Cited by 297Health Policy Implementation ScienceQualitative Research Methods and ApplicationsTelemedicine and Telehealth Implementation

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Applied Rapid Qualitative Analysis to Develop a Contextually Appropriate Intervention and Increase the Likelihood of Uptake

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Lewinski, Allison A., Crowley, Matthew J., Miller, Christopher, Bosworth, Hayden B., Jackson, George L., Steinhauser, Karen, White-Clark, Courtney, McCant, Felicia, Zullig, Leah L.·2021·Medical Care

DOI 10.1097/mlr.0000000000001553PMC PMC8132894

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Abstract

BACKGROUND: Rapid approaches to collecting and analyzing qualitative interview data can accelerate discovery timelines and intervention development while maintaining scientific rigor. We describe the application of these methods to a program designed to improve care coordination between the Veterans Health Administration (VHA) and community providers. METHODS: Care coordination between VHA and community providers can be challenging in rural areas. The Telehealth-based Coordination of Non-VHA Care (TECNO Care) intervention was designed to improve care coordination among VHA and community providers. To ensure contextually appropriate implementation of TECNO Care, we conducted preimplementation interviews with veterans, VHA administrators, and VHA and community providers involved in community care. Using both a rapid approach and qualitative analysis, an interviewer and 1-2 note-taker(s) conducted interviews. RESULTS: Over 5 months, 18 stakeholders were interviewed and we analyzed these data to identify how best to deliver TECNO Care. Responses relevant to improving care coordination include health system characteristics; target population; metrics and outcomes; challenges with the current system; and core components. Veterans who frequently visit VHA or community providers and are referred for additional services are at risk for poor outcomes and may benefit from additional care coordination. Using these data, we designed TECNO Care to include information on VHA services and processes, assist in the timely completion of referrals, and facilitate record sharing. CONCLUSION: Rapid qualitative analysis can inform near real-time intervention development and ensure relevant content creation while setting the stage for stakeholder buy-in. Rigorous and timely analyses support the delivery of contextually appropriate, efficient, high-value patient care.

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FIGURE 1 Conceptual framework of TECNO Care intervention. TECNO Care indicates Telehealth-based Coordination of Non-VHA Care; VHA, Veterans Health Administration.CC BY-NC-ND · PubMed Central

FIGURE 2 Timeline of activities from month 1 through month 5. VHA indicates Veterans Health Administration.CC BY-NC-ND · PubMed Central

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BackgroundMethodInfluential
Implementation science: What is it and why should I care?
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“(4) What are the central care coordination tasks TECNO Care should address? [Intervention characteristics]—We ensured that TECNO Care was neither duplicative nor burdensome to those who would be delivering TECNO Care.”
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“VHA and community providers Community care experiences (1) What conditions or types of patients do you think require better care coordination between VHA and community providers? [Outer setting; patient needs and resources] (2) Who are the key players inside your organization that we should talk with about TECNO? [Pro…”
Background
Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis
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“(6) What are the right metrics to assess TECNO Care’s effectiveness? [Process]—We identified which metrics should be followed to assess the program’s impact.”
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“They were audio-recorded but not transcribed, consistent with a rapid approach to qualitative analysis [22, 23].”
Self-citation
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Heuer, J. N., Kalvesmaki, A., Matson, S., Waslo, C. S., Panahi, S., George, R. T., & Pugh, M. J. (2026) · Medical Care Research and Review · doi:10.1177/10775587261445776
“…the completed inter-view notes were reviewed by the first independent coder to develop interview note summaries, which ensured that all relevant data were organized in accordance with the inter-view questions asked during the interviews (see Table 3; Keniston et al., 2023; Lewinski et al., 2021).”
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Kersten, S., Hohmann, E. D., Piotrowski, A., Lepper, A.-K., Dehnen, D., Pentzek, M., Weißbach, S., & Schweizer, J. (2026) · BMC Family Practice · doi:10.1186/s12875-026-03391-6 · Cited by 1
“This pragmatic approach supports timely yet rigorous findings in practice-based research [20], enables structured team-based analysis, and maintains analytic depth while reducing time to actionable results.”
Interactive Text Messaging to Promote Responsive Bottle-Feeding Among Mothers of Infants Enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children: A 12-Week Randomized Attention Control Trial
Kay, M. C., Richardson, T. N., Bell, L., Shelton, S. M., & Wasser, H. (2026) · Childhood Obesity · doi:10.1177/21532176261450308
“61,62 This approach reduces data by using templates for quick comparison of data across participants.”
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Riser, T. J., Jung, W. (., Curriero, S. N., McDaniel, K., Nogueira, A., Fabius, C. D., Schuchman, M., Leff, B. A., Ornstein, K. A., Szanton, S. L., et al. (2026) · Journal of Applied Gerontology · doi:10.1177/07334648261452327
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“Rapid analysis is rigorous, pragmatic, and designed to generate actionable findings from qualitative data in a shorter timeframe than traditional approaches (Lewinski et al., 2021).”
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“Transcripts will be deidentified and analyzed using rapid, framework-guided thematic methods to generate refinements [134].”
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“We applied a structured rapid qualitative analysis approach using summary templates and matrix-based data organization (14, 15).”
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“40,41 We measured engagement with the new team process 29 through the percentages of primary care providers and eligible patients respectively in each cluster who participated in the intervention, and the percentage of patients getting recommended follow up blood draws within 6 months of enrolling…”
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Spears, C. A., Gonzalez, C., Borghi, S. E. “., Correa-Fernández, V., Fraire, L., Chilito, C., Wangen, M., Bernal, R., Ramirez, D. B., Self‐Brown, S., et al. (2026) · Preventive Medicine · doi:10.1016/j.ypmed.2026.108679
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Narayanasamy, S., Griffith, B. C., Gonzales, S. E., Boeke, C. E., Gumulira, Y., Hamza, N., Joseph, J. T., Lewinski, A. A., Lufesi, N., Martin-Odoom, A., et al. (2026) · BMJ Public Health · doi:10.1136/bmjph-2025-004175
“Qualitative interview data were analysed with a rapid content analysis technique, 27 28 using Microsoft Excel V.2019 to support coding and analysis.”
Self-citation

Authors: Lewinski, A. A., Crowley, M. J., Miller, C., Bosworth, H. B., Jackson, G. L., Steinhauser, K., White-Clark, C., McCant, F., & Zullig, L. L.
Affiliations: Duke University (US)
Harvard University (US)
Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System
Durham VA Health Care System (US)
Corresponding author: Lewinski, Allison A.
Crowley, Matthew J.
Bosworth, Hayden B.
Jackson, George L.
Steinhauser, Karen
McCant, Felicia
Zullig, Leah L.
ORCID: Lewinski, Allison A.
Crowley, Matthew J.
Miller, Christopher
Bosworth, Hayden B.
Steinhauser, Karen
McCant, Felicia
Zullig, Leah L.
Venue: Medical Care
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2021-05-13
Volume: 59
Issue: Suppl 3
Pages: S242-S251
ISSN: 0025-7079 (ISSN-L)
DOI: 10.1097/mlr.0000000000001553
PMC: PMC8132894
OpenAlex: W3163088900
Cited by: 296
References: 32
Citations by year: 2026: 83 · 2025: 70 · 2024: 79 · 2023: 43 · 2022: 20 · 2021: 1
FWCI: 40.17
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/4.0/%20http://creativecommons.org/licenses/by-nc-nd/4.0/ (unspecified)
Locations: Medical Care (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs (CIN 13–410, IK6 HX003161)
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Education › Qualitative Research Methods and Applications
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords: rapid qualitative analysis, intervention development, care coordination, Veterans Health Administration, community service providers, telemedicine, rural veterans, stakeholder engagement, referral completion, health record sharing, implementation readiness
MeSH terms: Stakeholder Participation, Veterans Health Services, Community Health Services, Health Plan Implementation, Humans, Patient Acceptance of Health Care, Patient Care Management, United States, United States Department of Veterans Affairs, Veterans, Telemedicine, Rural Health Services, Qualitative Research

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Applied Rapid Qualitative Analysis to Develop a Contextually Appropriate Intervention and Increase the Likelihood of Uptake

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