Implementation research and practice最新文献

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Concordance of multiple informant assessment of school-based social skills intervention and association with child outcomes: Results from a randomized trial. 多方信息提供者对校本社交技能干预评估的一致性以及与儿童结果的关联:随机试验的结果。
Implementation research and practice Pub Date : 2023-02-12 eCollection Date: 2023-01-01 DOI: 10.1177/26334895231154289
Daina M Tagavi, Kaitlyn Ahlers, Alice Bravo, Alana J McVey, Jill Locke
{"title":"Concordance of multiple informant assessment of school-based social skills intervention and association with child outcomes: Results from a randomized trial.","authors":"Daina M Tagavi, Kaitlyn Ahlers, Alice Bravo, Alana J McVey, Jill Locke","doi":"10.1177/26334895231154289","DOIUrl":"10.1177/26334895231154289","url":null,"abstract":"<p><strong>Background: </strong>Fidelity, or the degree to which an intervention is implemented as designed, is essential for effective implementation. There has been a growing emphasis on assessing fidelity of evidence-based practices for autistic children in schools. Fidelity measurement should be multidimensional and focus on core intervention components and assess their link with program outcomes. This study evaluated the relation between intervention fidelity ratings from multiple sources, tested the relation between fidelity ratings and child outcomes, and determined the relations between core intervention components and child outcomes in a study of an evidence-based psychosocial intervention designed to promote inclusion of autistic children at school, Remaking Recess.</p><p><strong>Method: </strong>This study extends from a larger randomized controlled trial examining the effect of implementation support on Remaking Recess fidelity and child outcomes. Schools were randomized to receive the intervention or the intervention plus implementation support. Observers, intervention coaches, and school personnel completed fidelity measures to rate completion and quality of intervention delivery. A measure of peer engagement served as the child outcome. Pearson correlation coefficients were calculated to determine concordance between raters. Two sets of hierarchical linear models were conducted using fidelity indices as predictors of peer engagement.</p><p><strong>Results: </strong>Coach- and self-rated completion and quality scores, observer- and self-rated quality scores, and observer- and coach-rated quality fidelity scores were significantly correlated. Higher observer-rated completion and quality fidelity scores were predictors of higher peer engagement scores. No single intervention component emerged as a significant predictor of peer engagement.</p><p><strong>Conclusions: </strong>This study demonstrates the importance of using a multidimensional approach for measuring fidelity, testing the link between fidelity and child outcomes, and examining how core intervention components may be associated with child outcomes. Future research should clarify how to improve multi-informant reports to provide \"good enough\" ratings of fidelity that provide meaningful information about outcomes in community settings.</p><p><strong>Plain language summary: </strong>Fidelity is defined as how closely an intervention is administered in the way the creators intended. Fidelity is important because it allows researchers to determine what exactly is leading to changes. In recent years, there has been an interest in examining fidelity of interventions for autistic children who receive services in school. This study looked at the relationship between fidelity ratings from multiple individuals, the relationship between fidelity and child outcomes, and the relationship between individual intervention component and child changes in a study of Remaking Recess, an interve","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"4 ","pages":"26334895231154289"},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/50/10.1177_26334895231154289.PMC9978620.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9388667","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}
引用次数: 0
Teacher attitudes toward evidence-based practices: Exploratory and confirmatory analyses of the school-adapted evidence-based practice attitude scale. 教师对循证实践的态度:学校适应循证实践态度量表的探索性和验证性分析。
Implementation research and practice Pub Date : 2023-01-01 DOI: 10.1177/26334895221151026
James L Merle, Clayton R Cook, Jill J Locke, Mark G Ehrhart, Eric C Brown, Chayna J Davis, Aaron R Lyon
{"title":"Teacher attitudes toward evidence-based practices: Exploratory and confirmatory analyses of the school-adapted evidence-based practice attitude scale.","authors":"James L Merle, Clayton R Cook, Jill J Locke, Mark G Ehrhart, Eric C Brown, Chayna J Davis, Aaron R Lyon","doi":"10.1177/26334895221151026","DOIUrl":"https://doi.org/10.1177/26334895221151026","url":null,"abstract":"Background The Evidence-Based Practice Attitudes Scale (EBPAS) is widely used in implementation research, but it has not been adapted and validated for use among general education teachers, who are most likely to deliver evidence-based prevention programs in schools, the most common setting where youth access social, emotional, and behavioral health services. Method School-based stakeholders and a research team comprised of experts in the implementation of evidence-based practices in schools adapted the EBPAS for teachers (the S-EBPAS). The adapted instrument was administered to a representative sample (n = 441) of general education teachers (grades K—5) to assess the reliability and internal consistency via factor analyses. The S-EBPAS included two forms (i.e., EBP-agnostic and EBP-specific item referents), therefore, a multiple-group confirmatory factor analysis (CFA) was also performed to establish measurement invariance between the two forms. Results After adaptation and refinement, a 9-item, 3-factor structure was confirmed, with the final model supporting three first-order factors that load onto a second-order factor capturing attitudes toward adopting evidence-based practices. Multiple-group CFA analyses of measurement invariance indicated there were no significant differences between the two forms. Conclusions Overall, this study provides a brief, flexible instrument capturing attitudes toward adopting EBPs that has high reliability and internal consistency, which support its use among general education teachers in school settings implementing evidence-based practices. Plain Language Summary The Evidence-Based Practice Attitudes Scale (EBPAS) is a popular instrument for measuring attitudes toward evidence-based practices (EBPs). This instrument provides valuable information during implementation initiatives, such as whether providers or front-line implementers have favorable attitudes toward a given practice. The EBPAS has been used in many different settings, such as in community-based mental health clinics, medical hospitals, and in child welfare. However, it's use in schools has been limited, and it has not yet been tested with general education teachers, who are key implementers of evidence-based practices in schools. In order to trust that the scores from an instrument are accurate, it needs to be evaluated when scaling it out to new populations and settings. One popular method to determine this is to use factor analysis, which was employed in this study. This study fills the identified gap by assessing the reliability (i.e., accuracy) and internal consistency of the EBPAS among a representative sample of general education teachers. Findings from this study indicate that the school-adapted EBPAS (S-EBPAS) is a brief, nine-item instrument that provides a reliable estimate of teachers’ attitudes toward evidence-based practices. Our results also provide evidence that the S-EBPAS can be used to capture attitudes toward specific EBPs as w","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"4 ","pages":"26334895221151026"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/50/10.1177_26334895221151026.PMC9924278.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9388666","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}
引用次数: 0
Adaptation of an evidence-based parenting intervention for integration into maternal-child home-visiting programs: Challenges and solutions. 将循证育儿干预纳入妇幼家访计划:挑战和解决方案。
Implementation research and practice Pub Date : 2023-01-01 Epub Date: 2023-01-22 DOI: 10.1177/26334895221151029
Elizabeth Peacock-Chambers, Michael Moran, Maria Carolina Clark, Jessica L Borelli, Nancy Byatt, Peter D Friedmann, Nancy E Suchman, Emily Feinberg
{"title":"Adaptation of an evidence-based parenting intervention for integration into maternal-child home-visiting programs: Challenges and solutions.","authors":"Elizabeth Peacock-Chambers,&nbsp;Michael Moran,&nbsp;Maria Carolina Clark,&nbsp;Jessica L Borelli,&nbsp;Nancy Byatt,&nbsp;Peter D Friedmann,&nbsp;Nancy E Suchman,&nbsp;Emily Feinberg","doi":"10.1177/26334895221151029","DOIUrl":"10.1177/26334895221151029","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to assess potential challenges, prioritize adaptations, and develop an implementation and research approach to integrate and study a parenting intervention for mothers in recovery from substance use disorders in community-based home-visiting programs.</p><p><strong>Method: </strong>An explanatory mixed-methods design, guided by process mapping with Failure Modes and Effects Analysis tools, and an Advisory Panel of 15 community members, identified potential implementation challenges and recommended solutions for the proposed intervention within five pre-specified domains. Thematic content analysis identified themes from detailed field notes.</p><p><strong>Results: </strong>The Advisory Panel identified 44 potential challenges across all domains. They determined that the recruitment domain was most likely to create challenges. Regarding the potential challenges, two cross-domain themes emerged: (1) development of mistrust in the community and (2) difficulty initiating and sustaining engagement. Potential solutions and adaptations to protocols are reported.</p><p><strong>Conclusion: </strong>Mistrust in the community was cited as a potentially important challenge for the delivery and study of an evidence-based parenting intervention for mothers in recovery through home-visiting programs. Adaptations to research protocols and intervention delivery strategies are needed to prioritize the psychological safety of families, particularly for groups that have been historically stigmatized.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/c2/10.1177_26334895221151029.PMC9924283.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9330247","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}
引用次数: 0
Factors that influence clinical decisions about offering parent coaching for autistic youth served within the Medicaid system. 在医疗补助系统中,影响为自闭症青少年提供家长辅导的临床决策的因素。
Implementation research and practice Pub Date : 2023-01-01 Epub Date: 2023-02-15 DOI: 10.1177/26334895231153631
Diondra Straiton, Kyle Frost, Brooke Ingersoll
{"title":"Factors that influence clinical decisions about offering parent coaching for autistic youth served within the Medicaid system.","authors":"Diondra Straiton, Kyle Frost, Brooke Ingersoll","doi":"10.1177/26334895231153631","DOIUrl":"10.1177/26334895231153631","url":null,"abstract":"<p><strong>Background: </strong>Parent coaching is an evidence-based practice for young autistic children, but it is underutilized in lower-resourced community settings like the Medicaid system (Straiton et al., 2021b). Clinicians often struggle to implement parent coaching with low-income and marginalized families (Tomczuk et al., 2022), but little is known about which factors influence clinician decision making processes about providing parent coaching to this population.</p><p><strong>Methods: </strong>This qualitative analysis used the framework method and thematic analysis. We used the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework (Aarons et al., 2011) to identify factors in the clinical decision-making process that community providers use when offering parent coaching to families of Medicaid-enrolled autistic children. Interviews with 13 providers and a focus group with 13 providers were analyzed.</p><p><strong>Results: </strong>The following themes emerged: 1) Policies drive provider task priorities and affect competing demands; 2) Providers are more likely to use parent coaching when agency leaders monitor parent coaching benchmarks, though this is rarely done; 3) Logistical factors like scheduling and treatment location affect perceived feasibility of using parent coaching; 4) Previous experience or coursework in parent coaching and/or family systems supports the quality of parent coaching implementation; 5) Provider perceptions of \"parent readiness\" are initially indicated by overt expressions of parent interest.</p><p><strong>Conclusions: </strong>In the absence of outer-context and inner-context policies, providers have more decision-making power to offer parent coaching based on their own judgements and preferences, which may result in fewer families being offered parent coaching and increased bias related to which families are offered this service. State-, agency-, and clinician-level recommendations are provided for increasing equitable provision of this evidence-based practice for autism.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/f2/10.1177_26334895231153631.PMC9978664.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9330248","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}
引用次数: 0
Promoting rigor and sustainment in implementation science capacity building programs: A multi-method study. 促进科学能力建设项目实施的严谨性和持续性:一项多方法研究。
Implementation research and practice Pub Date : 2022-12-25 eCollection Date: 2022-01-01 DOI: 10.1177/26334895221146261
Amy G Huebschmann, Shelly Johnston, Rachel Davis, Bethany M Kwan, Elvin Geng, Debra Haire-Joshu, Brittney Sandler, Demetria M McNeal, Ross C Brownson, Borsika A Rabin
{"title":"Promoting rigor and sustainment in implementation science capacity building programs: A multi-method study.","authors":"Amy G Huebschmann, Shelly Johnston, Rachel Davis, Bethany M Kwan, Elvin Geng, Debra Haire-Joshu, Brittney Sandler, Demetria M McNeal, Ross C Brownson, Borsika A Rabin","doi":"10.1177/26334895221146261","DOIUrl":"10.1177/26334895221146261","url":null,"abstract":"<p><strong>Background: </strong>The field of Implementation science (IS) continues to evolve, and the number and type of IS capacity building Programs (ISCBPs) are in flux. These changes push the field to revisit the accepted IS competencies and to guide sustainment of ISCBPs. Our objectives were: (1) compare characteristics of current ISCBPs; (2) identify recommendations to support ISCBP sustainment; (3) measure how often ISCBPs address IS competencies; (4) identify novel and important IS competencies for the field.</p><p><strong>Method: </strong>This multi-method study included ISCBPs delivering structured, longitudinal IS training, excluding single courses and brief workshops. We used three complementary methods to meet our objectives. First, we identified ISCBPs via an internet search and snowball sampling methods. Second, we surveyed these ISCBPs to identify areas of program focus, types of trainees, IS competencies addressed, and recommendations to sustain ISCBPs. Third, we conducted a modified Delphi process with IS researchers/leaders to reach consensus on the IS competencies that were both important and novel as compared to the IS competencies published to date.</p><p><strong>Results: </strong>Among 74 eligible ISCBPs identified, 46 responded (62% response rate). Respondent ISCBPs represented diverse areas of focus (e.g., global health, cardiopulmonary disease) and trainee stages (e.g., graduate students, mid-career faculty). While most respondent ISCBPs addressed core IS methods, targeting IS competencies was less consistent (33% for nongraduate/non-fellowship ISCBPs; >90% for graduate/national ISCBPs). Our modified Delphi process identified eight novel and important IS competencies related to increasing health equity or the speed of translation. Recommendations to sustain ISCBPs included securing financial administrative support.</p><p><strong>Conclusions: </strong>Current ISCBPs train learners across varying career stages in diverse focus areas. To promote rigor, we recommend ISCBPs address specific IS competencies, with consideration of these eight novel/emerging competencies. We also recommend ISCBPs report on their IS competencies, focus area(s), and trainee characteristics. ISCBP programs need administrative financial support.</p><p><strong>Plain language summary: </strong>There is a limited workforce capacity to conduct implementation science (IS) research. To address this gap, the number and type of IS capacity building Programs (ISCBPs) focusing on training researchers and practitioners in IS methods continue to increase. Our efforts to comprehensively identify and describe ISCBPs for researchers and practitioners highlighted four implications for leaders of ISCBPs related to program sustainment and rigor. First, we identified a range of contextual characteristics of ISCBPs, including the research topics, methods, and IS competencies addressed, and the types of trainees accepted. Second, given the variability of trainee types a","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"3 ","pages":"26334895221146261"},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9444876","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}
引用次数: 0
Quantitative measures used in empirical evaluations of mental health policy implementation: A systematic review. 心理健康政策实施实证评估中使用的定量措施:系统回顾。
Implementation research and practice Pub Date : 2022-12-04 eCollection Date: 2022-01-01 DOI: 10.1177/26334895221141116
Meagan Pilar, Eliot Jost, Callie Walsh-Bailey, Byron J Powell, Stephanie Mazzucca, Amy Eyler, Jonathan Purtle, Peg Allen, Ross C Brownson
{"title":"Quantitative measures used in empirical evaluations of mental health policy implementation: A systematic review.","authors":"Meagan Pilar, Eliot Jost, Callie Walsh-Bailey, Byron J Powell, Stephanie Mazzucca, Amy Eyler, Jonathan Purtle, Peg Allen, Ross C Brownson","doi":"10.1177/26334895221141116","DOIUrl":"10.1177/26334895221141116","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mental health is a critical component of wellness. Public policies present an opportunity for large-scale mental health impact, but policy implementation is complex and can vary significantly across contexts, making it crucial to evaluate implementation. The objective of this study was to (1) identify quantitative measurement tools used to evaluate the implementation of public mental health policies; (2) describe implementation determinants and outcomes assessed in the measures; and (3) assess the pragmatic and psychometric quality of identified measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Guided by the Consolidated Framework for Implementation Research, Policy Implementation Determinants Framework, and Implementation Outcomes Framework, we conducted a systematic review of peer-reviewed journal articles published in 1995-2020. Data extracted included study characteristics, measure development and testing, implementation determinants and outcomes, and measure quality using the Psychometric and Pragmatic Evidence Rating Scale.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 34 tools from 25 articles, which were designed for mental health policies or used to evaluate constructs that impact implementation. Many measures lacked information regarding measurement development and testing. The most assessed implementation determinants were readiness for implementation, which encompassed training (&lt;i&gt;n&lt;/i&gt;  =  20, 57%) and other resources (&lt;i&gt;n&lt;/i&gt;  =  12, 34%), actor relationships/networks (&lt;i&gt;n&lt;/i&gt;  =  15, 43%), and organizational culture and climate (&lt;i&gt;n&lt;/i&gt;  =  11, 31%). Fidelity was the most prevalent implementation outcome (&lt;i&gt;n&lt;/i&gt;  =  9, 26%), followed by penetration (&lt;i&gt;n&lt;/i&gt;  =  8, 23%) and acceptability (&lt;i&gt;n&lt;/i&gt;  =  7, 20%). Apart from internal consistency and sample norms, psychometric properties were frequently unreported. Most measures were accessible and brief, though minimal information was provided regarding interpreting scores, handling missing data, or training needed to administer tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This work contributes to the nascent field of policy-focused implementation science by providing an overview of existing measurement tools used to evaluate mental health policy implementation and recommendations for measure development and refinement. To advance this field, more valid, reliable, and pragmatic measures are needed to evaluate policy implementation and close the policy-to-practice gap.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Mental health is a critical component of wellness, and public policies present an opportunity to improve mental health on a large scale. Policy implementation is complex because it involves action by multiple entities at several levels of society. Policy implementation is also challenging because it can be impacted by many factors, such as political will, stakeholder relationships, and resources available for implementation. Because of these factors","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"3 ","pages":"26334895221141116"},"PeriodicalIF":0.0,"publicationDate":"2022-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/39/10.1177_26334895221141116.PMC9924289.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10349287","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}
引用次数: 0
Together in care: Lessons learned at the intersection of integrated care, quality improvement, and implementation practice in opioid treatment programs. 共同护理:在阿片类药物治疗计划的综合护理、质量改进和实施实践的交叉点上汲取的经验教训。
Implementation research and practice Pub Date : 2022-11-04 eCollection Date: 2022-01-01 DOI: 10.1177/26334895221135265
Megan A O'Grady, Rina Randrianarivony, Keith Martin, Yaberci Perez-Cubillan, David C Collymore, Dina Shapiro-Luft, Alexa Beacham, Nyasia Heyward, Belinda Greenfield, Charles J Neighbors
{"title":"Together in care: Lessons learned at the intersection of integrated care, quality improvement, and implementation practice in opioid treatment programs.","authors":"Megan A O'Grady, Rina Randrianarivony, Keith Martin, Yaberci Perez-Cubillan, David C Collymore, Dina Shapiro-Luft, Alexa Beacham, Nyasia Heyward, Belinda Greenfield, Charles J Neighbors","doi":"10.1177/26334895221135265","DOIUrl":"10.1177/26334895221135265","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Integrated care programs that systematically and comprehensively address both behavioral and physical health may improve patient outcomes. However, there are few examples of such programs in addiction treatment settings. This article is a practical implementation report describing the implementation of an integrated care program into two opioid treatment programs (OTPs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Strategies used to implement integrated care into two OTPs included external facilitation, quality improvement (QI) processes, staff training, and an integrated organizational structure. Service, implementation, and client outcomes were examined using qualitative interviews with program staff (n  =  16), program enrollment data, and client outcome data (n  =  593) on mental health (MH), physical health, and functional indicators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Staff found the program to generally be acceptable and appropriate, but also noted that the new services added to already busy workflows and more staffing were needed to fully reach the program's potential. The program had a high level of penetration (∼60%-70%), enrolling over 1,200 clients. Staff noted difficulties in connecting clients with some services. Client general functioning and MH symptoms improved, and heavy smoking decreased. The organizational structure and QI activities provided a strong foundation for interactive problem-solving and adaptations that were needed during implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This article highlights an example of the intersection of QI and implementation practice. Simplified QI processes, consistent post-implementation meetings, and change teams and champions facilitated implementation; however, ongoing training and support, especially related to data are needed. The OTP setting provided a strong foundation to build integrated care, but careful consideration of new workflows and changes in philosophy for staff is necessary.&lt;b&gt;Plain Language Summary:&lt;/b&gt; Providing medical and behavioral health treatment services in the same clinic using coordinated treatment teams, also known as integrated care, improves outcomes among those with chronic physical and behavioral health conditions. However, there are few practical examples of implementation of such programs in addiction treatment settings, which are promising, yet underutilized settings for integrated care programs. A multi-sectoral team used quality improvement (QI) and implementation strategies to implement integrated care into two opioid treatment programs (OTPs). The program enrolled over 1,200 clients and client general functioning and mental health (MH) symptoms improved, and heavy smoking decreased. Qualitative interviews provided important information about the barriers, facilitators, and context around implementation of this program. The OTP setting provided a strong foundation to build integrated care, but careful consideration of new workflows a","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"3 ","pages":"26334895221135265"},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/84/10.1177_26334895221135265.PMC9924288.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9388976","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}
引用次数: 0
Human-centered design methods to achieve preparation phase goals in the multiphase optimization strategy framework. 以人为本的设计方法,实现多阶段优化战略框架中的准备阶段目标。
Implementation research and practice Pub Date : 2022-10-22 eCollection Date: 2022-01-01 DOI: 10.1177/26334895221131052
Karey L O'Hara, Lindsey M Knowles, Kate Guastaferro, Aaron R Lyon
{"title":"Human-centered design methods to achieve preparation phase goals in the multiphase optimization strategy framework.","authors":"Karey L O'Hara, Lindsey M Knowles, Kate Guastaferro, Aaron R Lyon","doi":"10.1177/26334895221131052","DOIUrl":"10.1177/26334895221131052","url":null,"abstract":"<p><strong>Background: </strong>The public health impact of behavioral and biobehavioral interventions to prevent and treat mental health and substance use problems hinges on developing methods to strategically maximize their effectiveness, affordability, scalability, and efficiency.</p><p><strong>Methods: </strong>The multiphase optimization strategy (MOST) is an innovative, principled framework that guides the development of multicomponent interventions. Each phase of MOST (<i>Preparation</i>, <i>Optimization</i>, <i>Evaluation</i>) has explicit goals and a range of appropriate research methods to achieve them. Methods for attaining <i>Optimization</i> and <i>Evaluation</i> phase goals are well-developed. However, methods used in the <i>Preparation</i> phase are often highly researcher-specific, and concrete ways to achieve <i>Preparation</i> phase goals are a priority area for further development.</p><p><strong>Results: </strong>We propose that the discover, design, build, and test (DDBT) framework provides a theory-driven and methods-rich roadmap for achieving the goals of the <i>Preparation</i> phase of MOST, including specifying the conceptual model, identifying and testing candidate intervention components, and defining the optimization objective. The DDBT framework capitalizes on strategies from the field of human-centered design and implementation science to drive its data collection methods.</p><p><strong>Conclusions: </strong>MOST and DDBT share many conceptual features, including an explicit focus on implementation determinants, being iterative and flexible, and designing interventions for the greatest public health impact. The proposed synthesized DDBT/MOST approach integrates DDBT into the <i>Preparation</i> phase of MOST thereby providing a framework for rigorous and efficient intervention development research to bolster the success of intervention optimization.</p><p><strong>Plain language summary: </strong>1. <i>What is already known about the topic?</i> Optimizing behavioral interventions to balance effectiveness with affordability, scalability, and efficiency requires a significant investment in intervention development.2. <i>What does this paper add?</i> This paper provides a structured approach to integrating human-centered design principles into the <i>Preparation</i> phase of the multiphase optimization strategy (MOST).3. <i>What are the implications for practice, research, or policy?</i> The proposed synthesized model provides a framework for rigorous and efficient intervention development research in the <i>Preparation</i> phase of MOST that will ensure the success of intervention optimization and contribute to improving public health impact of mental health and substance use interventions.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"3 ","pages":"26334895221131052"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/4d/10.1177_26334895221131052.PMC9924242.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9444874","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}
引用次数: 0
Training primary health care providers in Colombia, Mexico and Peru to increase alcohol screening: Mixed-methods process evaluation of implementation strategy. 培训哥伦比亚、墨西哥和秘鲁的初级卫生保健提供者,以加强酒精筛查:实施战略的混合方法过程评估。
Implementation research and practice Pub Date : 2022-07-15 eCollection Date: 2022-01-01 DOI: 10.1177/26334895221112693
Daša Kokole, Eva Jané-Llopis, Guillermina Natera Rey, Natalia Bautista Aguilar, Perla Sonia Medina Aguilar, Juliana Mejía-Trujillo, Katherine Mora, Natalia Restrepo, Ines Bustamante, Marina Piazza, Amy O'Donnell, Adriana Solovei, Liesbeth Mercken, Christiane Sybille Schmidt, Hugo Lopez-Pelayo, Silvia Matrai, Fleur Braddick, Antoni Gual, Jürgen Rehm, Peter Anderson, Hein de Vries
{"title":"Training primary health care providers in Colombia, Mexico and Peru to increase alcohol screening: Mixed-methods process evaluation of implementation strategy.","authors":"Daša Kokole,&nbsp;Eva Jané-Llopis,&nbsp;Guillermina Natera Rey,&nbsp;Natalia Bautista Aguilar,&nbsp;Perla Sonia Medina Aguilar,&nbsp;Juliana Mejía-Trujillo,&nbsp;Katherine Mora,&nbsp;Natalia Restrepo,&nbsp;Ines Bustamante,&nbsp;Marina Piazza,&nbsp;Amy O'Donnell,&nbsp;Adriana Solovei,&nbsp;Liesbeth Mercken,&nbsp;Christiane Sybille Schmidt,&nbsp;Hugo Lopez-Pelayo,&nbsp;Silvia Matrai,&nbsp;Fleur Braddick,&nbsp;Antoni Gual,&nbsp;Jürgen Rehm,&nbsp;Peter Anderson,&nbsp;Hein de Vries","doi":"10.1177/26334895221112693","DOIUrl":"10.1177/26334895221112693","url":null,"abstract":"<p><strong>Background: </strong>Initial results from the SCALA study demonstrated that training primary health care providers is an effective implementation strategy to increase alcohol screening in Colombia, Mexico and Peru, but did not show evidence of superior performance for the standard compared to the shorter training arm. This paper elaborates on those outcomes by examining the relationship of training-related process evaluation indicators with the alcohol screening practice.</p><p><strong>Methods: </strong>A mix of convergent and exploratory mixed-methods design was employed. Data sources included training documentation, post-training questionnaires, observation forms, self-report forms and interviews. Available quantitative data were compared on outcome measure - providers' alcohol screening.</p><p><strong>Results: </strong>Training reach was high: three hundred fifty-two providers (72.3% of all eligible) participated in one or more training or booster sessions. Country differences in session length reflected adaptation to previous topic knowledge and experience of the providers. Overall, 49% of attendees conducted alcohol screening in practice. A higher dose received was positively associated with screening, but there was no difference between standard and short training arms. Although the training sessions were well received by participants, satisfaction with training and perceived utility for practice were not associated with screening. Profession, but not age or gender, was associated with screening: in Colombia and Mexico, doctors and psychologists were more likely to screen (although the latter represented only a small proportion of the sample) and in Peru, only psychologists.</p><p><strong>Conclusions: </strong>The SCALA training programme was well received by the participants and led to half of the participating providers conducting alcohol screening in their primary health care practice. The dose received and the professional role were the key factors associated with conducting the alcohol screening in practice.<b>Plain Language Summary:</b> Primary health care providers can play an important role in detecting heavy drinkers among their consulting patients, and training can be an effective implementation strategy to increase alcohol screening and detection. Existing training literature predominantly focuses on evaluating trainings in high-income countries, or evaluating their effectiveness rather than implementation. As part of SCALA (Scale-up of Prevention and Management of Alcohol Use Disorders in Latin America) study, we evaluated training as implementation strategy to increase alcohol screening in primary health care in a middle-income context. Overall, 72.3% of eligible providers attended the training and 49% of training attendees conducted alcohol screening in practice after attending the training. Our process evaluation suggests that simple intervention with sufficient time to practice, adapted to limited provider availab","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"3 ","pages":"26334895221112693"},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9388968","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}
引用次数: 2
Development and use of a checklist for the implementation of medication for opioid use disorder in jails. 开发和使用监狱阿片类药物使用障碍药物治疗核对表。
Implementation research and practice Pub Date : 2022-06-07 eCollection Date: 2022-01-01 DOI: 10.1177/26334895221101214
Ariel Ludwig, Laura B Monico, Thomas Blue, Michael S Gordon, Robert P Schwartz, Shannon Gwin Mitchell
{"title":"Development and use of a checklist for the implementation of medication for opioid use disorder in jails.","authors":"Ariel Ludwig, Laura B Monico, Thomas Blue, Michael S Gordon, Robert P Schwartz, Shannon Gwin Mitchell","doi":"10.1177/26334895221101214","DOIUrl":"10.1177/26334895221101214","url":null,"abstract":"<p><strong>Background: </strong>In light of short lengths of stay and proximity to communities of release, jails are well-positioned to intervene in opioid use disorder (OUD). However, a number of barriers have resulted in a slow and limited implementation.</p><p><strong>Methods: </strong>This paper describes the development and testing of a Medication for Opioid Use Disorder (MOUD) Implementation Checklist developed as part of a Building Bridges project, a two-year planning grant which supported 16 US jail systems as they prepared to implement or expand MOUD services.</p><p><strong>Results: </strong>Although initially developed to track changes within sites participating in the initiative, participants noted its utility for identifying evidence-based benchmarks through which the successful implementation of MOUDs could be tracked by correctional administrators.</p><p><strong>Conclusions: </strong>The findings suggest that this checklist can both help guide and illustrate progress toward vital changes facilitated through established processes and supports.</p><p><strong>Plain language summary: </strong>People incarcerated in jails are more likely to have opioid use disorder than the general population. Despite this, jails in the United States (U.S.) often offer limited or no access to Medication for Opioid Use Disorder (MOUD). The Building Bridges project was designed to address this gap in 16 U.S. jail systems as they prepared to implement or expand MOUD services. This article addresses the use of a MOUD checklist that was initially designed to help the jails track changes toward evidence-based benchmarks. The findings suggest that this checklist can both help guide and illustrate progress toward vital changes facilitated through established processes and supports.</p>","PeriodicalId":73354,"journal":{"name":"Implementation research and practice","volume":"3 ","pages":"26334895221101214"},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/6d/10.1177_26334895221101214.PMC9924266.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9393576","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}
引用次数: 0
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