AHRQ Digital Health Equity Framework

Constructs Assessed:

Constructs assessed by the assessment instrument (linked to constructs included in the D&I models webtool)

• Adopter/implementer/decision maker characteristics
• Context – Outer setting
• Context – Inner setting
• Health Equity
• Patient/target audience characteristics and needs
• Outcomes
• Outcomes – Quality Improvement/Practice or Policy Change

Theories, Models, Frameworks Relevant:

• Adherence Optimization Framework
• Advancing health disparities research within the health care system
• Availability, Responsiveness & Continuity (ARC): An Organizational & Community Intervention Model
• Behaviour Change Wheel
• Blueprint for Dissemination
• Canadian Institutes of Health Research Knowledge Translation within the Research Cycle Model or Knowledge Action Model
• Choosing Wisely Deimplementation Framework
• Community Based Participatory Research (CBPR)
• Conceptual Framework For The Comparative Analysis of Policy Change
• Conceptual Model of Implementation Research
• Conceptual Model of Knowledge Utilization
• Conceptualizing Dissemination Research and Activity: Canadian Heart Health Initiative
• Conduct and Utilization of Research in Nursing (CURN)
• Consolidated Framework for Implementation Research
• Coordinated Implementation Model
• Critical Realism & the Arts Research Utilization Model (CRARIUM)
• Davis' Pathman-PRECEED Model
• Designing and evaluating interventions to eliminate racial and ethnic disparities in health care
• Dissemination and Implementation Framework for an Early Childhood Obesity Prevention Program
• Dissemination of Evidence-based Interventions to Prevent Obesity
• Dynamic Sustainability Framework
• EMTReK - Evidence-based Model for the Transfer and Exchange of Research Knowledge
• EQ-DI Framework
• Effective Dissemination Strategies
• Evidence Integration Triangle
• Exploration, Preparation, Implementation, Sustainment (EPIS) model (Conceptual Model of Evidence-based Practice Implementation in Public Service Sectors)
• Facilitating Adoption of Best Practices (FAB) Model
• Framework for Analyzing Adoption of Complex Health Innovations
• Framework for Enhancing the Value of Research for Dissemination and Implementation
• Framework for Knowledge Translation
• Framework for Spread
• Framework for the Dissemination & Utilization of Research for Health-Care Policy & Practice
• Framework of Dissemination in Health Services Intervention Research
• General theory of implementation
• Generic Implementation Framework
• Greenhalgh Diffusion of Innovations in Service Organizations
• Health Equity Implementation Framework
• Health Promotion Research Center Framework
• Implementation Effectiveness Model
• Interactive Systems Framework
• Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines
• Kingdon's Multiple-Streams Framework
• Knowledge Exchange Framework
• Knowledge Transfer and Exchange
• Model for Predictors of Adoption
• Normalization Process Theory
• Organizational Theory of Innovation Implementation
• Pathways to Evidence Informed Policy
• Practical, Robust Implementation and Sustainability Model (PRISM)
• Pragmatic-Explanatory Continuum Indicator Summary 2
• Precede-Proceed Model
• Promoting Action on Research Implementation in Health Services (PARIHS)
• Push-Pull Capacity Model
• RAND Model of Persuasive Communication and Diffusion of Medical Innovation
• RE-AIM 2.0/Contextually Expanded RE-AIM
• Real-World Dissemination
• Replicating Effective Programs Framework
• Six-Step Framework for International Physical Activity Dissemination
• Theoretical Domains Framework
• Transcreation Framework for Community-engaged Behavioral Interventions to Reduce Health Disparities
• Utilization-Focused Surveillance Framework
• Weiner organizational readiness
• conNECT Framework

Implementation Outcomes:

The relevance of the assessment instrument to various implementation outcomes

• Acceptability
• Adaptation
• Adoption
• Appropriateness
• Effectiveness
• Implementation
• Reach
• Sustainment

Implementation Strategies:

The implementation strategy/ies evaluated by the assessment instrument

• Adapt and tailor to context
• Develop stakeholder interrelationships
• Engage consumers
• Provide interactive assistance
• Train and educate stakeholders
• Use of evaluative and iterative strategies

Phase of Implementation Process:

Phase of implementation process when the assessment instrument can be used

• Pre-Implementation
• Implementation
• Sustainment

Levels of Data Collection:

The level(s) from which the assessment instrument collects data

• Individual (Patient, Community Member)
• Implementer
• Organizational
• Community
• System
• Policy

Intended Priority Population:

Intended priority population from whom data are collected using the assessment instrument

• Community Members/Patients
• Researcher/Evaluator
• Clinician
• Administrator
• Public Health Practitioner

Intended Priority Setting:

Intended priority setting in which the assessment instrument is used

• Clinical Outpatient
• Clinical Inpatient
• Residential Care
• Public Health Agency

Policy:

Assessment instrument is relevant to policy

• Public (Laws, Regulations)
• Healthcare Financing/Reimbursement
• Clinical Practice

Equity Relevant:

Assessment instrument includes at least one equity-focused component

Scoring:

The assessment instrument produces a composite score

Norms:

Measures of central tendency and distribution for the total score are based on small, medium, large sample size

Responsiveness:

The ability of the assessment instrument to detect change over time (i.e., sensitivity to change or intervention effects).

Validity:

The extent to which an instrument measures what it is intended to measure accurately.

Reliability:

The extent to which results are consistent results over time, across raters, across settings, or across items intended to measure the same thing.

Factor Analysis:

A statistical method that uses the correlation between observed variables to identify common factors.

Time to Administer:

The amount of time required to complete the assessment instrument

Uses Secondary Data:

Assessment instrument relies on a secondary data source

Cost:

Cost associated with access to assessment instrument (Some insturments might require login.)

Literacy:

Readability of the items reported on.

Interpretation:

Expertise needed for interpretation of data is reported.

Training:

Expertise needed to use the assessment instrument is reported

Resources Required to Administer:

Resources needed to administer the assessment instrument (FTE for data collector, equipment, etc.)

User Guidance:

Guides are provided to support administration of assessment instrument/data collection, and/or analysis of data from the assessment instrument, and/or interpretation of data, and/or action/decision on how to use data

• Guidance to Administer
• Guidance to Analyze
• Guidance to Interpret
• Guidance for Action/Decision

Obtrusiveness:

Degree of intrusion the participants will experience because of the data collection when using the assessment instrument (e.g., assessment instruments that rely on use of secondary data or automated data will be less obtrusive)

• High: Observation and syncronous collection of data

Interactivity:

Data collection and/or result generation involves interactive components.