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  1. Article ; Online: Adopting the RE-AIM analytic framework for rural program evaluation: experiences from the Advance Care Planning via Group Visits (ACP-GV) national evaluation.

    Matthieu, Monica M / Taylor, Laura D / Adkins, David A / Williams, J Silas / Hu, Bo / Oliver, Ciara M / McCullough, Jane Ann / Mallory, Mary J / Smith, Ian D / Painter, Jacob T / Ounpraseuth, Songthip T / Garner, Kimberly K

    Frontiers in health services

    2024  Volume 4, Page(s) 1210166

    Abstract: Introduction: To support rigorous evaluation across a national portfolio of grants, the United States Department of Veterans Affairs (VA) Office of Rural Health (ORH) adopted an analytic framework to guide their grantees' evaluation of initiatives that ... ...

    Abstract Introduction: To support rigorous evaluation across a national portfolio of grants, the United States Department of Veterans Affairs (VA) Office of Rural Health (ORH) adopted an analytic framework to guide their grantees' evaluation of initiatives that reach rural veterans and to standardize the reporting of outcomes and impacts. Advance Care Planning via Group Visits (ACP-GV), one of ORH's Enterprise-Wide Initiatives, also followed the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. ACP-GV is a national patient-centered intervention delivered in a large, veterans integrated healthcare system. This manuscript describes how RE-AIM was used to evaluate this national program and lessons learned from ORH's annual reporting feedback to ACP-GV on their use of the framework to describe evaluation impacts.
    Methods: We used patient, provider, and site-level administrative health care data from the VA Corporate Data Warehouse and national program management databases for federal fiscal years (FY) spanning October 1, 2018-September 30, 2023. Measures included cumulative and past FY metrics developed to assess program impacts.
    Results: RE-AIM constructs included the following cumulative and annual program evaluation results. ACP-GV reached 54,167 unique veterans, including 19,032 unique rural veterans between FY 2018 to FY 2023. During FY 2023, implementation adherence to the ACP-GV model was noted in 91.7% of program completers, with 55% of these completers reporting a knowledge increase and 14% reporting a substantial knowledge increase (effectiveness). As of FY 2023, 66 ACP-GV sites were active, and 1,556 VA staff were trained in the intervention (adoption). Of the 66 active sites in FY 2023, 27 were sites previously funded by ORH and continued to offer ACP-GV after the conclusion of three years of seed funding (maintenance).
    Discussion: Lessons learned developing RE-AIM metrics collaboratively with program developers, implementers, and evaluators allowed for a balance of clinical and scientific input in decision-making, while the ORH annual reporting feedback provided specificity and emphasis for including both cumulative, annual, and rural specific metrics. ACP-GV's use of RE-AIM metrics is a key step towards improving rural veteran health outcomes and describing real world program impacts.
    Language English
    Publishing date 2024-03-25
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2813-0146
    ISSN (online) 2813-0146
    DOI 10.3389/frhs.2024.1210166
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Integrating the Age-Friendly Health Systems Movement in Veterans Health Administration: National Advance Care Planning via Group Visits and the 4Ms Framework.

    Matthieu, Monica M / Church, Kimberly A / Taylor, Laura D / Oliver, Ciara M / McCullough, Jane Ann / Adkins, David A / Mallory, Mary J / Garner, Kimberly K

    Health & social work

    2023  Volume 48, Issue 4, Page(s) 277–280

    MeSH term(s) Humans ; Veterans Health ; Advance Care Planning ; Veterans
    Language English
    Publishing date 2023-08-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 448861-1
    ISSN 1545-6854 ; 0360-7283
    ISSN (online) 1545-6854
    ISSN 0360-7283
    DOI 10.1093/hsw/hlad022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Application of motivational interviewing to group: Teaching advance care planning via group visits for clinical professionals.

    Matthieu, Monica M / Oliver, Ciara M / Hernandez, Gissa I / McCullough, Jane Ann / Adkins, David A / Mallory, Mary J / Taylor, Laura D / Jensen, Jamie L / Garner, Kimberly K

    Patient education and counseling

    2023  Volume 120, Page(s) 108116

    Abstract: Objective: Advance Care Planning (ACP) via Group Visits (ACP-GV) is an innovative patient-centered intervention used in the United States Department of Veterans Affairs (VA) healthcare system. The goal of ACP-GV is to spread ACP to veterans and ... ...

    Abstract Objective: Advance Care Planning (ACP) via Group Visits (ACP-GV) is an innovative patient-centered intervention used in the United States Department of Veterans Affairs (VA) healthcare system. The goal of ACP-GV is to spread ACP to veterans and caregivers in medically underserved rural areas. Veterans, caregivers and those they trust participate in a group led by clinicians in Veterans Health Administration healthcare and/or community-based settings. To learn how to facilitate ACP-GV, clinicians attend ACP-GV training. The training teaches the ACP-GV group model and the theoretical components of Motivational Interviewing (MI) (Rollnick & Miller, 1995), which are used to empower participants to have conversations about their healthcare values and preferences. Therefore, the aim is to describe the specific MI techniques utilized by group facilitators in the innovative ACP-GV intervention.
    Discussion: We provide exemplars for how group facilitators apply the MI techniques to the group discussion with participants. Lastly, we provide a scripted case example of a coded MI-concordant session of ACP-GV delivered with veterans in a healthcare setting that can be used in future training and education for clinicians interested in facilitating ACP using a group modality.
    Conclusion: MI is a key aspect of delivering ACP-GV, a high-quality, patient-centered intervention for veterans, caregivers and those they trust.
    MeSH term(s) United States ; Humans ; Motivational Interviewing/methods ; Advance Care Planning ; Veterans ; Educational Status ; United States Department of Veterans Affairs
    Language English
    Publishing date 2023-12-14
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 605590-4
    ISSN 1873-5134 ; 0738-3991
    ISSN (online) 1873-5134
    ISSN 0738-3991
    DOI 10.1016/j.pec.2023.108116
    Database MEDical Literature Analysis and Retrieval System OnLINE

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