title: Evaluation of Subscription-based Culture Change Models in Care Settings: Findings From a Systematic Review.
abstract: Person-centered culture change models to which aged care service providers subscribe are gaining increasing traction. It has been suggested that culture change initiatives broadly are subject to a range of issues. It is difficult, however, to draw out from the existing literature specific information about the scope and quality of evidence regarding subscription-based approaches. The purpose of this study was to identify and review the peer-reviewed literature regarding these subscription-based models.
  
  
  
  The review used the Joanna Briggs Institute process and tools. Studies reporting on subscription-based person-centered culture change models in health and aged care, published in peer-reviewed literature in English up to and including 2015 were identified and assessed. In all, 28 articles reporting on 33 studies were included in the review.
  
  
  
  There was no single model for which a significant body of evidence was identified, and approaches to outcomes were fragmented. Research approaches varied. Rigor and reporting were of concern; however, strengths of the evidence base included generally adequate sample sizes and the use of multiple methods including large data sets and standardized scales.
  
  
  
  Despite their structured approaches, research and evaluation for subscription-based models are limited, ad hoc, and fragmented. A more comprehensive program of research that is embedded in the implementation process is needed. Recommendations include use of longitudinal study designs, attention to implementation and contextual factors, and measurement of both process and outcomes across the full range of culture change domains.
authors.affiliation: School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia. a.petriwskyj@uq.edu.au.
authors.forename: Andrea
authors.initials: A
authors.lastname: Petriwskyj
authors.affiliation: School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Parker
authors.affiliation: School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Brown Wilson
authors.affiliation: School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gibson
mesh_terms: D003468:Cultural Evolution; D003469:Culture; D003695:Delivery of Health Care; D006299:Health Services for the Aged; D006801:Humans; D018802:Patient-Centered Care
keywords: Culture change; Models of care; Person-centered care; Systematic review