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  4. Using Implementation Science to Guide the Process of Adapting a Patient Engagement Intervention for Inpatient Spinal Cord Injury/Disorder Rehabilitation

Using Implementation Science to Guide the Process of Adapting a Patient Engagement Intervention for Inpatient Spinal Cord Injury/Disorder Rehabilitation

Arch Phys Med Rehabil, 2022 · DOI: 10.1016/j.apmr.2022.04.010 · Published: November 1, 2022

Spinal Cord InjuryPatient ExperienceHealthcare

Simple Explanation

This study aimed to adapt an existing patient engagement program, enhanced medical rehabilitation (E-MR), for use in spinal cord injury rehabilitation using a structured approach. The researchers worked with a community advisory board (CAB) of clinicians, researchers, and a patient advocate to modify the program. The team identified key factors influencing patient engagement, revised intervention materials, and incorporated E-MR into hospital operations, while ensuring the core principles of the original intervention were maintained.

Study Duration
5 Months
Participants
Stakeholders from inpatient SCI/D rehabilitation (N=7) serving as a CAB and working with the research team (N=7)
Evidence Level
Not specified

Key Findings

  • 1
    Identified factors influencing patient engagement in SCI/D rehabilitation, such as therapist training and patient adjustment to new disabilities.
  • 2
    Revised intervention materials to better meet the needs of SCI/D rehabilitation, including modifications to personal goals interviews and therapy trackers.
  • 3
    Incorporated E-MR into the rehabilitation hospital's operations, coordinating with the CAB to store therapy trackers in the hospital system.

Research Summary

This study describes the process of adapting an evidence-based patient engagement intervention, E-MR, for inpatient SCI/D rehabilitation using an implementation science framework. The study applied the collaborative intervention planning framework and included a community advisory board (CAB) in an intervention mapping process. The CAB and research team implemented adaptations to E-MR, including identifying factors influencing patient engagement, revising intervention materials, incorporating E-MR into hospital operations, and retaining fidelity to the original intervention.

Practical Implications

Structured Adaptation Process

Demonstrates that structured processes guided by an implementation science framework can help researchers and clinicians identify adaptation targets.

Enhanced Patient Engagement

Adapting E-MR can potentially enhance the engagement of patients with SCI/D in therapy, leading to improved outcomes.

Practical Application of CIPF

Highlights the application of CIPF to customize the delivery and content of an intervention systematically, meeting clinical and organizational needs.

Study Limitations

  • 1
    Descriptive study; does not explore association or causation between adapted E-MR and patient outcomes.
  • 2
    Limited number of CAB sessions (5) and SCI/D rehabilitation stakeholders (7) due to budget constraints.
  • 3
    Only one SCI/D patient advocate with high level of function and extensive research experience participated.

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