Implementation outcomes and population impact of a statewide information technology deployment for family caregivers: A mixed-methods study (Preprint)

Abstract

In 2022, the US Department of Health and Human Services delivered the first National Strategy to Support Family Caregivers, identifying actions for both government and the private sector. One of the major goals is to expand data, research, and evidence-based practices to support family caregivers. While information technologies are widely deployed in health care settings, they are rarely available at scale in community agencies. In 2019, California recognized the importance of a state-wide data base and a platform to serve caregivers virtually by enhancing service supports and investing in an on-line platform, CareNav™. Implementation commenced in early 2020 across eleven Caregiver Resource Centers covering all regions of the state of California.

This paper describes implementation strategies and outcomes of the state-wide implementation of CareNav™, an on-line platform to support family caregivers.

The Consolidated Framework for Implementation Research (CFIR), including a recent addendum, guided this mixed-methods evaluation. Two major approaches were used to evaluate the implementation process: in-depth qualitative interviews with key informants (n=82) and surveys of staff (n=112) and caregivers (n=2,229). We analyzed interview transcripts using qualitative descriptive methods then identified sub-themes and relationships among ideas, mapping the findings to the CFIR addendum and used descriptive statistics for surveys.

We present findings about implementation strategies, implementation outcomes (i.e., adoption, fidelity and sustainment), and impact on population health (organizational effectiveness, equity, caregiver satisfaction, health and well-being). The platform was fully adopted within 18 months and the system is advancing towards sustainment through statewide collaboration. Deployment has progressed organizational effectiveness and quality, enhanced equity, and improved caregiver health and well-being.

This study provides a use case for technological implementation across a multi-site system with diverse community-based agencies. Future research can expand understanding of the barriers and facilitators of achieving relevant outcomes and population impact.

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