Abstract
BackgroundWe developed and disseminated an educational DVD to introduce U.S. Veterans to independently-practiced complementary and alternative medicine (CAM) techniques and encourage CAM experimentation. The project’s goal was to determine optimal dissemination methods to facilitate implementation within the Veteran’s Health Administration.MethodsIn the first phase, the DVD was disseminated using four methods: passive, provider-mediated, active, and peer-mediated. In the second, implementation phase, “champion” providers who supported CAM integrated dissemination into clinical practice. Qualitative data came from Veteran focus groups and semi-structured provider interviews. Data from both phases was triangulated to identify common themes.ResultsEffective dissemination requires engaging patients. Providers who most successfully integrated the DVD into practice already had CAM knowledge, and worked in settings where CAM was accepted clinical practice, or with leadership or infrastructure that supported a culture of CAM use. Institutional buy-in allowed for provider networking and effective implementation of the tool. Providers were given autonomy to determine the most appropriate dissemination strategies, which increased enthusiasm and use.ConclusionsMany of the lessons learned from this project can be applied to dissemination of any new educational tool within a healthcare setting. Results reiterate the importance of utilizing best practices for introducing educational tools within the healthcare context and the need for thoughtful, multi-faceted dissemination strategies.
Highlights
We developed and disseminated an educational DVD to introduce U.S Veterans to independentlypracticed complementary and alternative medicine (CAM) techniques and encourage CAM experimentation
Analysis The current paper focuses on qualitative information from providers and Veterans during both phases of the project
Providers poised for optimal dissemination had preexisting CAM knowledge and were positioned to incorporate change For successful, sustained dissemination, providers need to have an interest and knowledge of the product While our initial dissemination focused on Veterans, we found that providing the tool to clinical champions was a better implementation strategy
Summary
We developed and disseminated an educational DVD to introduce U.S Veterans to independentlypracticed complementary and alternative medicine (CAM) techniques and encourage CAM experimentation. Greenhalgh et al [5] proposed three broad system antecedents for innovation, i.e. characteristics of a facility that facilitate the successful dissemination of educational tools These system antecedents include (1) institutions that are large and mature enough to incorporate changes, since smaller, newer institutions focus on more basic growth and have fewer resources; (2) preexisting knowledge base within the institution, to better integrate new materials; and (3) a receptive context for change, including appropriate leadership within an organization. They identified factors that enhance implementation once a system is ready for dissemination, including assigning decisionmaking to frontline medical teams and having good internal communication, thereby allowing providers to communicate dissemination strategies with one another
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