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Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers

Overview of attention for article published in Implementation Science, July 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

news
3 news outlets
policy
1 policy source
twitter
10 tweeters

Citations

dimensions_citation
39 Dimensions

Readers on

mendeley
104 Mendeley
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Title
Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers
Published in
Implementation Science, July 2016
DOI 10.1186/s13012-016-0454-y
Pubmed ID
Authors

Cathleen Colón-Emeric, Mark Toles, Michael P. Cary, Melissa Batchelor-Murphy, Tracey Yap, Yuting Song, Rasheeda Hall, Amber Anderson, Andrew Burd, Ruth A. Anderson

Abstract

Little is known about the sustainability of behavioral change interventions in long-term care (LTC). Following a cluster randomized trial of an intervention to improve staff communication (CONNECT), we conducted focus groups of direct care staff and managers to elicit their perceptions of factors that enhance or reduce sustainability in the LTC setting. The overall aim was to generate hypotheses about how to sustain complex interventions in LTC. In eight facilities, we conducted 15 focus groups with 83 staff who had participated in at least one intervention session. Where possible, separate groups were conducted with direct care staff and managers. An interview guide probed for staff perceptions of intervention salience and sustainability. Framework analysis of coded transcripts was used to distill insights about sustainability related to intervention features, organizational context, and external supports. Staff described important factors for intervention sustainability that are particularly challenging in LTC. Because of the tremendous diversity in staff roles and education level, interventions should balance complexity and simplicity, use a variety of delivery methods and venues (e.g., group and individual sessions, role-play/storytelling), and be inclusive of many work positions. Intervention customizability and flexibility was particularly prized in this unpredictable and resource-strapped environment. Contextual features noted to be important include addressing the frequent lack of trust between direct care staff and managers and ensuring that direct care staff directly observe manager participation and support for the program. External supports suggested to be useful for sustainability include formalization of changes into facility routines, using "train the trainer" approaches and refresher sessions. High staff turnover is common in LTC, and providing materials for new staff orientation was reported to be important for sustainability. When designing or implementing complex behavior change interventions in LTC, consideration of these particularly salient intervention features, contextual factors, and external supports identified by staff may enhance sustainability. ClinicalTrial.gov, NCT00636675.

Twitter Demographics

The data shown below were collected from the profiles of 10 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 104 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Netherlands 1 <1%
Australia 1 <1%
Unknown 101 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 18 17%
Student > Master 17 16%
Student > Ph. D. Student 14 13%
Professor > Associate Professor 9 9%
Student > Doctoral Student 8 8%
Other 17 16%
Unknown 21 20%
Readers by discipline Count As %
Nursing and Health Professions 21 20%
Social Sciences 15 14%
Medicine and Dentistry 12 12%
Psychology 6 6%
Business, Management and Accounting 5 5%
Other 17 16%
Unknown 28 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 33. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 January 2021.
All research outputs
#883,487
of 20,150,223 outputs
Outputs from Implementation Science
#184
of 1,656 outputs
Outputs of similar age
#14,618
of 217,819 outputs
Outputs of similar age from Implementation Science
#1
of 11 outputs
Altmetric has tracked 20,150,223 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,656 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.5. This one has done well, scoring higher than 88% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 217,819 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 11 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.