Refining implementation determinants and strategies to scale an electronic assessment option for coordinating family-centred care in early intervention.

backgroundYoung Children's Participation and Environment Measure (YC-PEM) is a promising electronic patient-reported outcome (e-PRO) that could support family-centred care during service plan development in early intervention (EI), but prior implementation research has been limited to a single programme and state despite state level variability in EI administration. This study aims to identify shared and localised determinants and strategies for scaling YC-PEM e-PRO implementation in EI systems across multiple programmes and states.

methodsThis study used an explanatory-sequential mixed-methods case study design to engage EI stakeholders (leaders (n=4), providers (n=19) and caregivers (n=13)) across two of three geographical bands in the case state. Data were collected via virtual semi-structured interviews and focus groups, with stakeholders first rating and then explaining their responses to how helpful and easy it would be to implement the YC-PEM e-PRO option within their routine EI workflow. Transcripts were content analysed using a hybrid deductive and inductive approach to yield one analytical memo per EI stakeholder group that underwent team review and participant validation, followed by mapping of memo content to an established implementation research logic model that had been populated with content specific to another state.

resultsAll 37 EI stakeholders rated the YC-PEM e-PRO option as helpful, while most stakeholders rated it as somewhat or not easy to implement within their EI workflow. They confirmed the continued relevance of nine known determinants (four supports, five barriers) and introduced four new determinants (two supports, two barriers) for localised implementation in their state. Stakeholders confirmed and further refined the scope of two strategies and introduced one new potential strategy to support its localised implementation within their state.

conclusionsBoth shared and localised determinants and corresponding strategies are relevant to advance YC-PEM e-PRO implementation across state and local EI programmes with varied data system capabilities, organisational readiness and provider resources. TRIAL REGISTRATION NUMBER: NCT04562038.