Implementation research and practice最新文献

{"title":"Barriers and facilitators of inpatients and healthcare professionals prior to the implementation of a Multidisciplinary Lifestyle-Focused Approach in the Treatment of Inpatients With Mental Illness (MULTI+): The MULTI+ Study II.","authors":"Myrthe M E van Schothorst, Natascha M den Bleijker, Peter N van Harten, Nanne K De Vries, Jeroen Deenik","doi":"10.1177/26334895251351663","DOIUrl":"10.1177/26334895251351663","url":null,"abstract":"<p><strong>Background: </strong>Despite the efficacy of lifestyle interventions for the physical and mental health of people with mental illness, there is little change in clinical care. Understanding barriers and facilitators of implementation can help interpret intervention effectiveness and aid implementation. This cross-sectional study identifies barriers and facilitators before implementing a multidisciplinary lifestyle approach in the treatment of inpatients with mental illness (MULTI+). Additionally, we analyze associations between barriers and facilitators, and recipients' health and demographic characteristics.</p><p><strong>Method: </strong>This study used baseline data from an open cohort stepped wedge cluster randomized trial. The Measurement Instrument for Determinants of Innovations was used to investigate barriers and facilitators associated with the innovation (MULTI+), user (recipients and deliverers), and organization. Data was collected through semi-structured interviews for recipients and an online survey for deliverers. We explored associations between barriers and facilitators, and recipients' health and demographic characteristics through multiple regression models.</p><p><strong>Results: </strong>We included 134 recipients and 125 deliverers. Perceived barriers to implementing MULTI+ included complexity, incomplete information, and incompatibility with current treatment. Recipients and deliverers reported personal barriers, including a lack of personal benefits, potential drawbacks, and insufficient knowledge. Facilitators such as the recognized importance of lifestyle-focused care, social support, and organizational commitment could enhance implementation. Being hospitalized for more than a year was negatively associated with determinants such as compatibility, patient relevance, and satisfaction (range between <i>β</i> = -.25 and <i>β</i> = -.45). Regression models indicated few other associations. Suggestions to address barriers were made.</p><p><strong>Conclusions: </strong>This study is one of the first to analyze barriers and facilitators before the large-scale implementation of a multicomponent lifestyle-focused approach in mental healthcare. Recipients and deliverers experience barriers and facilitators across all domains. Addressing these factors through patient-level tailoring, structured training, the use of champions, and sustained organizational support may enhance implementation and sustainability.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov registration. Identifier: NCT04922749. Retrospectively registered 3rd of June 2021.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251351663"},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593063","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":"Evaluating implementation preparedness for suicide screening and referral in a Nepali emergency department: A mixed-methods study.","authors":"Anmol P Shrestha, Roshana Shrestha, Ajay Risal, Renu Shakya, Kripa Sigdel, Riya Bajracharya, Pratiksha Paudel, Divya Gumudavelly, Emilie Egger, Sophia Zhuang, Lakshmi Vijayakumar, Ashley Hagaman","doi":"10.1177/26334895251343644","DOIUrl":"10.1177/26334895251343644","url":null,"abstract":"<p><strong>Background: </strong>Most research on appropriate, feasible, and effective suicide screening has excluded research conducted in non-Western and low-income settings. This study explores preparedness and co-designing a suicide screening and referral intervention in a Nepali emergency department (ED) using the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Method: </strong>To assess implementation readiness and context, we conducted eight key informant interviews and four focus-group discussions with clinical staff along with 3 months of embedded ethnography. We also assessed clinical staff (<i>n</i> = 26) knowledge, attitudes, current practices, confidence, and institutional priorities surrounding implementing suicide screening using structured questionnaires. Qualitative analysis used CFIR to assess feasibility, acceptability, and necessary implementation strategies for a suicide screening intervention within the context of this resource-strained ED. We report descriptive statistics of quantitative findings using a convergent analytic mixed-methods approach.</p><p><strong>Results: </strong>Qualitatively, clinicians expressed hopelessness and reservations surrounding ED programs to prevent suicide given important system and social barriers. Additionally, they doubted their ability to meaningfully overcome broader structural issues in their patients' lives (e.g., poverty and family tension) that they believed more directly determined suicidal behavior and thwarted help seeking. They discussed practical and emotional motivators for doing suicide prevention work, which highlighted departmental leadership and deep teamwork that motivated action despite wider societal myths that suicide cannot easily be prevented. Quantitative assessments largely supported these findings, indicating shared beliefs that suicide prevention was important and supported by leadership. However, providers frequently endorsed suicide myths and noted barriers including difficult interdepartmental collaboration, limited confidence in suicide prevention communication and suicide screening.</p><p><strong>Conclusions: </strong>In under-resourced settings, staff must contend with competing responsibilities and complex structural causes of suicide and barriers to treatment. These can impede implementation of suicide screening interventions and must be integrated into the co-design of implementation strategy selection and deployment.</p><p><strong>Trial registration: </strong>NCT06094959 clinicaltrials.gov.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251343644"},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593064","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":"Supporting integration of substance use interventions in HIV service organizations: Assessing the fit of 10 strategies for AIDS Education and Training Centers to use.","authors":"Sheila V Patel, Sarah Philbrick, Michael Bradshaw, Heather J Gotham, Hannah K Knudsen, Tom Donohoe, Stephen Tueller, Bryan R Garner","doi":"10.1177/26334895251343647","DOIUrl":"10.1177/26334895251343647","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;People with HIV are more likely than the general population to have a substance use disorder (SUD), which can impact the HIV care continuum. HIV service organizations (HSOs) can implement SUD interventions but may need assistance from support systems like the AIDS Education and Training Center (AETC) network. We assess the fit of strategies AETCs may use to help HSOs integrate SUD interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;We invited 74 of 91 AETCs (81.3%) to participate. Using a real-time Delphi approach, 64 AETCs (86.5% of those invited) rated the (a) importance of, (b) feasibility of, (c) readiness to offer, (d) scalability of, (e) pressure to offer, and (f) current need for 10 strategies their AETC could use to help HSOs integrate SUD interventions. Items were examined via confirmatory factor analyses. Responses were summed to create the Setting-Strategy Fit index score. We conducted pairwise t-tests to examine differences in scores between strategies, plotted the mean importance ratings for each strategy against the mean ratings for other criteria to review the strategies' relative viability, and conducted bivariate and multiple regression analyses to examine correlates of the scores.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The items of the Setting-Strategy Fit index showed good internal consistency and model fit. Generally, strategies were considered somewhat important but AETCs felt very little pressure to offer them. Two strategies (disseminating information, providing access to asynchronous training) exceeded the \"important\" threshold. One strategy (disseminating information) was considered viable for also having high feasibility. Overall, AETCs were only somewhat ready to provide the strategies, which were perceived as only somewhat feasible or currently needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Although AETCs recognized the importance of several strategies for helping HSOs integrate SUD interventions, their responses resulted in only one having good fit. These findings can guide efforts to further prepare AETCs to support HSOs and to end the HIV epidemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;&lt;b&gt;&lt;i&gt;Strategies AIDS Education and Training Centers Could Use to Help HIV Service Organizations Implement Substance Use Interventions.&lt;/i&gt;&lt;/b&gt; &lt;b&gt;Why was the study done?:&lt;/b&gt; Having a substance use disorder (SUD) can complicate care for people with HIV by reducing their engagement in services. HIV service organizations (HSOs) serve people with HIV but not all of them offer services to address SUD. We assessed the fit of different strategies that AIDS Education and Training Centers (AETCs), which provide technical assistance to HSOs, could use to help HSOs implement SUD interventions.&lt;b&gt;What did the researchers do?:&lt;/b&gt; We engaged 74 AETC representatives nationally to rate 10 strategies. They were asked about (a) the importance of the strategies, (b) the feasibility of offering them, (c) their readiness to off","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251343647"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478135","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: Facilitators, barriers, and EDI considerations for clinical implementation of a stepped-care early mental health parenting program (I-InTERACT-North).","authors":"Tricia S Williams, Angela Deotto, Andrea Greenblatt, Giulia F Fabiano, Rivka Green, Janaksha Linga-Easwaran, Evdokia Anagnostou, Jennifer Crosbie, Elizabeth Kelley, Steven P Miller, Rob Nicolson, Jennifer Rosart, Shari L Wade, Melanie Barwick","doi":"10.1177/26334895251346816","DOIUrl":"10.1177/26334895251346816","url":null,"abstract":"<p><strong>Background: </strong>Clinicians, health care organizations, and families demand better and more accessible children's mental health services with greater patient engagement. The I-InTERACT-North program was developed for children following traumatic brain injury and adapted for a transdiagnostic neurological and neurodevelopmental focus, with a recent transition to a stepped-care model. To date, the program has been exclusively provided within research studies; however, demand for its clinical use is growing. Implementation frameworks provide essential guidance regarding facilitators and barriers of clinical implementation under real-world conditions. Similarly, intersectionality evaluation can provide insights to develop equitable and inclusive health care practices. Informed by the Consolidated Framework of Implementation Research 2.0 (CFIR) and recent intersectionality supplement, the objectives were to examine the perspectives of parents/caregivers and clinical partners involved in the I-InTERACT-North program to identify (a) facilitators and barriers to inform the scale and spread of the program, and (b) equity, diversity, and inclusion (EDI) considerations to integrate in future clinical implementation.</p><p><strong>Method: </strong>This study used a qualitative descriptive design with focus group methodology. Participants included parents/caregivers and clinical partners. Semi-structured focus groups were conducted virtually. Focus group data were coded inductively and deductively using CFIR 2.0. The team reflected on intersectionality in the data, coding results, and broader context of the program's history.</p><p><strong>Results: </strong>Positive perceptions of the innovation's relevance and adaptability were echoed across focus groups. Prominent facilitators included the program's adaptability, personalized, flexible format, and knowledge dissemination. Barriers included geography, technological accessibility, and workflow, with participants stressing the importance of tailoring to culture, language, and neurodiversity. Feedback from participants aligned with 10 reflective prompts highlighted within the CFIR intersectionality supplement pertaining to families' intersecting categories, diverse intervention experiences, and information access.</p><p><strong>Conclusions: </strong>Identified facilitators of I-InTERACT-North implementation extended across program knowledge sharing and recruitment. Recommendations included directions for clinical and system integration to facilitate scalability.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251346816"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478134","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 randomized controlled trial testing supervision strategies in community mental health.","authors":"Shannon Dorsey, Rashed AlRasheed, Suzanne Eu Kerns, Rosemary D Meza, Noah Triplett, Esther Deblinger, Nathaniel Jungbluth, Lucy Berliner, Lavangi Naithani, Michael D Pullmann","doi":"10.1177/26334895251330523","DOIUrl":"10.1177/26334895251330523","url":null,"abstract":"<p><strong>Background: </strong>Clinicians need supports beyond training to deliver evidence-based treatments with fidelity. Workplace-based clinical supervision often is a commonly provided support in community mental health, yet too few studies have empirically examined supervision and its impact on clinician fidelity and treatment delivery.</p><p><strong>Method: </strong>Building on a Washington State-funded evidence-based treatment initiative (CBT+), we conducted a randomized controlled trial (RCT), testing two supervision conditions delivered by workplace-based supervisors (supervisors employed by community mental health organizations). The RCT followed a supervision-as-usual (SAU) phase for comparison. The treatment of focus was trauma-focused cognitive behavioral therapy (TF-CBT). Clinicians (<i>N</i> = 238) from 25 organizations participated in the study across the SAU baseline and RCT phases. In the RCT phase, clinicians were randomized to either symptom and fidelity monitoring (SFM) or SFM and behavioral rehearsal (SFM + BR). For BR, clinicians engaged in a short role play of an upcoming treatment element. Supervisors delivered both conditions, with regular study monitoring for drift. Clinicians audiorecorded therapy sessions with enrolled clients, and masked coders coded a subset of recordings for adherence to TF-CBT. One hundred and thirty-three clinicians had recorded TF-CBT session data for 258 youth. We examined six adherence outcomes, including potential moderators.</p><p><strong>Results: </strong>Results of generalized estimating equations indicated that there were no real differences on adherence outcomes for experimental conditions (SFM, SFM + BR) compared to SAU. Adherence scores in the baseline SAU phase and the RCT conditions were high. Only one interaction was significant.</p><p><strong>Conclusions: </strong>Contrary to our hypotheses, we did not see improvements in adherence with the RCT conditions. However, nonsignificant findings seem best explained by clinicians' acceptable/high adherence in SAU. This study was conducted within the context of a long-standing, state-funded EBT initiative, in which clinicians and their supervisors receive training and support, and in which participating community mental health organizations have adopted and supported TF-CBT.</p><p><strong>Clinicaltrialsgov id: </strong>NCT01800266.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251330523"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144741","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":"Organizational readiness for change: A systematic review of the healthcare literature.","authors":"Laura Caci, Emanuela Nyantakyi, Kathrin Blum, Ashlesha Sonpar, Marie-Therese Schultes, Bianca Albers, Lauren Clack","doi":"10.1177/26334895251334536","DOIUrl":"10.1177/26334895251334536","url":null,"abstract":"<p><strong>Background: </strong>Organizational readiness for change (ORC), referring to psychological and behavioral preparedness of organizational members for implementation, is often cited in healthcare implementation research. However, evidence about whether and under which conditions ORC is relevant for positive implementation results remains ambiguous, with past studies building on various theories and assessing ORC with different measures. To strengthen the ORC knowledge base, we therefore identified factors investigated in the empirical literature alongside ORC, or as mediators and/or moderators of ORC and implementation.</p><p><strong>Method: </strong>We conducted a systematic review of experimental, observational, and hybrid studies in physical, mental, and public health care that included a quantitative assessment of ORC and at least one other factor (e.g., ORC correlate, predictor, moderator, or mediator). Studies were identified searching five online databases and bibliographies of included studies, employing dual abstract and full text screening. The study synthesis was guided by the Consolidated Framework for Implementation Research integrated with the Theory of ORC. Study quality was appraised using the Mixed Methods Appraisal Tool.</p><p><strong>Results: </strong>Of 2,907 identified studies, 47 met inclusion criteria, investigating a broad range of factors alongside ORC, particularly contextual factors related to individuals and the innovation. Various ORC measures, both home-grown or theory-informed, were used, confirming a lack of conceptual clarity surrounding ORC. In most studies, ORC was measured only once.</p><p><strong>Conclusions: </strong>This systematic review highlights the broad range of factors investigated in relation to ORC, suggesting that such investigation may enhance interpretation of implementation results. However, the observed diversity in ORC conceptualization and measurement supports previous calls for clearer conceptual definitions of ORC. Future efforts should integrate team-level perspectives, recognizing ORC as both an individual and team attribute. Prioritizing the use of rigorous, repeated ORC measures in longitudinal implementation research is essential for advancing the collective ORC knowledge base.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251334536"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095858","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":"Evaluating professionals' adaptations before and after a decision support intervention \"the Adaptation and Fidelity Tool\" (A-FiT)-A longitudinal within-person intervention design.","authors":"Johanna Zetterlund, Henna Hasson, Ulrica von Thiele Schwarz, Margit Neher, Emmie Wahlström","doi":"10.1177/26334895251334552","DOIUrl":"https://doi.org/10.1177/26334895251334552","url":null,"abstract":"<p><strong>Background: </strong>Implementing evidence-based interventions (EBIs) in practice requires balancing fidelity and adaptation to suit new contexts. Careful considerations are needed to maintain the core elements for effectiveness while ensuring fit with new contexts. The Adaptation and Fidelity Tool (A-FiT) intervention addresses this challenge by providing support for professionals using EBIs in the sustainment phase of implementation. This study evaluates the A-FiT intervention and examines how professionals delivering an EBI manage fidelity and adaptation during the sustainment phase of implementation, before and after the intervention. Method Short, structured interviews were repeatedly conducted with 14 professionals delivering an EBI (<i>n</i> = 127). Data was analyzed using deductive content analysis focusing on adaptation types, planning, intentionality, and fidelity consistency. The adaptations were counted and compared before versus after the A-FiT intervention using a chi²-test.</p><p><strong>Results: </strong>The professionals made about the same number of adaptations before and after the A-FiT intervention. However, after the intervention, significant changes in the type and intentionality of the adaptations were observed. Changes in type consisted of fewer \"removing,\" \"substituting,\" and \"integrating another framework\" adaptations and more \"loosening structure\" and \"departing from the intervention\" adaptations. Regarding intentionality, fewer planned adaptations with the intention of improving the EBI effects were made, while adaptations made for practical reasons, both planned and unplanned, increased after the A-FiT intervention. No statistical change was found regarding fidelity consistency.</p><p><strong>Conclusions: </strong>The findings indicate increased awareness about fidelity and adaptation among the group leaders, resulting in fewer planned adaptations to enhance program effects and more practical adaptations to address context challenges. The A-FiT intervention appears to help professionals in their management of fidelity and adaptations when delivering EBIs. The study underscores the importance of understanding adaptations in their context, purpose, and impact (intended and unintended) on the outcome/value.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251334552"},"PeriodicalIF":0.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013923","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":"Implementation of a novel pain coach educator program in a safety-net emergency department.","authors":"Jennifer H LeLaurin, Magda Montague, Megan E Curtis, Ramzi G Salloum, Sophia Sheikh, Phyllis L Hendry","doi":"10.1177/26334895251330511","DOIUrl":"10.1177/26334895251330511","url":null,"abstract":"<p><strong>Introduction: </strong>The ongoing opioid epidemic and rising number of patients with chronic pain highlight the need for alternative and integrative pain management approaches as a strategy to reduce opioid use and misuse. Evidence-based nonpharmacologic pain management strategies are available; however, they remain underutilized due to barriers including time limitations, cost, and lack of training. To address these barriers, we implemented a pain coach educator pilot program and nonpharmacologic patient toolkit in the emergency department of a large safety-net hospital. This paper describes the implementation process and preliminary evaluation of the first year of the program.</p><p><strong>Method: </strong>We implemented a multimodal pain coach educator program that included education on pain neuroscience and over-the-counter analgesic options, demonstration of integrative techniques, and dissemination of nonpharmacologic toolkits for home use in January 2021. Implementation strategies included changing the electronic health record infrastructure, developing stakeholder interrelationships, and ongoing education and training. We used the RE-AIM framework to guide evaluation of the first year of program implementation using data from the electronic health record, program records, and patient-reported outcomes.</p><p><strong>Results: </strong>In the first year of program implementation, 550 pain coach educator sessions were conducted. Upon session completion, 61% of patients felt the program was helpful, 39% were unsure at the time, and none reported session was not helpful. Clinician feedback was overwhelmingly positive. Program cost per patient was $344.35. Adaptations to intervention and implementation strategies included modifications of session delivery timing to accommodate clinical workflows, additions to program content to align with patient characteristics, and changes to patient identification strategies in response to the COVID-19 pandemic.</p><p><strong>Conclusions: </strong>Our pain coach educator program provides a model for implementing nonpharmacologic pain management opioid alternatives which can be scaled and adapted for other settings. This work demonstrates the importance of intervention and implementation strategy adaptations to enhance program reach and effectiveness.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251330511"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796284","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":"Implementation strategies for school-based universal prevention: A qualitative pilot study of Enhanced and standard Replicating Effective Programs.","authors":"Andria B Eisman, Christine Koffkey, Judy Fridline, Christina Harvey, Rebecca E Hasson, Lawrence A Palinkas, Amy M Kilbourne","doi":"10.1177/26334895251330520","DOIUrl":"10.1177/26334895251330520","url":null,"abstract":"<p><strong>Background: </strong>School-based universal prevention programs, like the Michigan Model for Health™ (MMH), hold promise for enhancing youth behavioral health but often face implementation challenges due to insufficiently addressing priority student issues. Previous research identified trauma-sensitive content as a student need in the MMH. Enhanced Replicating Effective Programs (REP), a multicomponent implementation strategy, is well suited to support program providers in addressing priority health issues among youth.</p><p><strong>Method: </strong>This pilot cluster-randomized controlled trial compared Enhanced REP (tailored curriculum, training, and implementation facilitation with trauma-sensitive content) to standard REP (standard curriculum, initial training, as-needed technical assistance) across eight high schools serving low-income students. Through semistructured interviews at three time points, we assessed teacher perceptions of feasibility, acceptability, and appropriateness related to REP core and enhanced components.</p><p><strong>Results: </strong>Teachers generally found Enhanced REP to deliver MMH satisfactory and suitable. However, the school environment, notably administrative support, influenced feasibility compared to standard REP. Enhanced REP teachers reported benefits in meeting student needs that were not seen in the standard REP group. The standard REP data helped to understand the comparative value of the enhanced strategy during a time of notable upheaval and mental health challenges due to the COVID-19 pandemic.</p><p><strong>Conclusions: </strong>While some schools may succeed with less intensive strategies (REP), many may require more intensive approaches for effective implementation. Enhanced REP shows promise in tailoring curriculum delivery and providing additional support to meet student needs, but its success may hinge on organizational support, especially from leadership. Future research should investigate the addition of organizational-level strategies, such as leadership training, to optimize implementation and explore the comparative effectiveness of Enhanced versus standard REP.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251330520"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766069","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":"Application of implementation science frameworks to inform the adaptation process of an evidence-based eating disorder prevention program for high-risk perinatal individuals.","authors":"Rachel Vanderkruik, Emily C Woodworth, Caroline M Frisch, Stacey Nelson, Madison M Dunk, Marlene P Freeman, Lee S Cohen, Eric Stice, Stephen J Bartels","doi":"10.1177/26334895251319811","DOIUrl":"https://doi.org/10.1177/26334895251319811","url":null,"abstract":"<p><strong>Background: </strong>The perinatal period is a high-risk time for body dissatisfaction and disordered eating. Evidence-based interventions for disordered eating have not been adapted to address the needs of this population. We describe the process of adapting the Body Project, an evidence-based eating disorder (ED) prevention program, for pregnant individuals with histories of disordered eating behaviors.</p><p><strong>Method: </strong>Our approach is informed by ADAPT, a framework offering guidance for adapting interventions to new contexts, to modify the Body Project for pregnant individuals. Following initial adaptations informed by a needs assessment and stakeholder input, we conducted a pilot trial with individuals who have lived experience relative to our target population (i.e., previously pregnant individuals with ED history, <i>n</i> = 10). Participants provided feedback on the intervention through surveys and a focus group assessing perceptions of the intervention and barriers and facilitators to its implementation as guided by the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Results: </strong>Eighty percent of enrolled participants attended five or more sessions (out of six). Across sessions, average satisfaction ratings were 9.28 (1 = <i>poor</i> to 10 = <i>excellent</i>). Most participants (89%) reported improvements in body satisfaction. Approximately 33% reported reductions in disordered eating with the remainder reporting no change due to healthy eating behaviors at baseline. Themes from the focus group are reported aligning with CFIR domains and all final modifications are summarized and reported aligning with the Framework for Reporting Adaptation and Modifications-Enhanced.</p><p><strong>Conclusions: </strong>Applying implementation science frameworks to structure our process for making and summarizing planned adaptations, we adapted an empirically supported ED prevention program for pregnant individuals with histories of an ED. We made adaptation decisions based on participant feedback while weighing intervention fidelity and scalability. We will formally test the adapted intervention in a subsequent pilot randomized controlled trial versus a time- and dose-matched educational control.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"6 ","pages":"26334895251319811"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544787","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}