{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:51:48Z","timestamp":1791265908743,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Effective and sustainable support for family caregivers is a growing priority, yet practical guidance for scaling promising coaching interventions into routine practice is limited. The objective of this evaluation was to identify organizational determinants, barriers, facilitators, and adaptations affecting national implementation of the Caregiver Health and Wellbeing Coaching (CHWC) program in the Veterans Health Administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>An explanatory, sequential mixed\u2011methods design included surveys of CHWC staff (n\u202f=\u202f53) and qualitative interviews (n\u202f=\u202f14), guided by the updated Consolidated Framework for Implementation Research, its Outcomes Addendum, and the Framework for Reporting Adaptations and Modifications\u2011Enhanced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Successful implementation\u2014defined as program launch and delivery to at least one caregiver at each site\u2014and successful sustainment\u2014defined as ongoing or expanding delivery to new and returning caregivers\u2014were associated with thorough planning, leadership engagement, and flexible delivery. Barriers included staff turnover, complex documentation, and challenges recruiting caregivers. Facilitators and process improvements were rapidly integrated into program operations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Implications<\/jats:title>\n                    <jats:p>Findings can inform strategies to scale caregiver support programs that underpin sustainable aging and long-term care systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geront\/gnag234","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T11:45:45Z","timestamp":1790941545000},"source":"Crossref","is-referenced-by-count":0,"title":["Scaling Caregiver Health and Wellbeing Coaching: A Mixed Methods Evaluation of Implementation and Sustainment in the Veterans Health Administration"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5430-7890","authenticated-orcid":false,"given":"Melissa","family":"Harris-Gersten","sequence":"first","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8844-791X","authenticated-orcid":false,"given":"Colleen","family":"Blue","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3213-8093","authenticated-orcid":false,"given":"Yujung","family":"Choi","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2395-7365","authenticated-orcid":false,"given":"Olivia","family":"Whitt","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1776-773X","authenticated-orcid":false,"given":"Cassandra","family":"Dictus","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]},{"name":"Duke University School of Nursing , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4020-8936","authenticated-orcid":false,"given":"Megan","family":"Shepherd-Banigan","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]},{"name":"Duke University School of Medicine\u2019s Department of Population Health Sciences , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6726-2369","authenticated-orcid":false,"given":"Katherine","family":"Miller","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health , Baltimore, MD,","place":["USA"]},{"name":"Boston VA Health Care System VA Partnered Evidence-based Policy Resource Center, , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3901-0172","authenticated-orcid":false,"given":"Nadya","family":"Majette","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Brown","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5112-8198","authenticated-orcid":false,"given":"Darrius","family":"McMillian","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Birchett-Street","sequence":"additional","affiliation":[{"name":"National Caregiver Support Program, Veterans Health Administration , Washington D.C.,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Essex","sequence":"additional","affiliation":[{"name":"National Caregiver Support Program, Veterans Health Administration , Washington D.C.,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0783-1611","authenticated-orcid":false,"given":"Courtney H","family":"Van Houtven","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine\u2019s Department of Population Health Sciences , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5969-0252","authenticated-orcid":false,"given":"Imari Z","family":"Smith","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, , Durham, NC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3859-8493","authenticated-orcid":false,"given":"Andrea L","family":"Nevedal","sequence":"additional","affiliation":[{"name":"Veterans Health Administration VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, , Ann Arbor, Michigan,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,5]]},"container-title":["The Gerontologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/gerontologist\/advance-article-pdf\/doi\/10.1093\/geront\/gnag234\/71611888\/gnag234.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/advance-article-pdf\/doi\/10.1093\/geront\/gnag234\/71611888\/gnag234.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:59:24Z","timestamp":1791262764000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/gerontologist\/advance-article\/doi\/10.1093\/geront\/gnag234\/8866690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/geront\/gnag234","relation":{},"ISSN":["0016-9013","1758-5341"],"issn-type":[{"value":"0016-9013","type":"print"},{"value":"1758-5341","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"article-number":"gnag234"}}