Seven Steps for Developing and Implementing a Preventive Training Program: Lessons Learned from JUMP-ACL and Beyond

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Key points

  • The Translating Research into Injury Prevention Practice (TRIPP) framework describes 6 stages in injury prevention. This article provided details on implementing injury prevention movement training programs, with an emphasis on developing the injury prevention intervention (stage 3) and to describing the implementation context to inform implementation strategies (stage 5). This article addresses both the military and civilian settings.

  • Establish administrative support for the preventive training

Establish administrative support

Assets and resources are typically focused on the mission of any organization and these behaviors reflect leadership priorities. Initiatives that do not have leadership support generally receive inadequate resources to support their initial and ongoing success. As a result, it is imperative to obtain leadership buy-in and support for injury prevention efforts and to ensure that an organization’s leadership is committed to implementing any new intervention14, 15; permission to implement should

Develop an interdisciplinary implementation team

Having obtained administrative support for program implementation, we developed an interdisciplinary implementation team to assist with developing the PTP and its associated implementation strategy, which is in line with key steps in a range of implementation planning frameworks and processes described in the literature.14, 22 We involved key stakeholders to ensure that the PTP we developed was both evidence based and context specific. Key stakeholders may include program implementers (those

Identify logistical barriers and solutions

We grouped the identified implementation barriers into 4 main categories: time, personnel, environment, and organization.

Develop an evidence-based and context-appropriate PTP

The specific PTP exercises were selected after a systematic review of the existing literature to identify those exercises previously used in successful PTPs while considering the previously identified context-specific implementation barriers. Exercises that were evidence-based, would best meet the needs of the organization, and would address the implementation barriers were selected for inclusion in the PTP. As noted earlier, we also worked with the interdisciplinary team and key stakeholders

Train the trainers and users

After working with key stakeholders to develop the DIME PTP, we then developed educational strategies and support materials to train those who would be leading the program (trainers) and delivering it to the end users. To address one of the acknowledged key drivers of implementation success,9 the goal was to develop high levels of competency and self-efficacy among the trainers who would be leading the DIME PTP. In addition, we sought to achieve buy-in from the trainers by highlighting that the

Fidelity control

The DIME PTP was implemented 3 to 5-times per week over a 5-week training period (17 total training sessions). In order to provide on-the-job coaching and performance assessment29 we developed a scoring rubric to evaluate the fidelity of implementation of the DIME PTP (Fig. 4). During each training session we evaluated the leadership abilities of the trainers as they led their groups through the DIME PTP exercises. We also evaluated how well the group performed each exercise and the ability of

Exit strategy

Given the existing logistical constraints of a military training environment, we provided support for the implementation of the DIME PTP over a 5-week training period. Time-based completion of PTPs may not be ideal for achieving success and an alternative approach based on achieving predefined goals may be more desirable if it fits within the implementation context. Objective criteria for achieving high-fidelity implementation should be established by the interdisciplinary implementation team

Summary

Our experience implementing the DIME PTP in a real-world military training environment led to the development of the 7 steps for PTP design and implementation planning that can be used to operationalize stages 3 and 5 of the TRIPP framework and other models for implementing behavioral health interventions. Perhaps the most important lesson learned was the significance of working with an interdisciplinary implementation team to consider the intervention implementation context and identify

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