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

      Abstract

      Objectives

      This study aimed to describe the process of adapting an evidence-based patient engagement intervention, enhanced medical rehabilitation (E-MR), for inpatient spinal cord injury/disease (SCI/D) rehabilitation using an implementation science framework.

      Design

      We applied the collaborative intervention planning framework and included a community advisory board (CAB) in an intervention mapping process.

      Setting

      A rehabilitation hospital.

      Participants

      Stakeholders from inpatient SCI/D rehabilitation (N=7) serving as a CAB and working with the research team (N=7) to co-adapt E-MR.

      Interventions

      E-MR.

      Main Outcome Measures

      Logic model and matrices of change used in CAB meetings to identify areas of intervention adaptation.

      Results

      The CAB and research team implemented adaptations to E-MR, including (1) identifying factors influencing patient engagement in SCI/D rehabilitation (eg, therapist training); (2) revising intervention materials to meet SCI/D rehabilitation needs (eg, modified personal goals interview and therapy trackers to match SCI needs); (3) incorporating E-MR into the rehabilitation hospital's operations (eg, research team coordinated with CAB to store therapy trackers in the hospital system); and (4) retaining fidelity to the original intervention while best meeting the needs of SCI/D rehabilitation (eg, maintained core E-MR principles while adapting).

      Conclusions

      This study demonstrated that structured processes guided by an implementation science framework can help researchers and clinicians identify adaptation targets and modify the E-MR program for inpatient SCI/D rehabilitation.

      Keywords

      List of abbreviations:

      CAB (community advisory board), CBPR (community-based participatory research), CIPF (collaborative intervention planning framework), D&I (dissemination and implementation), E-MR (enhanced medical rehabilitation), OT (occupational therapist), PCC (patient-centered care), PT (physical therapist), SCI/D (spinal cord injury/disease), IM (intervention mapping)
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