P3B369: Qualitative Evaluation of Healthy Steps DC Implementation at Goldberg Clinics

Background: An initial implementation evaluation of HealthySteps DC occurred in 2018 using secondary data extracted from electronic health records. Preliminary evidence found that 40% of caregivers who received support from the HealthySteps Specialist (HSS) decreased depressive symptoms compared to 32% of those who did not see the HSS, suggesting that the program was effective in providing mental health support. With staff turnover and new services offered because of the pandemic, as well as expansion to additional clinics, an implementation evaluation of the HealthySteps DC model was needed to understand barriers/challenges to and successes of program implementation at this stage.

Methods: This evaluation used a descriptive, qualitative, cross-sectional design. Data were gathered from HealthySteps DC team members (n=14), both past and present, and current clinic staff (n=15) across both clinic sites (Anacostia and THEARC). Each participant consented to a single interview that lasted between 30-60 minutes and was given a $25 Target gift card. Using a semi- structured interview guide, the study team conducted and transcribed interviews via Zoom, anonymizing them and assigning random participant IDs before coding them in nVivo.

Results: A codebook was iteratively derived, starting deductively from the Consolidated Framework for Advancing Implementation Science, and then inductively specifying codes specific to the HealthySteps DC program and its setting within Goldberg clinics and the DC community.

Conclusion: Initial results suggest communication across different organizational levels (between leadership and HealthySteps DC team members, between HealthySteps team members and clinic providers, and between HealthySteps team members and collocated service providers) has been hindered by remote work and needs to be frequent and in-person to best meet families’ needs.