Abstract
Background:
Concussion is a significant medical condition in military medicine requiring knowledge of evidence-based best practices by medical providers. Military primary care managers (PCMs) are often tasked with caring for this condition from point of injury to return to duty. Multiple evidence-based tools exist to guide military PCMs in the assessment and treatment of this condition, but little is known about the dissemination channels and implementation strategies (D&I) that are most preferred by military PCMs to receive these resources.
Methods:
This cross-sectional study using an internet-based survey disseminated via social media was conducted to determine the concordance between currently used vs preferred dissemination channels and implementation strategies in current and former PCMs of military service members and veterans. Percentage point differences between currently used and preferred channels and strategies were calculated to determine level of agreement. A McNemar Test was used to determine statistical significance.
Results
Dissemination strategies in which providers indicated that they preferred more than they were receiving were professional conferences, seminars at their clinics or institutions, infographics, podcasts produced by professional organizations, online videos by professional organizations, and email listserv. For implementation strategies, providers indicated that they wanted significantly more practice facilitation, needs assessments, addressing clinical specific barriers, technology solutions, in-person training events, audit and feedback, external consultations, and local interdisciplinary work-groups than were currently being used. The only implementation strategy that providers indicated receiving more than they would actually prefer was web-based training. Professional conferences, seminars, online peer reviewed clinical resources, and online clinical recommendations for providers, in that order, were the most preferred dissemination channels by participants. Practice facilitation, in-person training, and clinical specific needs assessments were the most preferred implementation strategies.
Conclusion
Consideration of provider preferences in D&I strategy by organizations that produce evidence-based guidance on concussion may enhance the use of existing recommendations by PCMs, increase military treatment facility compliance with metrics, and enhance patient outcomes.