Translational Behavioral Medicine最新文献

{"title":"Brick-and-mortar food retail implementation of a nutrition incentive program using Electronic Benefit Transfer integration in Southern California.","authors":"Bailey Houghtaling, James P Marriott, Amy L Yaroch, Joe Prickitt, Blanca Melendrez, Karemi Alvarez, Nancy Knauer, Carmen Byker Shanks","doi":"10.1093/tbm/ibag020","DOIUrl":"10.1093/tbm/ibag020","url":null,"abstract":"<p><strong>Background: </strong>Nutrition incentive programs (NIPs) that integrate fruit and vegetable (FV) incentives into Supplemental Nutrition Assistance Program (SNAP) Electronic Benefit Transfer (EBT) systems have strong potential for scaling in the United States, yet little is known about implementation from brick-and-mortar food retailers' perspectives.</p><p><strong>Purpose: </strong>To examine brick-and-mortar food retailers' perceptions and experiences with an NIP using SNAP EBT integration for FV incentives at the point of sale.</p><p><strong>Methods: </strong>Guided by the Inner Context of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, an implementation science evaluation was conducted among 79 independent chain grocers implementing the NIP in Southern California. Leadership and staff were invited to complete an online survey (89% response rate) using validated tools (e.g. Implementation Leadership Scale), expert-developed items, and open-ended questions. The analysis included descriptive statistics and inferential tests that assessed response differences between leadership and staff.</p><p><strong>Results: </strong>Of 538 respondents, most were female (76%) and Latino/a (94%). Perceptions and experiences with the NIP were favorable across EPIS Inner Context constructs, with some differences noted. Leadership support for implementation was rated highly overall, though staff scored items on supportive and knowledgeable leadership lower compared to leadership. While highly satisfied with NIP implementation overall, open-ended responses highlighted opportunities to optimize implementation across stores.</p><p><strong>Conclusions: </strong>Nutrition incentive programs integrating FV incentives into SNAP EBT systems appear well-suited to the brick-and-mortar food retail context. Findings can inform the design and testing of implementation strategies to support sustainment and scaling for population-level impact locally and nationally.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From trials to clinics: investigators' perspectives on translating psychedelic research into clinical care.","authors":"Joshua Mitchell, Logan Neitzke-Spruill, David S Mathai, Jill O Robinson, Zuzana Kavan, Lynnette A Averil, Amy L McGuire","doi":"10.1093/tbm/ibag027","DOIUrl":"10.1093/tbm/ibag027","url":null,"abstract":"<p><strong>Background: </strong>Psychedelics such as 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin are showing promising results in clinical trials for the treatment of mental health disorders, including post-traumatic stress disorder, addiction, and treatment-resistant depression. US Food and Drug Administration approval may be on the horizon. Yet, little is known about how these treatments will move from tightly controlled clinical trials to routine clinical care.</p><p><strong>Purpose: </strong>This study examines how psychedelic clinical investigators anticipate this transition and what challenges they expect.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 21 clinical investigators based at major academic psychedelic research centers across the United States. We transcribed and analyzed these conversations using inductive and deductive coding to identify major themes.</p><p><strong>Results: </strong>Investigators generally viewed psychedelic medicine as distinct from existing treatments, particularly in terms of drug effects, treatment models, and broader goals. They highlighted three major translational challenges: (i) uncertainty surrounding the role of psychotherapy, (ii) the cost of treatment and its scalability, and (iii) the effects of both hype and stigma on clinical uptake.</p><p><strong>Conclusion: </strong>Despite these challenges, most investigators anticipated that psychedelic medicine could eventually fit into routine clinical care and may even improve it.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding capability, opportunity, and motivation for at-home COVID-19 testing in underserved populations during the pandemic.","authors":"Joni H Pierce, Peter Taber, Leticia Stevens, Adriana Rush, Ryzen Benson, Catherine Staes, Andy J King, Chelsey R Schlechter, Kimberly A Kaphingst, David W Wetter, Guilherme Del Fiol","doi":"10.1093/tbm/ibag033","DOIUrl":"10.1093/tbm/ibag033","url":null,"abstract":"<p><strong>Background and purpose: </strong>We investigated the capabilities, opportunities and motivations associated with decision making related to at-home COVID-19 testing in populations most affected by the pandemic.</p><p><strong>Methods: </strong>We conducted semi-structured interviews to explore the capability, opportunity and motivation for COVID-19 testing by the pandemic populations most affected by the pandemic. Interviews were carried out according to the Critical Incident Technique, and analysis and interpretation were guided by the COM-B model for behavior change.</p><p><strong>Results: </strong>We conducted 19 (13 in English, 6 in Spanish) semi-structured interviews with participants from both urban and rural areas in Utah. The following 6 key themes emerged: (i) Participants sought clear information about COVID-19 from trustworthy, credible sources, (ii) Economic concerns relating to job security and income loss as well as costs associated with COVID-19 testing were concerns, conversely access to free COVID-19 tests facilitated testing, (iii) Rapid testing with fast results at convenient locations including at-home were key facilitators to COVID-19 testing, (iv) Wide variation of trust levels related to at-home COVID-19 test accuracy, (v) Perception of risk to self and others, including misconceptions surrounding risk, and (vi) Intense emotions ranging from fear associated with loss to peace of mind associated with confirmation of a negative COVID-19 test.</p><p><strong>Conclusion: </strong>The six themes identified surfaced as facilitators, barriers, and key considerations depending upon the context when participants were engaging in decision-making about COVID-19 testing. Providing validated easy to understand information, from trustworthy sources, while addressing and minimizing concerns about economic implications associated with testing are critical to increase patient engagement.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a leadership-focused implementation strategy on uptake of digital measurement-based care in mental health clinics: a cluster randomized trial.","authors":"Nathaniel J Williams, Gregory A Aarons, Mark G Ehrhart, Nallely Vega, Steven C Marcus","doi":"10.1093/tbm/ibag007","DOIUrl":"10.1093/tbm/ibag007","url":null,"abstract":"<p><strong>Background: </strong>Leaders of healthcare organizations are often called on to guide the implementation of new innovations, including evidence-based practices and digital health technologies. However, many leaders lack preparation for this role and most available leadership trainings have not been rigorously tested, particularly over periods incorporating multiple implementation phases.</p><p><strong>Purpose: </strong>This study tested the effects of the Leadership and Organizational Change for Implementation (LOCI) strategy on the uptake of digital measurement-based care (MBC) in mental health settings across 35 months, incorporating implementation and sustainment phases.</p><p><strong>Methods: </strong>In 21 outpatient mental health clinics serving youth, a two-arm, cluster randomized, hybrid type III effectiveness-implementation trial tested whether adding LOCI (k = 11) to standard digital MBC training and technical assistance (k = 10) improved uptake of digital MBC, assessed using system generated data and operationalized as clinic-level monthly counts of the number of youths with a measure administered and with feedback viewed by their clinician.</p><p><strong>Results: </strong>On both outcomes, clinics randomized to LOCI exhibited superior initial uptake (3 months post-baseline: mean difference in youths with measure administered per clinic (MYMA_Diff=5.09, 95% CI=[1.63-8.55]); mean difference in youths with feedback viewed per clinic (MYFV_Diff=3.81 [1.26-6.37]), superior uptake when the implementation phase concluded (13 months post-baseline: MYMA_Diff=9.03, [1.64-16.41]; MYFV_Diff=8.31 [3.07-13.56]), and superior uptake when the sustainment phase concluded (35 months post-baseline: MYMA_Diff=3.82 [1.28-6.36]; MYFV_Diff=1.41 [0.22-2.60]).</p><p><strong>Conclusions: </strong>LOCI is an effective approach for training organizational leaders to support implementation of evidence-based digital health technologies in healthcare settings. Studies examining how policy-level variables interact with leadership training are needed.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and provider perspectives of Brief Cognitive Behavioral Therapy for Chronic Pain: a qualitative analysis of a pilot randomized controlled trial.","authors":"Mandy Conrad, Justin M Kimber, Dezarie Moskal, Vincent A Pietropaoli, Paul R King, Gregory P Beehler, Mandy Conrad, Justin M Kimber, Dezarie Moskal, Vincent A Pietropaoli, Paul R King, Gregory P Beehler","doi":"10.1093/tbm/ibag011","DOIUrl":"10.1093/tbm/ibag011","url":null,"abstract":"<p><strong>Objective: </strong>Brief non-pharmacologic chronic pain treatments are largely effective and widely recommended for pain self-management. The purpose of this study was to evaluate veteran and provider perceptions of acceptability, appropriateness, and feasibility of Brief Cognitive Behavioral Therapy (Brief CBT-CP) content and materials to inform future implementation efforts in primary care and other integrated settings.</p><p><strong>Design: </strong>Qualitative analysis of data from a pilot randomized controlled trial (RCT).</p><p><strong>Setting: </strong>Two Veterans Affairs (VA) primary care clinics in the Northeast.</p><p><strong>Subjects: </strong>Veterans (n = 10) who completed Brief CBT-CP treatment, integrated behavioral health providers (IBHPs; n = 3 clinical social workers; n = 4 clinical psychologists), and primary care physicians (PCPs; n = 5).</p><p><strong>Method: </strong>Rapid Qualitative Analysis of semi-structured interview data.</p><p><strong>Intervention: </strong>Brief CBT-CP, an adapted intervention for chronic pain intended for use in primary care and other integrated care settings utilizing brief treatment modalities.</p><p><strong>Results: </strong>PCPs and IBHPs described Brief CBT-CP as highly acceptable and clinically useful, particularly in response to its focus on biopsychosocial pain self-management skills. Similarly, veterans pointed to the non-pharmacologic skills as a highly acceptable component of treatment. The intervention was also viewed as highly appropriate by providers who emphasized the treatment's alignment with the tenets of primary care, accessibility, and potential to strengthen stepped care adherence. Some providers suggested minor modifications to the content. Veterans regarded Brief CBT-CP as highly appropriate due to the customizability of the non-pharmacologic skills which helped them achieve their recovery goals while acknowledging that the primary limitation was the intervention's inability to completely eliminate pain. Providers, who viewed the intervention as practical overall, anticipated issues such as patient readiness and logistics as potentially impacting treatment uptake; veterans, however, perceived the intervention as feasible, favoring flexibility with scheduling.</p><p><strong>Conclusions: </strong>Veterans and providers endorsed Brief CBT-CP as a highly acceptable, highly appropriate, and generally feasible non-pharmacological behavioral pain treatment. Veterans described improvements across behavioral, cognitive, and affective domains including decreased pain levels, increased pain tolerance, improved functioning, and decreased stress related to pain.</p><p><strong>Clinical trial information: </strong>The Clinical Trials Registration #NCT03490981.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of AI for adjunctive supportive care in cancer survivorship: opportunities, challenges, and the PRECISION-AI practical framework.","authors":"Frank J Penedo, Sara E Fleszar-Pavlovic, Akina Natori, Andrew Wang, Vasileios Stathias, Jerry Bonnell, Blanca S Noriega Esquives, Tracy E Crane, Jessica MacIntyre, Carmen Calfa, Mitsunori Ogihara","doi":"10.1093/tbm/ibag063","DOIUrl":"https://doi.org/10.1093/tbm/ibag063","url":null,"abstract":"<p><p>Among the 18 million cancer survivors in the United States, many report significant unmet physical, psychosocial, and practical needs that existing healthcare systems struggle to address at scale. This conceptual perspective examines how artificial intelligence (AI)-powered platforms can serve as adjuncts to care by addressing unmet needs, supporting symptom management, and delivering psychoeducation and psychosocial support. Drawing on evidence from oncology AI and cancer survivorship, we consider how AI may improve the quality, personalization, and accessibility of care, distinguishing applications supported by prospective evidence from those that remain in early stages. Preliminary evidence suggests AI has the potential to deliver personalized psychoeducation, symptom monitoring, and psychosocial support as adjuncts to clinical care. To guide responsible development and implementation of these tools, we propose the PRECISION-AI Adjunctive Supportive Care Development Framework, a systematic model for developing, validating, and implementing AI in supportive oncology care. As a primary case example, we describe My Wellness Support, an agentic AI-enabled, risk-stratified supportive care platform designed to augment standard survivorship care, including its conceptual framework and development, ethical considerations, data protections, transparency, and bias mitigation. A proof-of-concept study in breast cancer patients is currently underway. Outcome data are not yet available, and no effectiveness or safety claims are made for the platform. AI in cancer survivorship has potential to expand access to survivorship support and improve health-related quality of life, but realizing this potential requires rigorous prospective validation, equitable implementation across diverse populations, and sustained collaboration among healthcare providers, developers, survivors, ethicists, and policymakers.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors critical for implementing a sustainable depression intervention in faith-based settings.","authors":"Bernadine Y Waller, Michelle Richardson-Ridley, Ana Stefancic, Chiamaka Chidi, Temiloluwa Adeyemo, Leah G Pope, Mosinmiloluwa Adeyemo, Sidney H Hankerson Iii, Rachel C Shelton","doi":"10.1093/tbm/ibaf091","DOIUrl":"10.1093/tbm/ibaf091","url":null,"abstract":"<p><strong>Background: </strong>There is an adverse circuitous relationship between intimate partner violence (IPV) victimization, depression, and femicide, disproportionately affecting depressed Black women IPV survivors, hereafter referred to as \"depressed survivors\", who lack access to culturally responsive care. The Black church has long-been a trusted resource and may be a viable pathway for depression care delivery.</p><p><strong>Purpose: </strong>Plan for implementing a sustainable mental health intervention for depressed survivors help-seeking in faith-based organizations.</p><p><strong>Methods: </strong>We conducted individual, in-depth interviews with 10 Black women IPV survivors, hereafter referred to as \"survivors,\" 10 women clergy or lay ministry leaders and 10 mental health providers. The integrated sustainability framework (ISF) guided interview protocol development and analysis. Inductive-deductive thematic analysis was employed.</p><p><strong>Results: </strong>Factors were found in five ISF domains: (i) outer/community context, (ii) inner/church context, (iii) processes, (iv) intervention characteristics, and (v) interventionist/lay provider characteristics. The funding environment and sociopolitical context emerged as critical outer/community contextual factors. Within the inner/church context, clergy- and lay ministry leader-participants highlighted the need for pastoral support, program champions, and organizational resources/funding. Among processes, the need for stepped care with community partners for crisis referrals as needed, as well as training and supervision were identified. Intervention characteristics included perceived need, adaptability, and contextual fit. As it relates to interventionist/lay provider characteristics, survivor-participants emphasized the demand for discreet, psychologically healthy, and proficient lay health providers.</p><p><strong>Conclusion: </strong>Findings point to the elements critical for developing and implementing sustainable solutions for depressed survivors help-seeking in the Black church. Fundamental to achieving mental health equity is employing collaborative approaches that respond to the nuanced needs and cultural preferences of this historically marginalized community of depressed survivors.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the ORBIT model to design a patient-facing mHealth app for diabetes prevention in urban primary care: translating patient perspectives into app design.","authors":"Cara Stephenson-Hunter, Katherine Florian, Chandra Singh, Earle C Chambers, Andrew Telzak, Linda C Gallo","doi":"10.1093/tbm/ibag065","DOIUrl":"10.1093/tbm/ibag065","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes affects nearly one in three U.S. adults-often progressing to type 2 diabetes within 10 years. Although prediabetes is increasingly identified in primary care and prevention strategies exist, uptake remains low, particularly in urban safety-net settings. This translational gap reflects the complexity of prevention, which is preference- and context-sensitive. Mobile health could bridge this gap and improve engagement, but effective design requires understanding patient needs, barriers, and care context.</p><p><strong>Purpose: </strong>Guided by the Obesity-Related Behavioral Intervention Trials (ORBIT) model, this formative study identified perspectives on prediabetes and diabetes prevention and translated them into components of a patient-facing digital intervention.</p><p><strong>Methods: </strong>Semi-structured qualitative interviews were conducted among 24 adult primary care patients with documented prediabetes in an urban safety-net health system. Interviews explored understanding of prediabetes, decision-making about prevention options, motivation for lifestyle change, and integration of behavioral changes into daily routines. Interviews were transcribed and analyzed using rapid qualitative analysis.</p><p><strong>Results: </strong>Participants (mean age 58.8 years; 83% women; 46% African American/Black; 46% Hispanic/Latino) described six interrelated themes: understanding the diagnosis; making informed treatment decisions; integrating lifestyle change into daily life; finding motivation; staying on track with behavior change; and navigating prevention within health and financial constraints. Themes revealed gaps in risk understanding, counseling, and action planning and were mapped to preliminary app features.</p><p><strong>Conclusions: </strong>This study translated patient-identified needs into initial components for a patient-informed mHealth tool. The findings define early-stage content domains and behavioral targets that will inform prototype refinement, usability testing, and evaluation in primary care.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining interpretation of national trends in lung cancer screening discussions.","authors":"Nav La, Nathkapach K Rattanapitoon, Chutharat Thanchonnang, Schawanya K Rattanapitoon","doi":"10.1093/tbm/ibag012","DOIUrl":"10.1093/tbm/ibag012","url":null,"abstract":"<p><p>This letter comments on Williamson et al.'s nationally representative analysis of patient-clinician discussions on LCS across the 2013-2021 USPSTF guideline periods. We highlight that changes in survey wording and approximated eligibility criteria may partially explain the reported decline in discussions, rather than a true reduction in clinician engagement. We emphasize the behavioral and measurement implications of terminology awareness and eligibility approximation, and propose analytic considerations for future surveillance efforts to support equitable translation of LCS guidelines.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using EPIS and facilitation to support delivery of classroom-based physical activity interventions: a case study.","authors":"Rebecca E Hasson, Danielle Dros, Heidi Roy-Borland, Andria B Eisman, Penelope J Friday, Anna Schwartz, Hala I Abbas","doi":"10.1093/tbm/ibag005","DOIUrl":"10.1093/tbm/ibag005","url":null,"abstract":"<p><strong>Background: </strong>Youth physical inactivity is a major public health concern, particularly in schools serving socioeconomically disadvantaged children. Classroom-based physical activity (PA) interventions offer structured, equitable opportunities for movement, but adoption-fidelity gaps persist. Implementation science frameworks can support schools in aligning interventions with local context and sustaining delivery.</p><p><strong>Purpose: </strong>This study examined the feasibility of using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, paired with facilitation by trained regional school health coordinators, to guide classroom PA implementation in a Michigan elementary school.</p><p><strong>Methods: </strong>An EPIS-aligned implementation guide was developed and refined through a two-phase process to ensure theoretical grounding and practical applicability. Six coordinators were trained and evaluated the training using validated measures of acceptability, appropriateness, and feasibility. One coordinator facilitated InPACT implementation at a single school over 18 months, supporting pre-implementation, rollout, and early sustainment. Implementation was documented using the Hexagon Tool, RE-AIM, Plan-Do-Study-Act cycles, and routine administrative data.</p><p><strong>Results: </strong>Coordinators rated the training highly on all measures. In the pilot school, teachers delivered an average of three PA breaks per day, with lower-elementary classrooms averaging four and upper-elementary classrooms averaging two. Fidelity was supported through structured ramp-up, teacher training, technical assistance, and classroom tracking. Integration into school systems helped to fill gaps in the school district wellness policy. Behavioral referral data indicated a 34% reduction in minor classroom incidents over the first year of implementation.</p><p><strong>Conclusions: </strong>EPIS-guided implementation with facilitation is feasible for supporting adoption, fidelity, and early sustainment of classroom PA. Structured pre-implementation planning, phase-specific support, and alignment with school priorities are critical. Multi-site studies are needed to examine grade-specific strategies, fidelity variability, and long-term sustainment.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}