Implementation Science,
Год журнала:
2024,
Номер
19(1)
Опубликована: Фев. 16, 2024
Abstract
Background
A
myriad
of
federal,
state,
and
organizational
policies
are
designed
to
improve
access
evidence-based
healthcare,
but
the
impact
these
likely
varies
due
contextual
determinants
of,
reinterpretations
poor
compliance
with
policy
requirements
throughout
implementation.
Strategies
enhancing
implementation
intent
can
population
health.
Critically
assessing
multi-level
environments
where
health
their
related
services
implemented
is
essential
designing
effective
policy-level
strategies.
California
passed
a
2019
insurance
benefit
mandate
requiring
coverage
fertility
preservation
for
individuals
at
risk
infertility
medical
treatments,
in
order
that
otherwise
cost
prohibitive.
Our
objective
was
document
understand
environment,
relationships,
activities
involved
using
state
mandates
facilitate
patient
services.
Methods
We
conducted
mixed-methods
study
used
policy-optimized
exploration,
preparation,
implementation,
sustainment
(EPIS)
framework
analyze
California’s
(SB
600)
between
regulator,
insurer,
clinic
levels.
Results
Seventeen
publicly
available
mandate-relevant
documents
were
reviewed.
Interviews
four
insurers;
25
financial,
administrative,
provider
participants
from
16
oncology
clinics;
three
pharmaceutical
representatives;
two
advocates.
The
regulator
guidance
represented
“Big
P”
(system
level)
gave
rise
host
“little
p”
(organizational)
by
insurers,
clinics,
patients.
Many
little
p
bridging
factors
support
across
levels
service
access.
Characterizing
mandate’s
functions
(i.e.,
goals)
forms
ways
enacted)
led
identification
(1)
intended
unintended
service,
outcomes,
(2)
processes
level
EPIS
phase,
(3)
actor-delineated
key
heterogeneity
among
them,
(4)
inner
outer
context
drove
adaptations.
Conclusions
Following
midstream
downstream
mandate,
data
generated
will
enable
development
strategies,
evaluation
important
outcomes
design
future
fit
fidelity.
Frontiers in Health Services,
Год журнала:
2024,
Номер
4
Опубликована: Апрель 4, 2024
This
study's
aims
are
to:
(1)
Compare
the
acceptability
and
feasibility
of
five
types
implementation
strategies
that
could
be
deployed
to
increase
reach
evidence-based
practices
(EBPs)
with
revenue
from
policies
earmark
taxes
for
behavioral
health
services,
(2)
Illustrate
how
definitions
measures
can
used
in
policy-focused
science
research.
Frontiers in Health Services,
Год журнала:
2024,
Номер
4
Опубликована: Июль 15, 2024
Typical
quantitative
evaluations
of
public
policies
treat
as
a
binary
condition,
without
further
attention
to
how
are
implemented.
However,
policy
implementation
plays
an
important
role
in
the
impacts
behavioral
and
health
outcomes.
The
field
policy-focused
science
is
beginning
consider
may
be
conceptualized
analyses
(e.g.,
mediator
or
moderator),
but
less
work
has
considered
measure
for
inclusion
work.
To
help
address
this
gap,
we
discuss
four
design
considerations
researchers
interested
developing
identifying
measures
using
three
independent
NIH-funded
research
projects
studying
e-cigarette,
food,
mental
policies.
Mini
case
studies
these
were
developed
via
group
discussions;
used
logic
model
structure
our
discussions.
Design
include
(1)
clearly
specifying
under
study,
(2)
interdisciplinary
team
consisting
practitioners
with
expertise
methods,
law,
science,
subject
matter
knowledge,
(3)
mixed
methods
identify,
measure,
analyze
relevant
determinants
processes,
(4)
building
flexibility
into
project
timelines
manage
delays
challenges
due
real-world
nature
policy.
By
applying
their
own
work,
can
better
identify
develop
that
fit
needs.
experiences
highlighted
paper
reinforce
need
high-quality
transferrable
implementation,
area
where
collaboration
between
scientists
experts
could
particularly
fruitful.
These
measurement
practices
provide
foundation
build
on
incorporating
grows
will
ensure
more
complete
understanding
impact
Implementation Science Communications,
Год журнала:
2023,
Номер
4(1)
Опубликована: Март 31, 2023
Insufficient
funding
is
frequently
identified
as
a
critical
barrier
to
the
implementation
and
sustainment
of
evidence-based
practices
(EBPs).
Thus,
increasing
access
recognized
an
strategy.
Policies
that
create
earmarked
taxes-defined
taxes
for
which
revenue
can
only
be
spent
on
specific
activities-are
increasingly
common
mental
health
financing
strategy
could
improve
reach
EBPs.
This
project's
aims
are
(1)
identify
all
jurisdictions
in
USA
have
implemented
catalogue
information
about
tax
design;
(2)
characterize
experiences
implementing
among
local
(e.g.,
county,
city)
agency
leaders
other
government
community
organization
officials
assess
their
perceptions
acceptability
feasibility
different
types
policy
strategies;
(3)
develop
framework
guide
effect
designs,
inform
selection
strategies,
disseminate
audiences.The
project
uses
Exploration,
Preparation,
Implementation,
Sustainment
(EPIS)
data
collection
determinants
processes
Leeman's
typology
strategies
examine
support
implementation.
A
legal
mapping
will
conducted
achieve
aim
1.
To
2,
survey
300
involved
with
health.
The
followed
by
approximately
50
interviews
these
officials.
3,
quantitative
qualitative
integrated
through
systematic
development
dissemination
process.This
exploratory
process
study
build
evidence
base
outer-context
focusing
policies
services.
Implementation Science,
Год журнала:
2024,
Номер
19(1)
Опубликована: Фев. 16, 2024
Abstract
Background
A
myriad
of
federal,
state,
and
organizational
policies
are
designed
to
improve
access
evidence-based
healthcare,
but
the
impact
these
likely
varies
due
contextual
determinants
of,
reinterpretations
poor
compliance
with
policy
requirements
throughout
implementation.
Strategies
enhancing
implementation
intent
can
population
health.
Critically
assessing
multi-level
environments
where
health
their
related
services
implemented
is
essential
designing
effective
policy-level
strategies.
California
passed
a
2019
insurance
benefit
mandate
requiring
coverage
fertility
preservation
for
individuals
at
risk
infertility
medical
treatments,
in
order
that
otherwise
cost
prohibitive.
Our
objective
was
document
understand
environment,
relationships,
activities
involved
using
state
mandates
facilitate
patient
services.
Methods
We
conducted
mixed-methods
study
used
policy-optimized
exploration,
preparation,
implementation,
sustainment
(EPIS)
framework
analyze
California’s
(SB
600)
between
regulator,
insurer,
clinic
levels.
Results
Seventeen
publicly
available
mandate-relevant
documents
were
reviewed.
Interviews
four
insurers;
25
financial,
administrative,
provider
participants
from
16
oncology
clinics;
three
pharmaceutical
representatives;
two
advocates.
The
regulator
guidance
represented
“Big
P”
(system
level)
gave
rise
host
“little
p”
(organizational)
by
insurers,
clinics,
patients.
Many
little
p
bridging
factors
support
across
levels
service
access.
Characterizing
mandate’s
functions
(i.e.,
goals)
forms
ways
enacted)
led
identification
(1)
intended
unintended
service,
outcomes,
(2)
processes
level
EPIS
phase,
(3)
actor-delineated
key
heterogeneity
among
them,
(4)
inner
outer
context
drove
adaptations.
Conclusions
Following
midstream
downstream
mandate,
data
generated
will
enable
development
strategies,
evaluation
important
outcomes
design
future
fit
fidelity.
