{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:38:54Z","timestamp":1783114734269,"version":"3.54.6"},"reference-count":38,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:00:00Z","timestamp":1733097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["1R18HS029815"],"award-info":[{"award-number":["1R18HS029815"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["T32-NR-007104"],"award-info":[{"award-number":["T32-NR-007104"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["1R18HS029815"],"award-info":[{"award-number":["1R18HS029815"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["T32-NR-007104"],"award-info":[{"award-number":["T32-NR-007104"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nursing Reports"],"abstract":"<jats:p>Background: Economically disadvantaged patients diagnosed with serious mental illness (SMI) experience post-hospitalizations disparities due to fragmented care transitions. Purpose: To describe the pre-implementation strategies used to adapt and implement a nurse-led transitional care intervention (Thrive) to meet the needs of economically disadvantaged patients diagnosed with an SMI. Methods: Two pre-implementation strategies, Evidence Based Quality Improvement (EBQI) meetings and Formative Evaluation (FE) research, were used to adapt intervention components. FE data included semi-structured interviews analyzed using Rapid Qualitative Analysis. Findings: Adaptations were made to core components of Thrive and strategies to support implementation were identified. Conclusions: Participatory strategies help to adapt interventions that are person-centered and tailored to the organizational context. Trial: NCT06203509.<\/jats:p>","DOI":"10.3390\/nursrep14040278","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T09:30:18Z","timestamp":1733391018000},"page":"3803-3818","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pre-Implementation Strategies to Support Adaptation of Thrive: A Care Transitions Model for Economically Disadvantaged Patients with Serious Mental Illness"],"prefix":"10.3390","volume":"14","author":[{"given":"J. Margo","family":"Brooks Carthon","sequence":"first","affiliation":[{"name":"Center for Health Outcomes & Policy Research, Leonard Davis Institute of Health Economics, University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celsea","family":"Tibbitt","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes & Policy Research, Leonard Davis Institute of Health Economics, University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin Eyram","family":"Amenyedor","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, Yale University, 333 Cedar St., New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-231X","authenticated-orcid":false,"given":"Amanda P.","family":"Bettencourt","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes & Policy Research, Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Babe","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes & Policy Research, University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela Z.","family":"Cacchione","sequence":"additional","affiliation":[{"name":"Penn Presbyterian Medical Center, Leonard Davis Institute of Health Economics, University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4295-6372","authenticated-orcid":false,"given":"Heather","family":"Brom","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes & Policy Research, Leonard Davis Institute of Health Economics, University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"key":"ref_1","unstructured":"National Institute of Mental Health (2023, July 06). Mental Illness, Available online: https:\/\/www.nimh.nih.gov\/health\/statistics\/mental-illness#part_2538."},{"key":"ref_2","unstructured":"Zur, J., Musumeci, M., and Garfield, R. (2017). Medicaid\u2019s Role in Financing Behavioral Health Services for Low-Income Individuals, The Henry J. Kaiser Family Foundation."},{"key":"ref_3","first-page":"1","article-title":"Trends in hospital inpatient stays in the United States, 2005\u20132014: Statistical brief # 225","volume":"24","author":"McDermott","year":"2017","journal-title":"Healthcare Cost Util. Proj."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1377\/hlthaff.2018.05412","article-title":"Patient readmission rates for all insurance types after implementation of the hospital readmissions reduction program","volume":"38","author":"Ferro","year":"2019","journal-title":"Health Aff."},{"key":"ref_5","unstructured":"Boutwell, A., Maxwell, J., Bourgoin, A., Genetti, S., John Snow Inc., and Collaborative Healthcare Strategies, Inc. (2014). Hospital Guide to Reducing Medicaid Readmissions."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e192662","DOI":"10.1001\/jamanetworkopen.2019.2662","article-title":"US Emergency Department Visits and Hospital Discharges Among Uninsured Patients Before and After Implementation of the Affordable Care Act","volume":"2","author":"Singer","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-021-06605-y","article-title":"Community Socioeconomic Disadvantage Drives Type of 30-day Medical-Surgical Revisits Among Patients with Serious Mental Illness","volume":"21","author":"Germack","year":"2021","journal-title":"BMC Health Serv. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.schres.2013.12.002","article-title":"Emergency department utilization among Medicaid beneficiaries with schizophrenia and diabetes: The consequences of increasing medical complexity","volume":"152","author":"Shim","year":"2014","journal-title":"Schizophrenia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/1468-0009.12311","article-title":"The effect of Medicaid on management of depression: Evidence from the Oregon Health Insurance Experiment","volume":"96","author":"Baicker","year":"2018","journal-title":"Milbank Q."},{"key":"ref_10","first-page":"115","article-title":"Understanding patient, provider, and system factors related to Medicaid readmissions","volume":"42","author":"Jiang","year":"2016","journal-title":"Jt. Comm. J. Qual. Patient Saf."},{"key":"ref_11","unstructured":"Medicare Payment Advisory Commission, and Medicaid and CHIP Payment and Access Commission (2018). Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1176\/appi.ps.201700063","article-title":"Mind the gap: Developing an integrated behavioral health home to address health disparities in serious mental illness","volume":"68","author":"Tepper","year":"2017","journal-title":"Psychiatr. Serv."},{"key":"ref_13","first-page":"30","article-title":"How innovation and design thinking can improve care","volume":"16","author":"Brom","year":"2021","journal-title":"Am. Nurse. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.2105\/AJPH.90.8.1212","article-title":"Levels of racism: A theoretic framework and a gardener\u2019s tale","volume":"90","author":"Jones","year":"2000","journal-title":"Am. J. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e001798","DOI":"10.1136\/bmjoq-2021-001798","article-title":"Transitional care innovation for Medicaid-insured individuals: Early findings","volume":"11","author":"Brom","year":"2022","journal-title":"BMJ Open Qual."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/NCQ.0000000000000805","article-title":"Determining the Post Discharge Care Needs of Medicaid-Insured Adults with Co-occurring Chronic Medical and Serious Mental Illnesses","volume":"40","author":"Nikpour","year":"2025","journal-title":"J. Nurs. Care Qual."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/NMD.0000000000001282","article-title":"Psychiatric medication changes associated with increased rate of medical readmissions in patients with serious mental illness","volume":"209","author":"Germack","year":"2021","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.genhosppsych.2021.02.004","article-title":"Serious mental illness, other mental health disorders, and outpatient health care as predictors of 30-day readmissions following medical hospitalization","volume":"70","author":"Cook","year":"2021","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111604","DOI":"10.1016\/j.jpsychores.2024.111604","article-title":"Serious mental illness is associated with elevated risk of hospital readmission in veterans with heart failure","volume":"178","author":"Browne","year":"2024","journal-title":"J. Psychosom. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.genhosppsych.2024.10.007","article-title":"Transitional care programs to improve the post-discharge experience of patients with multiple chronic conditions and co-occurring serious mental illness: A scoping review","volume":"15","author":"Brom","year":"2024","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_21","first-page":"e64575","article-title":"Transitional Care Support for Medicaid Insured Patients with Serious Mental Illness: A Type 1 Hybrid Effectiveness Implementation Stepped-Wedge Cluster Randomized Trial","volume":"12","author":"Brom","year":"2024","journal-title":"JMIR Res. Protoc."},{"key":"ref_22","unstructured":"(2024, November 19). Thrive: Transforming Healthcare Equity. Available online: https:\/\/thrive-care.org\/."},{"key":"ref_23","unstructured":"Goodrich, D.E., Miake-Lye, I., Braganza, M.Z., Wawrin, N., and Kilbourne, A.M. (2024, September 05). The QUERI Roadmap for Implementation and Quality Improvement Pre-Implementation\u2014The QUERI Roadmap for Implementation and Quality Improvement\u2014NCBI Bookshelf, Available online: www.nih.gov."},{"key":"ref_24","first-page":"396","article-title":"Empirical examinations of modifications and adaptations to evidence-based psychotherapies: Methodologies, impact, and future directions","volume":"24","author":"Gamarra","year":"2017","journal-title":"Clin. Psychol. Sci. Pract."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S418","DOI":"10.1111\/jrh.12201","article-title":"Pre-implementation strategies to adapt and implement a veteran peer coaching intervention to improve mental health treatment engagement among rural veterans","volume":"32","author":"Koenig","year":"2016","journal-title":"J. Rural. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1007\/s11606-006-0267-9","article-title":"The role of formative evaluation in implementation research and the QUERI experience","volume":"21","author":"Stetler","year":"2006","journal-title":"J. Gen. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s43058-021-00146-5","article-title":"A more practical guide to incorporating health equity domains in implementation determinant frameworks","volume":"2","author":"Woodward","year":"2021","journal-title":"Implement. Sci. Commun."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s10488-013-0528-y","article-title":"Purposeful sampling for qualitative data collection and analysis in mixed method implementation research","volume":"42","author":"Palinkas","year":"2015","journal-title":"Adm. Policy Ment. Health Ment. Health Serv. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies: Guided by information power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qual. Health Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13012-017-0635-3","article-title":"Psychometric assessment of three newly developed implementation outcome measures","volume":"12","author":"Weiner","year":"2017","journal-title":"Implement. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1748-5908-9-7","article-title":"Organizational readiness for implementing change: A psychometric assessment of a new measure","volume":"9","author":"Shea","year":"2014","journal-title":"Implement. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s13012-021-01111-5","article-title":"Rapid versus traditional qualitative analysis using the Consolidated Framework for Implementation Research (CFIR)","volume":"16","author":"Nevedal","year":"2021","journal-title":"Implement. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"112516","DOI":"10.1016\/j.psychres.2019.112516","article-title":"Qualitative methods in implementation research: An introduction","volume":"280","author":"Hamilton","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_34","unstructured":"(2020, November 16). Hamilton AB. Qualitative Methods in Rapid Turn-Around Health Services Research. PowerPoint Present 2013 VA HSRD Cyberseminar Spotlight Womens Health. Published Online 2013, Available online: www.hsrd.research.va.gov\/for_researchers\/cyber_seminars\/archives\/video_archive.cfm?SessionID=780."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/BF02766777","article-title":"Criteria for assessing the trustworthiness of naturalistic inquiries","volume":"29","author":"Guba","year":"1981","journal-title":"ECTJ"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Watson, A.K., Hernandez, B.F., Kolodny-Goetz, J., Walker, T.J., Lamont, A., Imm, P., Wandersman, A., and Fernandez, M.E. (2022). Using implementation mapping to build organizational readiness. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.904652"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.1017\/cts.2022.467","article-title":"Facilitating future implementation and translation to clinical practice: The Implementation Planning Assessment Tool for clinical trials","volume":"6","author":"Kowalski","year":"2022","journal-title":"J. Clin. Transl. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s43058-022-00355-6","article-title":"Applying implementation frameworks to the clinical trial context","volume":"3","author":"Stensland","year":"2022","journal-title":"Implement. Sci. Commun."}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/14\/4\/278\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:45:06Z","timestamp":1760114706000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/14\/4\/278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,2]]},"references-count":38,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["nursrep14040278"],"URL":"https:\/\/doi.org\/10.3390\/nursrep14040278","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,2]]}}}