A Contextual Analysis and Logic Model for Integrated Care for Frail Older Adults Living at Home: The INSPIRE Project

Olivia Yip, Evelyn Huber, Samuel Stenz, Leah L Zullig, Andreas Zeller, Sabina M De Geest, Mieke Deschodt, INSPIRE consortium, Olivia Yip, Evelyn Huber, Samuel Stenz, Leah L Zullig, Andreas Zeller, Sabina M De Geest, Mieke Deschodt, INSPIRE consortium

Abstract

Introduction: Implementation science methods and a theory-driven approach can enhance the understanding of whether, how, and why integrated care for frail older adults is successful in practice. In this study, we aimed to perform a contextual analysis, develop a logic model, and select preliminary implementation strategies for an integrated care model in newly created information and advice centers for older adults in Canton Basel-Landschaft, Switzerland.

Methods: We conducted a contextual analysis to determine factors which may influence the integrated care model and implementation strategies needed. A logic model depicting the overall program theory, including inputs, core components, outputs and outcomes, was designed using a deductive approach, and included stakeholders' feedback and preliminary implementation strategies.

Results: Contextual factors were identified (e.g., lack of integrated care regulations, existing community services, and a care pathway needed). Core components of the care model include screening, referral, assessment, care plan creation and coordination, and follow-up. Outcomes included person-centred coordinated care experiences, hospitalization rate and symptom burden, among others. Implementation strategies (e.g., nurse training and co-developing educational materials) were proposed to facilitate care model adoption.

Conclusion: Contextual understanding and a clear logic model should enhance the potential for successful implementation of the integrated care model.

Keywords: Frail elderly; Implementation science; Integrated care; Logic model; Program development; Program theory.

Conflict of interest statement

The authors have no competing interests to declare.

Copyright: © 2021 The Author(s).

Figures

Figure 1
Figure 1
INSPIRE project overview mapped according to the Framework of the Medical Research Council.
Figure 2
Figure 2
The INSPIRE project approach to care model development.
Figure 3
Figure 3
The logic model for the INSPIRE care model. BL = Basel-Landschaft; CGA = Comprehensive Geriatric Assessment; ED = Emergency Department; HC = Health care; HCP = Health care providers; HR-QoL = Health-related Quality of Life; IAC = Information and Advice Center; SSP = Social service providers.

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