description is below the image.

A Closer Look

Clinic Kiosk:

  • R: n = 200 patients.
    Well-controlled diabetes.
  • E: Small effect size.
    200 CERSGs (~1/pt.).
  • A: 75% of clinics.
  • I: 50% completion rate.
    Technical problems.
  • M: Few support resources.
    Limited patient interest.

Web Portal:

  • R: n = 1000 patients.
    Poor diabetes control.
  • E: Medium effect size.
    2,500 CERSGs (~2.5/pt.).
  • A: 100% of clinics.
  • I: 75% completion rate.
    Few technical problems.
  • M: Minimal maintenance.
    Low-direct cost to patients.

Slide 10

Text Description is below the image.

Conclusions

  • A flexible evaluation framework.
  • Multi-domain evaluation approach.
  • Identify facilitators, barriers, and future directions.
  • Creative approaches may be needed!

Slide 11

Text Description is below the image.

RE-AIM Resources

  • NCI DCCPS web site for RE-AIM:
  • Resources include:
    • Figures/graphics illustrating key concepts.
    • Checklists and planning tools.
    • Example measures.
    • Publications, presentation.

Slide 12

Text Description is below the image.

References

Bernhardt, JM, Mays, D, & Kreuter, MW. (2011). Dissemination 2.0: Closing the gap between knowledge and practice with new media. J Health Comm 16(S1), 32-44.

Glasgow, RE, Vogt, TM, & Boles, SM. (1999). Evaluating the public health impact of health promotion interventions: The RE-AIM framework. AJPH 89(9), 1322-1327.

Glasgow, RE, et al. (2001). The RE-AIM framework for evaluating interventions: What can it tell us about approaches to chronic illness management. Patient Ed. & Counsel 44, 119-127.

Glasgow, RE, Lichtenstein, E, & Marcus, AC. (2003). Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. AJPH 93(8), 1261-1267.

Glasgow, RE, et al. (2006). Using RE-AIM metrics to evaluate diabetes self-management support interventions. AJPM, 30(1), 67-73.

Current as of December 2011

Internet Citation:

Evaluating Dissemination of AHRQ CER Products. Slide Presentation from the AHRQ 2011 Annual Conference (Text Version). December 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/annualconf11/cravens_heisler_mays_safford_yelin/mays.htm

Current as of March 2012
Internet Citation: Evaluating Dissemination of AHRQ CER Products (Text Version): Slide Presentation from the AHRQ 2011 Annual Conference. March 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/conference/2011/mays/index.html