Implementation research and practice最新文献

{"title":"Not getting better but not getting worse: A cluster randomized controlled pilot trial of a leadership implementation strategy.","authors":"Jill Locke, Catherine M Corbin, Roger Goosey, Vaughan K Collins, Mark G Ehrhart, Kurt Hatch, Christine Espeland, Aaron R Lyon","doi":"10.1177/26334895241312405","DOIUrl":"10.1177/26334895241312405","url":null,"abstract":"<p><strong>Background: </strong>Implementation of evidence-based practices (EBPs) in schools is fraught with challenges. Even when EBPs are initiated, deterioration of implementation efforts often hinders their long-term success. School leadership behaviors can influence teachers' EBP implementation. Our study tested an implementation strategy called Helping Educational Leaders Mobilize Evidence (HELM), adapted from the Leadership and Organizational Change for Implementation strategy, to enhance EBP implementation through improvements in school leadership teams' implementation leadership and climate to buffer against the deterioration of implementation efforts. This study explores the impact of HELM on theorized mechanisms of change (i.e., implementation leadership, climate), educator-level factors (i.e., implementation citizenship), and implementation outcomes (i.e., fidelity, initiative stability).</p><p><strong>Method: </strong>One school district and 10 schools in Washington participated. Five of the schools were randomized to receive the HELM strategy and the remaining five schools received an alternative leadership training as an implementation attention control. Teachers at every school (<i>n</i> = 341) received training for an EBP called Positive Greetings at the Door that has been previously demonstrated to reduce student behavior problems. Principals and Assistant Principals (<i>n</i> = 18) received the HELM strategy or alternative leadership training. Three district Administrators also participated in HELM as part of the Organizational Strategy Development meetings.</p><p><strong>Results: </strong>HELM significantly slowed the average decline of implementation leadership (perseverant leadership and communication), three dimensions of implementation climate (recognition, rewards, and existing supports) and total implementation climate, and one dimension of implementation citizenship (keeping informed). No significant effects were found with regard to implementation outcomes (i.e., fidelity, initiative stability).</p><p><strong>Conclusions: </strong>HELM shows promise in buffering the deterioration of EBP implementation efforts in schools. HELM positively influenced implementation leadership and climate, which are the hypothesized mechanisms for promoting successful long-term implementation efforts. An appropriately powered trial is needed to determine the efficacy of HELM in the future.Name of the registry: clinicaltrials.govTrial registration number: NCT06340074Date of registration: March 29, 2024. Retrospectively registeredURL of trial registry record: https://clinicaltrials.gov/study/NCT06340074?intr=helm&rank=.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895241312405"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of caregiver opinion leaders to increase demand for evidence-based practices for youth anxiety: A cluster randomized controlled trial.","authors":"Margaret E Crane, Marc S Atkins, Sara J Becker, Jonathan Purtle, Gillian C Dysart, Sydney Keller, Olivia Brauer, Sirina E Tiwari, Thomas M Olino, Lara Baez, John Lestino, Philip C Kendall","doi":"10.1177/26334895241312406","DOIUrl":"10.1177/26334895241312406","url":null,"abstract":"<p><strong>Background: </strong>Dissemination initiatives have the potential to increase consumer knowledge of and engagement with evidence-based treatments (e.g., cognitive behavioral therapy [CBT]). Opinion leaders (OLs) have been used in public health campaigns, but have not been examined for the dissemination of mental health treatments. This study uses the Theory of Planned Behavior to test the dissemination strategy of involving an OL in an educational presentation to increase caregiver demand for CBT for youth anxiety.</p><p><strong>Method: </strong>Participants (<i>N </i>= 262; 92% female; 69% White, 82% non-Hispanic) were caregivers who registered for a virtual presentation on youth anxiety treatment through their child's school. Schools within 1.5-hr drive of Philadelphia, PA were cluster-randomized (<i>k </i>= 25; two-arm prospective randomization) to the OL condition (presented by a clinical researcher and local caregiver OL; <i>n </i>= 119 participants) or the researcher-only condition (<i>n </i>= 143 participants). Presentations occurred from May 2021 to May 2022. Measures were completed pre- and post-presentation and at 3-month follow-up.</p><p><strong>Results: </strong>Relative to the researcher co-presenter, participants rated the OL as significantly more relatable, familiar, similar, and understanding of their community, but less credible than the researcher co-presenter. In both conditions, there was a significant pre-post increase in participants' knowledge of, attitudes about, subjective norms related to, and intention of seeking CBT for youth anxiety, but not stigma. Presentation conditions did not differ in change on these measures, or on rates of seeking youth anxiety CBT at follow-up.</p><p><strong>Conclusions: </strong>Although involvement of a caregiver OL did not increase caregiver demand for evidence-based treatment for youth anxiety, the outreach presentation was associated with increases in knowledge of, attitudes about, subjective norms related to, and intention to seek CBT for youth anxiety. Involving OLs in researcher-delivered dissemination efforts may not be necessary for all consumer audiences, but may be beneficial for engendering a sense of relatability, similarity, and connection with disseminators.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895241312406"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissemination through trusted credible messengers: 133 weeks of the Flint Community Webinar on COVID-19.","authors":"Heatherlun Uphold, E Yvonne Lewis, Amy Drahota, Blair Warren, Jennifer Edwards-Johnson, Mary Katherine Crawford, Richard Sadler, Susan J Woolford, Roni Ellington, Marc Zimmerman, Alison Grodzinski, C Debra Furr-Holden","doi":"10.1177/26334895241312404","DOIUrl":"10.1177/26334895241312404","url":null,"abstract":"<p><strong>Background: </strong>Community access to evidence-based information is critical, especially during a pandemic, as it can impact knowledge and adoption of health behaviors that affect health disparities. The field of dissemination and implementation (D&I) science is ideally positioned to address this need through its focus on reducing the research-to-practice gap through improved distribution of information. The purpose of this paper is to describe the creation of a weekly webinar series about COVID-19 directed toward community members, and the extent to which webinars were found useful and increased awareness of evidence-based information and services. Lessons learned about this dissemination strategy as well as the selection and involvement of trusted credible messengers (TCMs) to share information are discussed.</p><p><strong>Method: </strong>Data were derived from Zoom attendance reports, YouTube views, and survey responses collected about the weekly webinar series over 133 weeks from March 20, 2020 through September 30, 2022.</p><p><strong>Results: </strong>The webinar reached a minimum of 877 unique within-webinar participants, representing more than 9,190 in-webinar participant hours and an additional 17,303 YouTube views. A consistent base of weekly attendees (e.g., service providers, community members) reported increasing levels of satisfaction and utility over time.</p><p><strong>Conclusions: </strong>This study supports the use of a community webinar series to disseminate evidence-based, locally relevant information through TCMs to improve community access to knowledge of health information and resource utility.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895241312404"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing or validating physician opioid prescribing behaviors through audit and feedback and academic detailing interventions in primary care.","authors":"Celia Laur, Natasha Kithulegoda, Nicola McCleary, Emily Nicholas Angl, Michael Strange, Barbara Sklar, Thivja Sribaskaran, Gail Dobell, Sharon Gushue, Jonathan M C Lam, Lindsay Bevan, Victoria Burton, Lena Salach, Justin Presseau, Laura Desveaux, Noah Ivers","doi":"10.1177/26334895241307638","DOIUrl":"https://doi.org/10.1177/26334895241307638","url":null,"abstract":"<p><strong>Background: </strong>In Ontario, Canada, province-wide initiatives supporting safer opioid prescribing in primary care include voluntary audit and feedback reports and academic detailing. In this process evaluation, we aimed to determine the fidelity of delivery and receipt of the interventions, the observed change strategies used by physicians, potential mechanisms of action, and how complementary the initiatives can be to each other.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with academic detailers and with physicians who received both interventions. Academic detailer interviews were coded using the Behavior Change Technique Taxonomy; physician interviews were coded to the Theoretical Domain Framework. Change strategies were summarized based on academic detailer intentions and physician-reported practice changes. Potential mechanisms of action were identified using the Theories and Techniques Tool and the literature. Patient partners informed the interpretation of results through ongoing group discussions of preliminary findings.</p><p><strong>Results: </strong>Interviews were conducted with eight academic detailers and 12 physicians. Change strategies described by academic detailers to support physicians' opioid prescribing included <i>problem solving</i>, <i>instructions on how to perform the behavior</i>, <i>adding objects to the environment</i>, <i>credible source</i>, <i>shaping knowledge</i>, and <i>social support.</i> Physicians mentioned that academic detailing validated current opioid practices or increased their <i>belief about capabilities</i> and their <i>intentions</i>, mediated by increased <i>skills</i> and the impact of <i>environmental context and resources</i>. Potential mechanisms of action included <i>behavioral regulation</i>, <i>behavioral cueing</i>, and <i>general attitudes/beliefs.</i> On its own, receiving the audit and feedback report did not lead to changes in beliefs about prescribing practices; however, for some physicians, it provided validation and reassurance. Physicians saw unrealized potential for complementarity.</p><p><strong>Conclusions: </strong>New interventions are often implemented in a complex ecosystem with other competing interventions. In this study, we show how examining the fidelity of the intervention from initial design through to delivery can identify opportunities for potential optimization.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895241307638"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formative evaluation of the implementation of digital therapeutics for opioids and other substance use disorders in primary care (DIGITS trial).","authors":"Lorella Palazzo, Caitlin N Dorsey, Jess Mogk, Tara Beatty, Deborah King, Kelsey Stefanik-Guizlo, Dustin Key, Tessa E Matson, Mary Shea, Ryan M Caldeiro, Angela Garza McWethy, Edwin S Wong, Abisola E Idu, Joseph E Glass","doi":"10.1177/26334895241301670","DOIUrl":"10.1177/26334895241301670","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorders (SUDs) result in individual and societal burden. However, most individuals with SUD receive no treatment. Implementing SUD interventions in primary care could address this population's treatment needs. In the USA, reSET^® and reSET-O^® were the first prescription digital therapeutics (PDTs) for SUDs and opioid use disorder (OUD), respectively. The Digital Treatments for Substance Use Disorder (DIGITS) study tested the effectiveness of practice facilitation and health coaching strategies to support reSET and reSET-O implementation into primary care. A formative evaluation was conducted to monitor implementation, inform adaptations, and learn what promotes PDT sustainment.</p><p><strong>Method: </strong>The Dynamic Sustainability Framework and the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies guided the evaluation. Using rapid qualitative methods, we collected and analyzed observational fieldnotes, key informant interviews, and document sources (e.g., meeting minutes) for synthesis and dissemination to clinical partners and the study team via formative reports. We analyzed the reports to generate evaluation results.</p><p><strong>Results: </strong>Twenty-four primary care clinics participated. Evaluation data included 98 observational fieldnotes, 16 interviews, and 253 document sources. We produced nine formative reports. The study encountered barriers and facilitators in each DSF domain (ecological system, practice setting, and intervention). In the ecological system, the PDT vendor enabled the study, but the COVID-19 pandemic, laws, regulations, and contracting delayed implementation. In the practice setting, staff shortages and low clinic capacity were implementation challenges, while electronic health record capabilities were both barriers and facilitators. At the intervention level, non-routine workflows, clinician burden, and low patient engagement were barriers despite clinicians' efforts.</p><p><strong>Conclusions: </strong>Digital therapeutics are promising SUD and OUD treatments, but integration into primary care requires conducive laws and regulations, organizational capacity, and patient and clinician engagement. Formative evaluation identified important lessons for future PDT implementation.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"5 ","pages":"26334895241301670"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A conceptual framework for assessing implementation strategy integrity.","authors":"Todd Molfenter, Lori Ducharme, Lynda Stein, Steven Belenko, Shannon Gwin Mitchell, Dennis P Watson, Matthew C Aalsma, Peter D Friedmann, Jennifer E Becan, Bryan R Garner, Jessica Vechinski, Alida Bouris, Emily Claypool, Kate Elkington","doi":"10.1177/26334895241297278","DOIUrl":"10.1177/26334895241297278","url":null,"abstract":"<p><strong>Background: </strong>The outcomes of planned implementation efforts have been mixed, with some applications failing to achieve the desired change or impact. While reasons for mixed findings in implementation research are multifaceted (e.g., Damschroder et al., 2009, 2022), how the implementation strategy (IS) was deployed (i.e., integrity) and its impact on the implementation outcomes of evidence-based innovations (EBIs) is under-studied and warrants further clarification.</p><p><strong>Method: </strong>This article builds on the IS fidelity and mechanisms of change literature to create the Implementation Strategy Integrity Framework (ISIF). The ISIF was developed by a set of implementation science researchers in the Justice Community Opioid Innovation Network seeking to document the role of implementation strategies in influencing EBI outcomes.</p><p><strong>Results: </strong>The authors identified four areas of documentation and measurement to examine the role of IS integrity on EBI outcomes. (a) Implementation Strategy Rigor (i.e., adherence, dose, and quality) requires those implementing the strategy/strategies to specify them, document adherence to the planned strategies, quality of execution, and any adaptations made. (b) Target User Responsiveness documents the extent and quality of targeted users' participation in IS activities and how well the target users perform their roles in conducting actions intended by the implementation strategies. (c) Target Mechanism Activation notes to what degree the implementation strategies achieved the intended impact(s) on targeted factors that facilitate EBI use. Finally, (d) these three areas are combined with selected Inner and Outer Context variables to explain IS integrity's potential moderating and mediating effects on EBI outcomes.</p><p><strong>Conclusions: </strong>A framework that can define the integrity of an IS and allow for its subsequent use as an explanatory variable in EBI outcomes is necessary for better elucidating mechanisms of action. The ISIF offers a structured approach to operationalize, measure, and evaluate the application and related impacts of implementation strategies.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"5 ","pages":"26334895241297278"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling up mental health service provision through multisectoral integration: A qualitative analysis of factors shaping delivery and uptake among South Sudanese refugees and healthcare workers in Uganda.","authors":"Jacqueline N Ndlovu, Soukaina Ouizzane, Marx R Leku, Kenneth K Okware, Hafsa Sentongo, Bathsheba Nyangwen, Nawaraj Upadhaya, Morten Skovdal, Jura L Augustinavicius, Wietse A Tol","doi":"10.1177/26334895241288574","DOIUrl":"10.1177/26334895241288574","url":null,"abstract":"<p><strong>Background: </strong>There is a growing need for mental health and psychosocial support (MHPSS) interventions that can feasibly be provided to larger groups of people, particularly in humanitarian settings. However, scaling up mental health interventions is notoriously difficult. There are therefore growing calls for integrating mental health outside traditional health structures, both to increase reach and to address social determinants of mental health. The objective of this study is to explore barriers and facilitators of Self-Help Plus (SH+), an MHPSS innovation implemented through multisectoral integration. We explore delivery and uptake at the scale of SH+ and aim to understand intervention adaptation needs when integrating SH+ within other health and non-health sectors in Uganda.</p><p><strong>Method: </strong>We conducted a qualitative study using in-depth interviews in two phases: first for a needs and resource assessment, and second for a process evaluation. We conducted 50 in-depth interviews with BRAC Uganda and MoH partner staff, intervention facilitators, and target impact group members between July and December 2022. A thematic network analysis process was used to identify barriers and facilitators of SH+ delivery and uptake at scale in Uganda.</p><p><strong>Results: </strong>We identified five major factors that should be considered when scaling through multisectoral integration, namely: (1) adaptivity, (2) funding mechanisms, (3) social capital, (4) participation, and (5) sustainability. Within these factors, there were varying degrees to which a factor was a facilitator or barrier, depending on participants' perceptions of the intervention.</p><p><strong>Conclusions: </strong>Our findings suggest that multisectoral integration of SH+ into sectors both inside and outside of health may be a viable means to scale SH+ and increase reach. However, funding, partnerships, co-creation, and adaptability need to be further explored to facilitate better and more sustainable integration.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"5 ","pages":"26334895241288574"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a pilot implementation of a digital cognitive behavioral therapy platform for isolated older adults in county mental health services.","authors":"Rosa Hernandez-Ramos, Stephen M Schueller, Judith Borghouts, Kristina Palomares, Elizabeth Eikey, Margaret Schneider, Nicole A Stadnick, Kai Zheng, Dana B Mukamel, Dara H Sorkin","doi":"10.1177/26334895241288571","DOIUrl":"10.1177/26334895241288571","url":null,"abstract":"<p><strong>Background: </strong>Technology-enabled services (TESs) have the potential to increase access to mental healthcare. However, little research has focused on how TESs can be integrated into publicly funded service settings. As part of the state-wide Help@Hand project, Marin County conducted a pilot implementation of myStrength, a digital cognitive behavioral therapy platform, to explore its potential to reduce loneliness among isolated older adults. We evaluated the pilot impact using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.</p><p><strong>Method: </strong>A single-site 6-month pilot implementation recruited English (<i>n</i> = 15) and Spanish-speaking (<i>n</i> = 15) isolated older adults who received a digital literacy course followed by 8 weeks of myStrength access and human support. We evaluated factors related to reach, effectiveness, adoption, and implementation using the perspectives of users and County staff. Descriptive statistics were used to examine reach, adoption, and implementation. Nonparametric tests, including Friedman and Wilcoxon signed-rank, were used to examine effectiveness.</p><p><strong>Results: </strong>Reach: Compared to overall county demographics, platform users were majority female (93.1% vs. 50.5%), ethnoracialized (62.1% vs. 24.2%), and of lower socioeconomic status (<i>Mdn</i> = $35,000 vs. $131,008). Effectiveness: Users reported a significant (<i>z</i> = -2.62, <i>p</i> < .001) decrease in loneliness. Adoption: Users logged into myStrength an average of 10 times and completed 33 activities during the 8 weeks of myStrength use. Implementation: Each pilot staff (<i>N</i> = 20) spent an average of 19.8 hr (<i>SD</i> = 16.51) supporting users' use of myStrength during the pilot. Pilot staff reported several adaptations to meet the needs of users.</p><p><strong>Conclusions: </strong>Successes included reaching the target population, reducing loneliness, and user adoption. However, pilot staff invested significant time to support those with lower digital literacy skills. As such, although TESs may address unmet needs, their use with underserved populations may require upfront and ongoing support provided by the settings where they are implemented.</p><p><strong>Plain language summary title: </strong>Testing a New Digital Therapy Tool for Isolated Older Adults in County Mental Health Services.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"5 ","pages":"26334895241288571"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calculating power for multilevel implementation trials in mental health: Meaningful effect sizes, intraclass correlation coefficients, and proportions of variance explained by covariates.","authors":"Nathaniel J Williams, Nicholas C Cardamone, Rinad S Beidas, Steven C Marcus","doi":"10.1177/26334895241279153","DOIUrl":"https://doi.org/10.1177/26334895241279153","url":null,"abstract":"<p><strong>Background: </strong>Despite the ubiquity of multilevel sampling, design, and analysis in mental health implementation trials, few resources are available that provide reference values of design parameters (e.g., effect size, intraclass correlation coefficient [ICC], and proportion of variance explained by covariates [covariate <i>R</i> ²]) needed to accurately determine sample size. The aim of this study was to provide empirical reference values for these parameters by aggregating data on implementation and clinical outcomes from multilevel implementation trials, including cluster randomized trials and individually randomized repeated measures trials, in mental health. The compendium of design parameters presented here represents plausible values that implementation scientists can use to guide sample size calculations for future trials.</p><p><strong>Method: </strong>We searched NIH RePORTER for all federally funded, multilevel implementation trials addressing mental health populations and settings from 2010 to 2020. For all continuous and binary implementation and clinical outcomes included in eligible trials, we generated values of effect size, ICC, and covariate <i>R²</i> at each level via secondary analysis of trial data or via extraction of estimates from analyses in published research reports. Effect sizes were calculated as Cohen <i>d</i>; ICCs were generated via one-way random effects ANOVAs; covariate <i>R²</i> estimates were calculated using the reduction in variance approach.</p><p><strong>Results: </strong>Seventeen trials were eligible, reporting on 53 implementation and clinical outcomes and 81 contrasts between implementation conditions. Tables of effect size, ICC, and covariate <i>R²</i> are provided to guide implementation researchers in power analyses for designing multilevel implementation trials in mental health settings, including two- and three-level cluster randomized designs and unit-randomized repeated-measures designs.</p><p><strong>Conclusions: </strong>Researchers can use the empirical reference values reported in this study to develop meaningful sample size determinations for multilevel implementation trials in mental health. Discussion focuses on the application of the reference values reported in this study.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"5 ","pages":"26334895241279153"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparation for implementation of evidence-based practices in urban schools: A shared process with implementing partners.","authors":"Ricardo Eiraldi, Rachel Comly, Courtney Benjamin Wolk, Quinn Rabenau-McDonnell, Barry L McCurdy, Muniya S Khanna, Abbas F Jawad, Jayme Banks, Stacina Clark, Kristina M Popkin, Tara Wilson, Kathryn Henson","doi":"10.1177/26334895241279503","DOIUrl":"https://doi.org/10.1177/26334895241279503","url":null,"abstract":"<p><strong>Background: </strong>Shifting organizational priorities can negatively affect the sustainment of innovations in community settings. Shifting priorities can present barriers to conducting clinical research in schools if a misalignment occurs between school district priorities and the aims of the study. Often this misalignment occurs due to a shift during the period between when the study is submitted for funding and when research activities begin. Participatory research approaches can be employed to restore alignment between study processes and school district priorities. The purpose of the study is to describe data from a shared process with district partners. The shared process resulted in modifications to the main study's implementation processes and strategies in order to restore alignment with evolving school priorities while remaining faithful to the aims of the study.</p><p><strong>Method: </strong>Data originated from qualitative interviews conducted with 20 school district and school personnel in a large urban school district. Qualitative themes were organized into categories based on a social-ecological school implementation framework. Data from team meetings, meetings with school district administrators, and emails served to supplement and verify findings from interview analyses.</p><p><strong>Results: </strong>Themes included barriers and facilitators at the macro-, school-, individual-, team-, and implementation quality levels. Adaptations were made to address barriers and facilitators and restore alignment with school district priorities. Most adaptations to study processes and implementation strategies focused on re-training and providing more information to school district coaches and school-based staff. New procedures were created, and resources were re-allocated for the larger study.</p><p><strong>Conclusions: </strong>Findings were discussed in relation to the implementation literature in schools. Recommendations for sustaining strong collaboration among researchers and school partners are provided.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"5 ","pages":"26334895241279503"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}