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Determinants of Implementation of a Clinical Practice Guideline for Homeless Health

Clinical practice guidelines can improve the clinical and social care for marginalized populations, thereby improving health equity. The aim of this study is to identify determinants of guideline implementation from the perspective of patients and practitioner stakeholders for a homeless health guid...

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Autores principales: Magwood, Olivia, Hanemaayer, Amanda, Saad, Ammar, Salvalaggio, Ginetta, Bloch, Gary, Moledina, Aliza, Pinto, Nicole, Ziha, Layla, Geurguis, Michael, Aliferis, Alexandra, Kpade, Victoire, Arya, Neil, Aubry, Tim, Pottie, Kevin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7663114/
https://www.ncbi.nlm.nih.gov/pubmed/33138054
http://dx.doi.org/10.3390/ijerph17217938
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author Magwood, Olivia
Hanemaayer, Amanda
Saad, Ammar
Salvalaggio, Ginetta
Bloch, Gary
Moledina, Aliza
Pinto, Nicole
Ziha, Layla
Geurguis, Michael
Aliferis, Alexandra
Kpade, Victoire
Arya, Neil
Aubry, Tim
Pottie, Kevin
author_facet Magwood, Olivia
Hanemaayer, Amanda
Saad, Ammar
Salvalaggio, Ginetta
Bloch, Gary
Moledina, Aliza
Pinto, Nicole
Ziha, Layla
Geurguis, Michael
Aliferis, Alexandra
Kpade, Victoire
Arya, Neil
Aubry, Tim
Pottie, Kevin
author_sort Magwood, Olivia
collection PubMed
description Clinical practice guidelines can improve the clinical and social care for marginalized populations, thereby improving health equity. The aim of this study is to identify determinants of guideline implementation from the perspective of patients and practitioner stakeholders for a homeless health guideline. We completed a mixed-method study to identify determinants of equitable implementation of homeless health guidelines, focusing on the Grading of Recommendations Assessment, Development and Evaluation Feasibility, Acceptability, Cost, and Equity Survey (GRADE-FACE) health equity implementation outcomes. The study included a survey and framework analysis. Eighty-eight stakeholders, including practitioners and 16 persons with lived experience of homelessness, participated in the study. Most participants favourably rated the drafted recommendations’ priority status, feasibility, acceptability, cost, equity impact, and intent-to-implement. Qualitative analysis uncovered stakeholder concerns and perceptions regarding “fragmented services”. Practitioners were reluctant to care for persons with lived experience of homelessness, suggesting that associated social stigma serves as a barrier for this population to access healthcare. Participants called for improved “training of practitioners” to increase knowledge of patient needs and preferences. We identified several knowledge translation strategies that may improve implementation of guidelines for marginalized populations. Such strategies should be considered by other guideline development groups who aim to improve health outcomes in the context of limited and fragmented resources, stigma, and need for advocacy.
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spelling pubmed-76631142020-11-14 Determinants of Implementation of a Clinical Practice Guideline for Homeless Health Magwood, Olivia Hanemaayer, Amanda Saad, Ammar Salvalaggio, Ginetta Bloch, Gary Moledina, Aliza Pinto, Nicole Ziha, Layla Geurguis, Michael Aliferis, Alexandra Kpade, Victoire Arya, Neil Aubry, Tim Pottie, Kevin Int J Environ Res Public Health Article Clinical practice guidelines can improve the clinical and social care for marginalized populations, thereby improving health equity. The aim of this study is to identify determinants of guideline implementation from the perspective of patients and practitioner stakeholders for a homeless health guideline. We completed a mixed-method study to identify determinants of equitable implementation of homeless health guidelines, focusing on the Grading of Recommendations Assessment, Development and Evaluation Feasibility, Acceptability, Cost, and Equity Survey (GRADE-FACE) health equity implementation outcomes. The study included a survey and framework analysis. Eighty-eight stakeholders, including practitioners and 16 persons with lived experience of homelessness, participated in the study. Most participants favourably rated the drafted recommendations’ priority status, feasibility, acceptability, cost, equity impact, and intent-to-implement. Qualitative analysis uncovered stakeholder concerns and perceptions regarding “fragmented services”. Practitioners were reluctant to care for persons with lived experience of homelessness, suggesting that associated social stigma serves as a barrier for this population to access healthcare. Participants called for improved “training of practitioners” to increase knowledge of patient needs and preferences. We identified several knowledge translation strategies that may improve implementation of guidelines for marginalized populations. Such strategies should be considered by other guideline development groups who aim to improve health outcomes in the context of limited and fragmented resources, stigma, and need for advocacy. MDPI 2020-10-29 2020-11 /pmc/articles/PMC7663114/ /pubmed/33138054 http://dx.doi.org/10.3390/ijerph17217938 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Magwood, Olivia
Hanemaayer, Amanda
Saad, Ammar
Salvalaggio, Ginetta
Bloch, Gary
Moledina, Aliza
Pinto, Nicole
Ziha, Layla
Geurguis, Michael
Aliferis, Alexandra
Kpade, Victoire
Arya, Neil
Aubry, Tim
Pottie, Kevin
Determinants of Implementation of a Clinical Practice Guideline for Homeless Health
title Determinants of Implementation of a Clinical Practice Guideline for Homeless Health
title_full Determinants of Implementation of a Clinical Practice Guideline for Homeless Health
title_fullStr Determinants of Implementation of a Clinical Practice Guideline for Homeless Health
title_full_unstemmed Determinants of Implementation of a Clinical Practice Guideline for Homeless Health
title_short Determinants of Implementation of a Clinical Practice Guideline for Homeless Health
title_sort determinants of implementation of a clinical practice guideline for homeless health
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7663114/
https://www.ncbi.nlm.nih.gov/pubmed/33138054
http://dx.doi.org/10.3390/ijerph17217938
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