Introduction
In the ever-evolving field of speech-language pathology, practitioners are continuously seeking effective frameworks to enhance the implementation and sustainability of interventions. The Practical, Robust Implementation and Sustainability Model (PRISM) offers a data-driven approach that can significantly improve outcomes for children receiving online therapy services. This blog delves into the findings of a comprehensive citation analysis and systematic review of PRISM, providing valuable insights for practitioners aiming to refine their skills and improve therapeutic outcomes.
Understanding PRISM
PRISM was developed as an extension of the Reach, Adoption, Effectiveness, Implementation, and Maintenance (RE-AIM) framework. It provides a pragmatic model to facilitate the translation of research into practice by considering contextual factors that influence implementation and sustainability. Since its inception in 2008, PRISM has been applied across diverse settings, including clinical and community environments, to enhance the adoption and maintenance of evidence-based interventions.
Key Findings from the Systematic Review
The systematic review identified 180 articles that utilized PRISM to some degree, with 32 articles representing 23 unique studies integrating PRISM into their design. The studies spanned various contexts, predominantly in high-income countries and clinical outpatient settings. Key findings include:
- Evaluation and Planning: PRISM was primarily used for evaluation (19 studies) and planning/development (10 studies), highlighting its utility in both assessing and designing interventions.
- Implementation and Sustainability: Ten studies employed PRISM for implementation, while four focused on sustainment, underscoring the model's versatility in different stages of intervention.
- Contextual Domains: The studies varied in their operationalization of PRISM's contextual domains, with a notable emphasis on implementation and sustainability infrastructure and external environment.
Recommendations for Practitioners
For practitioners in speech-language pathology, the review offers several actionable insights:
- Comprehensive Use of PRISM: To maximize the benefits of PRISM, practitioners should strive for a consistent and comprehensive application of the model, integrating its contextual domains with RE-AIM outcomes.
- Focus on Contextual Factors: Understanding the dynamic context in which interventions are implemented is crucial. Practitioners should consider factors such as organizational culture, management support, and community resources when planning and evaluating interventions.
- Health Equity Considerations: Given the model's emphasis on representativeness, practitioners should prioritize health equity by focusing on underserved populations and addressing disparities in intervention access and outcomes.
Encouraging Further Research
The systematic review highlights the need for further research to explore the relationships between PRISM contextual factors and RE-AIM outcomes. Practitioners are encouraged to engage in research that tests these connections, contributing to a deeper understanding of how contextual factors influence implementation success.
Conclusion
PRISM offers a robust framework for enhancing the implementation and sustainability of interventions in speech-language pathology. By leveraging the insights from this systematic review, practitioners can refine their skills, improve therapeutic outcomes, and contribute to the broader field of implementation science. For those interested in delving deeper into the research, the original paper can be accessed here.
