Strategies for Implementing Evidence-Based Interventions Into Practice With Community-Dwelling Older Adults

Abstract

Date Presented 04/04/19

Because of the rapid growth of the older adult population, the OT profession is currently faced with the urgent need to implement effective interventions into practice to meet the needs of community-dwelling older adults. We conducted a scoping review of the OT literature to identify effective implementation strategies for integrating research into practice with older clients. Strategies ranged from interactive workshops and consultations to fidelity vignettes and peer mentoring.

Primary Author and Speaker: Lisa Juckett

Additional Authors and Speakers: Monica Robinson

PURPOSE: Various interventions have been designed to enhance occupational engagement for older adults, ranging from fall prevention programs to dementia caregiver trainings. Although these interventions may be promising, the actual implementation of evidence-based interventions into practice with older adults can present an array of challenges. Such challenges have included practitioners’ lack of time, difficulties interpreting evidence, and concerns surrounding the adaptability of interventions, all of which contribute to the widespread research-to-practice gap.

Because of the rapid growth of the older adult population, the occupational therapy profession is currently faced with the urgent need to implement effective interventions into practice to meet the needs of older clients. To explore what strategies influence the uptake of evidence-based interventions for older adults into practice, we performed a scoping review of the occupational therapy literature. We applied concepts from the implementation science field to guide our review process.

DESIGN: Our search process involved five electronic databases, 11 occupational therapy journals, and two implementation science journals. We identified key terms to incorporate into our search strategy based on our interdisciplinary collaboration with an implementation scientist.

The lead authors agreed on search parameters before selecting relevant studies. Inclusion criteria included studies that were published between 2002-2017; targeted community-dwelling older adults age 55 and older; were conducted in developed countries; and utilized qualitative, quantitative, and/or mixed-methods approaches. Exclusion criteria included studies that highlighted disciplines other than occupational therapy (e.g. physical therapy, nursing); measured older client outcomes only (e.g. did not measure implementation); were presented as a review paper; and were not yet conducted (e.g. study protocols).

METHOD: We established two processes when synthesizing the results from our review: a descriptive summary and a thematic analysis. Our descriptive summary presented details about the number and type of studies included, where the studies were conducted, and characteristics about implementation strategies/outcomes. We utilized a thematic analysis approach to identify implementation commonalities across studies.

RESULTS: Of 1036 original references, 46 were selected for full-text review, and 9 articles were included in our final review of implementation strategies. We identified exploratory (n = 3), experimental (n = 3), and descriptive (n = 3) studies measuring the implementation of occupational therapy interventions/activities. Strategies used to enhance the adoption of evidence-based interventions into practice included the following: interactive workshops, follow-up consultations, fidelity vignettes, peer mentoring, outreach meetings, and online resources. Specific implementation outcomes measured included adoption, acceptability, fidelity, appropriateness, sustainability, and feasibility.

CONCLUSION: Our findings indicate that multiple strategies have been utilized to enhance the implementation of evidence-based intervention with older adults. While these strategies have been found effective for promoting the use of evidence into practice, further research is warranted to explain the components of each strategy, enhancing their replicability across practice settings.

IMPACT STATEMENT: By utilizing effective strategies to increase the uptake of evidence into practice, occupational therapy researchers, practitioners, and administrators can begin to decrease the research-to-practice gap, thereby improving the well-being and occupational performance of community-dwelling older adults.

References

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