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Walker SC, Bumbarger BK, Phillippi SW. Achieving successful evidence-based practice implementation in juvenile justice: The importance of diagnostic and evaluative capacity. EVALUATION AND PROGRAM PLANNING 2015; 52:189-197. [PMID: 26141970 DOI: 10.1016/j.evalprogplan.2015.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/30/2015] [Accepted: 05/14/2015] [Indexed: 06/04/2023]
Abstract
Evidence-based programs (EBPs) are an increasingly visible aspect of the treatment landscape in juvenile justice. Research demonstrates that such programs yield positive returns on investment and are replacing more expensive, less effective options. However, programs are unlikely to produce expected benefits when they are not well-matched to community needs, not sustained and do not reach sufficient reach and scale. We argue that achieving these benchmarks for successful implementation will require states and county governments to invest in data-driven decision infrastructure in order to respond in a rigorous and flexible way to shifting political and funding climates. We conceptualize this infrastructure as diagnostic capacity and evaluative capacity: Diagnostic capacity is defined as the process of selecting appropriate programing and evaluative capacity is defined as the ability to monitor and evaluate progress. Policy analyses of Washington State, Pennsylvania and Louisiana's program implementation successes are used to illustrate the benefits of diagnostic and evaluate capacity as a critical element of EBP implementation.
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Affiliation(s)
- Sarah Cusworth Walker
- Division of Public Behavioral Health & Justice Policy, Department of Psychiatry and Behavioral Sciences, University of Washington, 2815 Eastlake Ave E Ste 200, Seattle, WA 98102, United States.
| | - Brian K Bumbarger
- Prevention Research Center, Pennsylvania State University, 320F Biobehavioral Health Bldg., University Park, PA 16802, United States; Doctoral Program, Griffith University, Australia.
| | - Stephen W Phillippi
- Health Sciences Center, School of Public Health, Louisiana State University, 2020 Gravier St., 3rd Floor, New Orleans, LA 70112, United States.
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152
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A review of diabetes prevention program translations: use of cultural adaptation and implementation research. Transl Behav Med 2015; 5:401-14. [PMID: 26622913 DOI: 10.1007/s13142-015-0341-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The Diabetes Prevention Program (DPP) has been shown to prevent type 2 diabetes through lifestyle modification. The purpose of this study was to describe the literature on DPP translation, synthesizing studies using cultural adaptation and implementation research. A systematic search was conducted. Original studies evaluating DPP implementation and/or cultural adaptation were included. Data about cultural adaptation, implementation outcomes, and translation strategies was abstracted. A total of 44 were included, of which 15 reported cultural adaptations and 38 explored implementation. Many studies shortened the program length and reported a group format. The most commonly reported cultural adaptation (13 of 15) was with content. At the individual level, the most frequently assessed implementation outcome (n = 30) was adoption. Feasibility was most common (n = 32) at the organization level. The DPP is being tested in a variety of settings and populations, using numerous translational strategies and cultural adaptations. Implementation research that identifies, evaluates, and reports efforts to translate the DPP into practice is crucial.
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153
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Husebo BS, Flo E, Aarsland D, Selbaek G, Testad I, Gulla C, Aasmul I, Ballard C. COSMOS--improving the quality of life in nursing home patients: protocol for an effectiveness-implementation cluster randomized clinical hybrid trial. Implement Sci 2015; 10:131. [PMID: 26374231 PMCID: PMC4572450 DOI: 10.1186/s13012-015-0310-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 08/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nursing home patients have complex mental and physical health problems, disabilities and social needs, combined with widespread prescription of psychotropic drugs. Preservation of their quality of life is an important goal. This can only be achieved within nursing homes that offer competent clinical conditions of treatment and care. COmmunication, Systematic assessment and treatment of pain, Medication review, Occupational therapy, Safety (COSMOS) is an effectiveness-implementation hybrid trial that combines and implements organization of activities evidence-based interventions to improve staff competence and thereby the patients' quality of life, mental health and safety. The aim of this paper is to describe the development, content and implementation process of the COSMOS trial. METHODS/DESIGN COSMOS includes a 2-month pilot study with 128 participants distributed among nine Norwegian nursing homes, and a 4-month multicenter, cluster randomized effectiveness-implementation clinical hybrid trial with follow-up at month 9, including 571 patients from 67 nursing home units (one unit defined as one cluster). Clusters are randomized to COSMOS intervention or current best practice (control group). The intervention group will receive a 2-day education program including written guidelines, repeated theoretical and practical training (credited education of caregivers, physicians and nursing home managers), case discussions and role play. The 1-day midway evaluation, information and interviews of nursing staff and a telephone hotline all support the implementation process. Outcome measures include quality of life in late-stage dementia, neuropsychiatric symptoms, activities of daily living, pain, depression, sleep, medication, cost-utility analysis, hospital admission and mortality. DISCUSSION Despite complex medical and psychosocial challenges, nursing home patients are often treated by staff possessing low level skills, lacking education and in facilities with a high staff turnover. Implementation of a research-based multicomponent intervention may improve staff's knowledge and competence and consequently the quality of life of nursing home patients in general and people with dementia in particular. TRIAL REGISTRATION ClinicalTrials.gov NCT02238652.
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Affiliation(s)
- Bettina S Husebo
- Department of Global Public Health and Primary Care, Centre for Elderly - and Nursing Home Medicine, University of Bergen, Kalfarveien 31, N-5020, Bergen, Norway.
- Centre for Elderly and Nursing Home Medicine, Stavanger University Hospital, Stavanger, Norway.
| | - Elisabeth Flo
- Department of Global Public Health and Primary Care, Centre for Elderly - and Nursing Home Medicine, University of Bergen, Kalfarveien 31, N-5020, Bergen, Norway.
| | - Dag Aarsland
- Centre for Elderly and Nursing Home Medicine, Stavanger University Hospital, Stavanger, Norway.
- Karolinska Institutet (KI), Department of Neurobiology, Care Sciences and Society, KI-Alzheimer Disease Research Center, Stockholm, Sweden.
| | - Geir Selbaek
- Norwegian National Advisory Unit of Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
- Centre for Old Age Psychiatry Research, Innlandet Hospital Trust, Ottestad, Norway.
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ingelin Testad
- Centre for Elderly and Nursing Home Medicine, Stavanger University Hospital, Stavanger, Norway.
| | - Christine Gulla
- Department of Global Public Health and Primary Care, Centre for Elderly - and Nursing Home Medicine, University of Bergen, Kalfarveien 31, N-5020, Bergen, Norway.
| | - Irene Aasmul
- Department of Global Public Health and Primary Care, Centre for Elderly - and Nursing Home Medicine, University of Bergen, Kalfarveien 31, N-5020, Bergen, Norway.
| | - Clive Ballard
- Centre for Elderly and Nursing Home Medicine, Stavanger University Hospital, Stavanger, Norway.
- The Wolfson Wing & Hodgkin Building Guys Campus, Kings College, London, SE1 1UL, UK.
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154
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Powell BJ, Beidas RS, Lewis CC, Aarons GA, McMillen JC, Proctor EK, Mandell DS. Methods to Improve the Selection and Tailoring of Implementation Strategies. J Behav Health Serv Res 2015. [PMID: 26289563 DOI: 10.1007/s11414‐015‐9475‐6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Implementing behavioral health interventions is a complicated process. It has been suggested that implementation strategies should be selected and tailored to address the contextual needs of a given change effort; however, there is limited guidance as to how to do this. This article proposes four methods (concept mapping, group model building, conjoint analysis, and intervention mapping) that could be used to match implementation strategies to identified barriers and facilitators for a particular evidence-based practice or process change being implemented in a given setting. Each method is reviewed, examples of their use are provided, and their strengths and weaknesses are discussed. The discussion includes suggestions for future research pertaining to implementation strategies and highlights these methods' relevance to behavioral health services and research.
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Affiliation(s)
- Byron J Powell
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Rinad S Beidas
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cara C Lewis
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Gregory A Aarons
- Department of Psychiatry, University of California-San Diego, San Diego, California, USA
| | - J Curtis McMillen
- School of Social Service Administration, University of Chicago, Chicago, Illinois, USA
| | - Enola K Proctor
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - David S Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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155
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Breimaier HE, Heckemann B, Halfens RJG, Lohrmann C. The Consolidated Framework for Implementation Research (CFIR): a useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice. BMC Nurs 2015; 14:43. [PMID: 26269693 PMCID: PMC4533946 DOI: 10.1186/s12912-015-0088-4] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 07/13/2015] [Indexed: 11/21/2022] Open
Abstract
Background Implementing clinical practice guidelines (CPGs) in healthcare settings is a complex intervention involving both independent and interdependent components. Although the Consolidated Framework for Implementation Research (CFIR) has never been evaluated in a practical context, it appeared to be a suitable theoretical framework to guide an implementation process. The aim of this study was to evaluate the comprehensiveness, applicability and usefulness of the CFIR in the implementation of a fall-prevention CPG in nursing practice to improve patient care in an Austrian university teaching hospital setting. Methods The evaluation of the CFIR was based on (1) team-meeting minutes, (2) the main investigator’s research diary, containing a record of a before-and-after, mixed-methods study design embedded in a participatory action research (PAR) approach for guideline implementation, and (3) an analysis of qualitative and quantitative data collected from graduate and assistant nurses in two Austrian university teaching hospital departments. The CFIR was used to organise data per and across time point(s) and assess their influence on the implementation process, resulting in implementation and service outcomes. Results Overall, the CFIR could be demonstrated to be a comprehensive framework for the implementation of a guideline into a hospital-based nursing practice. However, the CFIR did not account for some crucial factors during the planning phase of an implementation process, such as consideration of stakeholder aims and wishes/needs when implementing an innovation, pre-established measures related to the intended innovation and pre-established strategies for implementing an innovation. For the CFIR constructs reflecting & evaluating and engaging, a more specific definition is recommended. The framework and its supplements could easily be used by researchers, and their scope was appropriate for the complexity of a prospective CPG-implementation project. The CFIR facilitated qualitative data analysis and provided a structure that allowed project results to be organised and viewed in a broader context to explain the main findings. Conclusions The CFIR was a valuable and helpful framework for (1) the assessment of the baseline, process and final state of the implementation process and influential factors, (2) the content analysis of qualitative data collected throughout the implementation process, and (3) explaining the main findings. Electronic supplementary material The online version of this article (doi:10.1186/s12912-015-0088-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helga E Breimaier
- Institute of Nursing Science, Medical University of Graz, Billrothgasse 6, 8010 Graz, Austria
| | - Birgit Heckemann
- Department of Health Services Research, CAPHRI, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands
| | - Ruud J G Halfens
- Department of Health Services Research, CAPHRI, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Billrothgasse 6, 8010 Graz, Austria
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156
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Lyssenko L, Müller G, Kleindienst N, Schmahl C, Berger M, Eifert G, Kölle A, Nesch S, Ommer-Hohl J, Wenner M, Bohus M. Life Balance - a mindfulness-based mental health promotion program: conceptualization, implementation, compliance and user satisfaction in a field setting. BMC Public Health 2015; 15:740. [PMID: 26231662 PMCID: PMC4522090 DOI: 10.1186/s12889-015-2100-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 07/27/2015] [Indexed: 12/21/2022] Open
Abstract
Background Mental health disorders account for a large percentage of the total burden of illness and constitute a major economic challenge in industrialized countries. Several prevention programs targeted at high-risk or sub-clinical populations have been shown to decrease risk, to increase quality of life, and to be cost-efficient. However, there is a paucity of primary preventive programs aimed at the general adult population. “Life Balance” is a program that employs strategies borrowed from well-established psychotherapeutic approaches, and has been made available to the public in one federal German state by a large health care insurance company. The data presented here are the preliminary findings of an ongoing field trial examining the outcomes of the Life Balance program with regard to emotional distress, life satisfaction, resilience, and public health costs, using a matched control group design. Methods Life Balance courses are held at local health-care centers, in groups of 12 to 15 which are led by laypeople who have been trained on the course materials. Participants receive instruction on mindfulness and metacognitive awareness, and are assigned exercises to practice at home. Over an 8-month period in 2013–2014, all individuals who signed up for the program were invited at the time of enrollment to take part in a study involving the provision of psychometric data and of feedback on the course. A control group of subjects was invited to complete the questionnaires on psychometric data but did not receive any intervention. Results Of 4,898 adults who attended Life Balance courses over the specified period, 1,813 (37.0 %) provided evaluable study data. The average age of study participants was 49.5 years, and 83 % were female. At baseline, participants’ self-reported symptoms of depression and anxiety, life satisfaction, and resilience were significantly higher than those seen in the general German population. Overall, evaluations of the course were positive, and 83 % of participants attended at least at 6 of the 7 sessions. Some sociodemographic correlations were noted: men carried out the assigned exercises less often than did women, and younger participants practiced mindfulness less frequently than did older ones. However, satisfaction and compliance with the program were similar across all sociodemographic categories. Conclusions While the Life Balance program is publicized as a primary prevention course that is not directed at a patient population, the data indicate that it was utilized by people with a significant mental health burden, and that the concept can be generalized to a broad population. As data from the control group are not yet available, conclusions about effectiveness cannot yet be drawn. Trial registration German Clinical Trials Registration ID: DRKS00006216
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Affiliation(s)
- Lisa Lyssenko
- Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany.
| | | | - Nikolaus Kleindienst
- Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany.
| | - Christian Schmahl
- Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany.
| | - Mathias Berger
- Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg im Breisgau, Germany.
| | - Georg Eifert
- College of Health & Behavioral Sciences, Chapman University, Orange, USA.
| | | | - Siegmar Nesch
- AOK Baden-Württemberg, Villingen-Schwenningen, Germany.
| | | | | | - Martin Bohus
- Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany. .,Faculty of Health, University of Antwerp, Antwerp, Belgium.
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157
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Newman K, Van Eerd D, Powell BJ, Urquhart R, Cornelissen E, Chan V, Lal S. Identifying priorities in knowledge translation from the perspective of trainees: results from an online survey. Implement Sci 2015; 10:92. [PMID: 26093912 PMCID: PMC4475286 DOI: 10.1186/s13012-015-0282-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 06/18/2015] [Indexed: 11/17/2022] Open
Abstract
Background The need to identify priorities to help shape future directions for research and practice increases as the knowledge translation (KT) field advances. Since many KT trainees are developing their research programs, understanding their concerns and KT research and practice priorities is important to supporting the development and advancement of KT as a field. Our purpose was to identify research and practice priorities in the KT field from the perspectives of KT researcher/practitioner trainees. Findings Survey response rate was 62 % (44/71). Participants were mostly Canadian graduate students, post-doctoral fellows, residents, and learners from various disciplines; the majority was from Ontario (44 %) and Quebec (20 %). Seven percent (5/71) were from other countries including USA, UK, and Switzerland. Seven main KT priority themes were identified: determining the effectiveness of KT strategies, technology use, increased key stakeholder involvement, context, theory, expand ways of inquiry, and sustainability. Conclusions Overall, the priorities identified by the trainees correspond with KT literature and with KT experts’ views. The trainees appeared to push the boundaries of current KT literature with respect to creative use of communication technologies research. Electronic supplementary material The online version of this article (doi:10.1186/s13012-015-0282-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristine Newman
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, M5B 2K3, Canada.
| | - Dwayne Van Eerd
- Institute for Work and Health, Toronto, Canada. .,School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.
| | - Byron J Powell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA.
| | - Robin Urquhart
- Department of Surgery, Dalhousie University, Halifax, Canada.
| | - Evelyn Cornelissen
- Department of Family Practice, Faculty of Medicine, University of BC, Vancouver, BC, Canada.
| | - Vivian Chan
- Department of Medicine, Quality and Safety, Vancouver Coastal Health, Vancouver, Canada.
| | - Shalini Lal
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada.
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158
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Strand V, Popescu M, Abramovitz R, Richards S. Building Agency Capacity for Trauma-Informed Evidence-Based Practice and Field Instruction. JOURNAL OF EVIDENCE-INFORMED SOCIAL WORK 2015; 13:179-97. [PMID: 26083452 DOI: 10.1080/23761407.2015.1014124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Through this article the authors describe how schools of social work offering a child and adolescent trauma specialization actively partnered with their community-based field placement agencies to achieve a dual purpose: help agencies sustain the capacity for evidence-based trauma treatment (EBTT) and provide sufficient EBTT MSW student field placement sites that support preparation of trauma-informed practitioners by schools of social work. Development and description of the specific conceptual framework used to inform the trauma-informed organizational change initiative is described. Results of an Organizational Readiness assessment undertaken at six agencies reflect a strong alignment between implementation drivers identified in the literature (Fixsen, Blase, Naoom, & Wallace, 2009) and the conceptual framework. The manner in which these results are being used by schools of social work and their agency partners in sustaining the implementation of evidence-based trauma treatment is reviewed, and implications for future research, education, and practice is discussed.
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Affiliation(s)
- Virginia Strand
- a National Center for Social Work, Trauma Education and Workforce Development, Fordham University Graduate School of Social Service , West Harrison , New York , USA
| | - Marciana Popescu
- a National Center for Social Work, Trauma Education and Workforce Development, Fordham University Graduate School of Social Service , West Harrison , New York , USA
| | - Robert Abramovitz
- b National Center for Social Work, Trauma Education and Workforce Development, Silberman School of Social Work at Hunter College , New York , New York , USA
| | - Sean Richards
- a National Center for Social Work, Trauma Education and Workforce Development, Fordham University Graduate School of Social Service , West Harrison , New York , USA
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159
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Baumann AA, Powell BJ, Kohl PL, Tabak RG, Penalba V, Proctor EE, Domenech-Rodriguez MM, Cabassa LJ. Cultural Adaptation and Implementation of Evidence-Based Parent-Training: A Systematic Review and Critique of Guiding Evidence. CHILDREN AND YOUTH SERVICES REVIEW 2015; 53:113-120. [PMID: 25960585 PMCID: PMC4419735 DOI: 10.1016/j.childyouth.2015.03.025] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
With advances in knowledge regarding efficacious evidence-based interventions, there have been significant attempts to culturally adapt, implement, and disseminate parent training interventions broadly, especially across ethnic and cultural groups. We sought to examine the extent to which researchers and developers of evidence-based parent training programs have used cultural adaptation models, tested implementation strategies, and evaluated implementation outcomes when integrating the interventions into routine care by conducting a systematic review of the literature for four evidence-based parent training interventions: Parent-Child Interaction Therapy (PCIT), The Incredible Years (IY), Parent Management Training-Oregon Model (PMTO™), and the Positive Parenting Program (Triple P). A total of 610 articles across the four programs were identified. Of those, only eight documented a rigorous cultural adaptation process, and only two sought to test the effectiveness of implementation strategies by using rigorous research designs. Our findings suggest that there is much work to be done to move parent-training intervention research towards a more rigorous examination of cultural adaptation and implementation practices.
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Affiliation(s)
- Ana A. Baumann
- Brown School, Washington University in St. Louis. 600 S. Euclid, CB 8217, St. Louis, Missouri 63110
| | - Byron J. Powell
- Brown School, Washington University in St. Louis. One Brookings Drive, Campus Box 1196, St. Louis, Missouri 63130
| | - Patricia L. Kohl
- Brown School, Washington University in St. Louis. One Brookings Drive, Campus Box 1196, St. Louis, Missouri 63130
| | - Rachel G. Tabak
- Prevention Research Center, Washington University in St. Louis. 621 Skinker Boulevard, St. Louis, Missouri 63130. United States
| | - Valentina Penalba
- Department of Counseling & Family Therapy, Saint Louis University. 3500 Lindell Blvd., St. Louis, Missouri 63103
| | - Enola E. Proctor
- Brown School, Washington University in St. Louis. One Brookings Drive, Campus Box 1196, St. Louis, Missouri 63130
| | | | - Leopoldo J. Cabassa
- School of Social Work, Columbia University. 1255 Amsterdam Avenue, Mail Code 4600, New York, New York 10027
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160
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Hartwig EK, Maynard BR. Practitioner perspectives of implementing check & connect. JOURNAL OF EVIDENCE-INFORMED SOCIAL WORK 2015; 12:438-49. [PMID: 25748052 DOI: 10.1080/15433714.2013.873752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
While there is a growing reserve of evidence-based practices (EBPs) available to practitioners, much can be learned about how to implement EBPs in real-world settings. Evidence of the effects of a widely disseminated student engagement intervention, Check & Connect (C&C), is emerging yet little is known about the implementation of C&C in community-based settings. The purpose of the authors in this study was to examine practitioner attitudes and perspectives related to the C&C intervention and implementation to gain an understanding of core implementation components that facilitated or impeded implementation. A researcher-developed survey instrument was used to assess practitioner attitudes related to the C&C model and implementation among 14 school-based practitioners working in a dropout prevention program. Findings indicate that practitioners were highly positive about the C&C intervention and in their attitudes about implementing EBPs. Benefits of C&C identified by practitioners included increased relationship building with students, tracking students on a consistent and timely basis, and addressing attendance issues as a main focus of treatment. The most common implementation challenges were time constraints, paperwork, and targeting absentee students. These findings contribute to the emerging literature on C&C and the implementation of EBPs in schools and community-based settings.
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Affiliation(s)
- Elizabeth Kjellstrand Hartwig
- a Department of Counseling, Leadership, Adult Education, and School Psychology , Texas State University , San Marcos , Texas , USA
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161
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Waltz TJ, Powell BJ, Chinman MJ, Smith JL, Matthieu MM, Proctor EK, Damschroder LJ, Kirchner JE. Expert Recommendations for Implementing Change (ERIC): protocol for a mixed methods study. Implement Sci 2014; 9:39. [PMID: 24669765 PMCID: PMC3987065 DOI: 10.1186/1748-5908-9-39] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying feasible and effective implementation strategies that are contextually appropriate is a challenge for researchers and implementers, exacerbated by the lack of conceptual clarity surrounding terms and definitions for implementation strategies, as well as a literature that provides imperfect guidance regarding how one might select strategies for a given healthcare quality improvement effort. In this study, we will engage an Expert Panel comprising implementation scientists and mental health clinical managers to: establish consensus on a common nomenclature for implementation strategy terms, definitions and categories; and develop recommendations to enhance the match between implementation strategies selected to facilitate the use of evidence-based programs and the context of certain service settings, in this case the U.S. Department of Veterans Affairs (VA) mental health services. METHODS/DESIGN This study will use purposive sampling to recruit an Expert Panel comprising implementation science experts and VA mental health clinical managers. A novel, four-stage sequential mixed methods design will be employed. During Stage 1, the Expert Panel will participate in a modified Delphi process in which a published taxonomy of implementation strategies will be used to establish consensus on terms and definitions for implementation strategies. In Stage 2, the panelists will complete a concept mapping task, which will yield conceptually distinct categories of implementation strategies as well as ratings of the feasibility and effectiveness of each strategy. Utilizing the common nomenclature developed in Stages 1 and 2, panelists will complete an innovative menu-based choice task in Stage 3 that involves matching implementation strategies to hypothetical implementation scenarios with varying contexts. This allows for quantitative characterizations of the relative necessity of each implementation strategy for a given scenario. In Stage 4, a live web-based facilitated expert recommendation process will be employed to establish expert recommendations about which implementations strategies are essential for each phase of implementation in each scenario. DISCUSSION Using a novel method of selecting implementation strategies for use within specific contexts, this study contributes to our understanding of implementation science and practice by sharpening conceptual distinctions among a comprehensive collection of implementation strategies.
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Affiliation(s)
- Thomas J Waltz
- Department of Veterans Affairs Medical Center, 2200 Fort Roots Drive (152/NLR), Central Arkansas Veterans Healthcare System, HSR&D and Mental Health Quality Enhancement Research Initiative (QUERI), Little Rock, Arkansas, USA
- Department of Psychology, 301D Science Complex, Eastern Michigan University, Ypsilanti, MI, USA 48197
| | - Byron J Powell
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
- Veterans Research and Education Foundation of Saint Louis, d.b.a. Vandeventer Place Research Foundation, St. Louis, Missouri, USA
| | - Matthew J Chinman
- VISN 4 MIRECC, Pittsburgh, Pennsylvania, USA
- RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Jeffrey L Smith
- Department of Veterans Affairs Medical Center, 2200 Fort Roots Drive (152/NLR), Central Arkansas Veterans Healthcare System, HSR&D and Mental Health Quality Enhancement Research Initiative (QUERI), Little Rock, Arkansas, USA
| | - Monica M Matthieu
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, St. Louis, Missouri and St. Louis VA Health Care System, St. Louis, USA
| | - Enola K Proctor
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Laura J Damschroder
- HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - JoAnn E Kirchner
- Department of Veterans Affairs Medical Center, 2200 Fort Roots Drive (152/NLR), Central Arkansas Veterans Healthcare System, HSR&D and Mental Health Quality Enhancement Research Initiative (QUERI), Little Rock, Arkansas, USA
- Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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