@article{fd102fbb544441fcb52d06e9eecb3903,
title = "Drivers and restrainers to adoption and spread of evidence-based health service delivery interventions: The case of CAPABLE",
abstract = "Context: Very few programs improve physical function among older adults and those that do should achieve farther reach. Methods: We used Force Field Analysis to examine drivers and restrainers for the CAPABLE program to impact the function of older adults throughout the United States. Findings: We found 19 distinct drivers for CAPABLE. These include robust research findings demonstrating clinical and economic utility, expansion from an evidence-based program, grounding in theory, high value to older adults themselves, and common sense approach. A major policy environment shifting towards value-based payment and payer flexibility to experiment with social determinants significantly changed the perception of the program's value by key stakeholders. We found 8 distinct restrainers. Conclusions: Factors which drive and restrain CAPABLE provide lessons for other programs to move from research to sustainability. Policymakers, payers, and communities should look to proven programs as solutions to improve function for older adults and society.",
keywords = "Equity, Function, Older adults, Social determinants",
author = "Szanton, {Sarah L} and Alice Bonner and Deborah Paone and Mark Atalla and Erika Hornstein and Dawn Alley and Bruce Leff and Gitlin, {Laura N}",
note = "Funding Information: Philanthropic investment. CAPABLE attracted philanthropic funding at key moments such as in initial pilot phase and once the initial trial was over but before more widespread adoption. New CAPABLE sites received philanthropic funding, particularly from the Harry and Jeanette Weinberg Foundation, The John A Hartford Foundation, the St. David's Foundation and the Retirement Research Foundation. In addition, a philanthropic funder (Rita and Alex Hillman foundation) created an infrastructure to grow CAPABLE which enabled growth with fidelity and support for new sites. This funding paid for team members who do not usually exist in academia – Director of Strategic Partnerships, Director of Implementation and Evaluation, and Clinician Training Specialist which expedited expansion. This funding also allowed for the development of processes and resources to make CAPABLE more easily implementable and adapt to the needs of a scaling program. Funding Information: Drs. Szanton and Gitlin reported being inventors of the CAPABLE training program, for which they, Johns Hopkins University and Thomas Jefferson University are entitled to fees. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. The analysis and writing for this paper were supported by NIDILRR award-90RTGE0003 And the Rita & Alex Hillman Foundation Publisher Copyright: {\textcopyright} 2022 The Author(s)",
year = "2022",
month = mar,
day = "1",
doi = "10.1016/j.gerinurse.2022.02.002",
language = "English (US)",
volume = "44",
pages = "192--198",
journal = "Geriatric Nursing",
issn = "0197-4572",
publisher = "Mosby Inc.",
}