biostudies-literatureBlok ACHSRD VAU.S. Department of Veterans AffairsQuality Enhancement Research Initiativee14360https://www.ebi.ac.uk/biostudies/studies/S-EPMC11540588biostudies-literatureUnknown59 Suppl 2<h4>Objective</h4>To examine the relationship between site-level adaptation and early adoption of Caregivers Finding Important Resources, Support, and Training (FIRST) training during national implementation across diverse Veteran Health Administration (VA) medical centers.<h4>Data sources and study setting</h4>We enrolled and evaluated 25 VA medical centers (VAMCs). Along with administrative data on site characteristics, we examined site-reported data on adaptations and intervention adoption, defined as ≥4 training classes delivered to ≥5 caregivers at 6 months from April through October 2022.<h4>Study design</h4>A type III hybrid implementation-effectiveness cluster randomized controlled trial, randomized VAMCs 1:1 to receive foundational (low-touch) implementation support (n = 12) or thHealth services researchAdaptations and early adoption of a family caregiver intervention in the Veterans Affairs Health Care System: A multimethod pragmatic approach for national scaling.PMC11540588CIN 13-410CIN 13‐410QUE-20-023RCS‐21‐137RCS-19-332CDA 21‐161RCS‐19‐332CDA 21-161RCS-21-137QUE‐20‐023IK2 HX003530CDA 17-006CDA 17‐006Shepherd-Banigan MHughes JMSperber NRDrake CKota SVan Houtven CHBlok ACFranzosa EDecosimo KAllen KDCoffman CJZullig LLChadduck THastings SNfalseAdaptations and early adoption of a family caregiver intervention in the Veterans Affairs Health Care System: A multimethod pragmatic approach for national scaling.<h4>Objective</h4>To examine the relationship between site-level adaptation and early adoption of Caregivers Finding Important Resources, Support, and Training (FIRST) training during national implementation across diverse Veteran Health Administration (VA) medical centers.<h4>Data sources and study setting</h4>We enrolled and evaluated 25 VA medical centers (VAMCs). Along with administrative data on site characteristics, we examined site-reported data on adaptations and intervention adoption, defined as ≥4 training classes delivered to ≥5 caregivers at 6 months from April through October 2022.<h4>Study design</h4>A type III hybrid implementation-effectiveness cluster randomized controlled trial, randomized VAMCs 1:1 to receive foundational (low-touch) implementation support (n = 12) or th2024-01-01T00:00:00Z2024 Dec2026-07-16T15:01:14.942Z2025-04-05T18:50:03.143ZS-EPMC115405883909078510.1111/1475-6773.14360