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Conference Abstracts

Development of a logic model to guide the implementation of INSPIRE, a community-based integrated care model for frail older adults

Author:

Olivia Yip

University Of Basel, CH
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Abstract

1. An introduction

Integrated care models are commonly accepted to improve care for the frail older population. Given the potentially beneficial outcomes yet heterogeneity of these models, using a logic model as part of a theory-driven approach can enhance the understanding of whether, how, and why a new integrated care model is successful in practice. In Switzerland, a new cantonal law included creation of centers including a nurse to assess home-dwelling older adults’ needs and provide information and care advice. Implementation of the new law presented an ideal opportunity to develop and evaluate integrated care for frail older adults.

2. Theory/Methods

A contextual analysis was conducted to analyze contextual factors which may influence the program; facilitate development of the integrated care model; and select contextually-relevant implementation strategies. A logic model depicting the overall program theory was designed from the contextual analysis, literature, and program documents using a deductive approach.  Potential implementation strategies will be selected and rated by stakeholders according to their feasibility, importance and acceptability. 

3. Results 

The logic model conveys the program theory linking the inputs, activities (i.e., core components of the care model: screening, referral, assessment, integrated care plan creation and care coordination, and follow-up), outputs (e.g., adoption, reach and fidelity indicators), anticipated outcomes (e.g., increased patients' person-centred, coordinated care experience; decreased nursing home admissions, hospitalizations and caregiver burden) and underlying assumptions. The co-developed implementation strategies (e.g., nurse training and developing educational materials) shown in the logic model will be tested locally in practice. Stakeholders will be engaged to validate the logic model, establish a shared understanding of the program and consider any gaps or revisions.

4. Discussions

This study describes the generation of a logic model for integrated care for frail older adults, and the accompanying implementation strategies. The logic model will guide the monitoring and evaluation of the program working theories and help to differentiate between implementation versus intervention success/failure.

5. Conclusions

Stronger understanding of program theory and the implementation process/outcomes is needed in studies of integrated care models. The key steps taken during this research and resultant program theory can be used as a basis and adapted when developing future integrated care programs.

6. Lessons learned

Investing sufficient efforts into program development is essential to ensure a strong fit between the context and care model, identify the implementation strategies needed, and reduce research waste. A diverse range of stakeholders can provide a comprehensive perspective.

7. Limitations

Linear relationships depicted within many logic models can be a drawback, however this format supports program planning. Contextual factors will differ for every setting limiting the generalizability of the model; however, the methodological approach can guide researchers for assessing their own setting and to facilitate the design and evaluation of future care models.

8. Suggestions for future research  

This study set the foundation for the next steps in the INSPIRE research project: to conduct a feasibility study of the integrated care model and implementation strategies prior to full evaluation of the implementation and intervention outcomes.

How to Cite: Yip O. Development of a logic model to guide the implementation of INSPIRE, a community-based integrated care model for frail older adults. International Journal of Integrated Care. 2021;21(S1):33. DOI: http://doi.org/10.5334/ijic.ICIC2028
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Published on 01 Sep 2021.

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