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Dinnen HL, Litvitskiy NS, Flaspohler PD. Effective Teacher Professional Development for School-Based Mental Health Promotion: A Review of the Literature. Behav Sci (Basel) 2024; 14:780. [PMID: 39335995 PMCID: PMC11428657 DOI: 10.3390/bs14090780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 08/27/2024] [Accepted: 08/30/2024] [Indexed: 09/30/2024] Open
Abstract
Teachers are critically involved in the delivery of school-based mental health promotion (SMHP) interventions in school, though pre-service teacher education often leaves teachers feeling underprepared in this area. Thus, understanding how best to build teachers' capacity for delivery through effective professional development (PD) is essential for teachers to fulfill their role as delivery agents to achieve SMHP outcomes. This systematized review focuses on identifying components of high-quality teacher PD for SMHP and examining the empirical support for these components. In a two-phase analysis, we examined the descriptive literature regarding teacher PD for SMHP to identify common elements. This resulted in the identification of components relevant to training (interactive, guided by staff input) and technical assistance (TA), including the goals (skill development, motivation, generalization/adaptation), approach (collaborative, individualized, data-driven, strengths-based), and activities (modeling, performance feedback, reflection, problem solving) involved. A second phase focused on the examination of empirical evidence for these PD components. While the empirical evidence for these components was limited, the identified components represent a current standard of practice in teacher PD for SMHP, based on the existing research. These components may provide a framework for practical use in planning teacher PD related to SMHP and for designing future research into effective capacity building in this area.
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Affiliation(s)
- Hannah L Dinnen
- Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45225, USA
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Rahmani H, Talebianpour H, Sharafi SE, Daroudi R, Jaafaripooyan E. Development of attributes and levels of mental health insurance services using a discrete choice experiment. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:134. [PMID: 37397093 PMCID: PMC10312408 DOI: 10.4103/jehp.jehp_433_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/18/2022] [Indexed: 07/04/2023]
Abstract
BACKGROUND Despite the fact that mental illness is among the ten top diseases with the highest burden, the health services required by these patients do not have adequate insurance coverage. The purpose of this study is to develop the attributes and levels of mental health insurance services using a discrete choice experiment (DCE). MATERIALS AND METHOD This study involved a qualitative phase of the DCE that was conducted in Iran in 2020-2021 and included several stages. First, during a literature review, the attributes and levels were determined. Then, the attributes of health insurance were identified and weighed through virtual and in-person interviews with 16 mental health insurance professionals and policymakers in this field who were selected by purposive sampling. Finally, after a few sessions, through review studies, interviews, and a group of the expert panel, attributes and levels were finalized. RESULTS This study showed that coverage of inpatient services, outpatient services, place of receiving services, use of online internet services, limitation of services, and monthly premiums were the most important attributes of mental health insurance services. CONCLUSION To promote mental health insurance, policymakers and health insurance organizations should pay attention to premiums to be commensurate with the payment of people, packages of mental health services, and the ability of people to pay in appropriation with inflation. Identifying these attributes can determine people's willingness to pay and preferences for mental health insurance and lead to better planning for more comprehensive coverage for patients and increase the desirability of individuals in receiving services.
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Affiliation(s)
- Hojjat Rahmani
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Talebianpour
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayedeh Elham Sharafi
- Psychosomatic Research Center, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Rajabali Daroudi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Jaafaripooyan
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Karim S, Craig BM, Vass C, Groothuis-Oudshoorn CGM. Current Practices for Accounting for Preference Heterogeneity in Health-Related Discrete Choice Experiments: A Systematic Review. PHARMACOECONOMICS 2022; 40:943-956. [PMID: 35960434 DOI: 10.1007/s40273-022-01178-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Accounting for preference heterogeneity is a growing analytical practice in health-related discrete choice experiments (DCEs). As heterogeneity may be examined from different stakeholder perspectives with different methods, identifying the breadth of these methodological approaches and understanding the differences are major steps to provide guidance on good research practices. OBJECTIVES Our objective was to systematically summarize current practices that account for preference heterogeneity based on the published DCEs related to healthcare. METHODS This systematic review is part of the project led by the Professional Society for Health Economics and Outcomes Research (ISPOR) health preference research special interest group. The systematic review conducted systematic searches on the PubMed, OVID, and Web of Science databases, as well as on two recently published reviews, to identify articles. The review included health-related DCE articles published between 1 January 2000 and 30 March 2020. All the included articles also presented evidence on preference heterogeneity analysis based on either explained or unexplained factors or both. RESULTS Overall, 342 of the 2202 (16%) articles met the inclusion/exclusion criteria for extraction. The trend showed that analyses of preference heterogeneity increased substantially after 2010 and that such analyses mainly examined heterogeneity due to observable or unobservable factors in individual characteristics. Heterogeneity through observable differences (i.e., explained heterogeneity) is identified among 131 (40%) of the 342 articles and included one or more interactions between an attribute variable and an observable characteristic of the respondent. To capture unobserved heterogeneity (i.e., unexplained heterogeneity), the studies largely estimated either a mixed logit (n = 205, 60%) or a latent-class logit (n = 112, 32.7%) model. Few studies (n = 38, 11%) explored scale heterogeneity or heteroskedasticity. CONCLUSIONS Providing preference heterogeneity evidence in health-related DCEs has been found as an increasingly used practice among researchers. In recent studies, controlling for unexplained preference heterogeneity has been seen as a common practice rather than explained ones (e.g., interactions), yet a lack of providing methodological details has been observed in many studies that might impact the quality of analysis. As heterogeneity can be assessed from different stakeholder perspectives with different methods, researchers should become more technically pronounced to increase confidence in the results and improve the ability of decision makers to act on the preference evidence.
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Affiliation(s)
- Suzana Karim
- University of South Florida, 4202 E Fowler Ave, Tampa, FL, 33620, USA.
| | - Benjamin M Craig
- University of South Florida, 4202 E Fowler Ave, Tampa, FL, 33620, USA
| | - Caroline Vass
- RTI Health Solutions, Manchester, UK
- The University of Manchester, Manchester, UK
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von Thiele Schwarz U, Lyon AR, Pettersson K, Giannotta F, Liedgren P, Hasson H. Understanding the value of adhering to or adapting evidence-based interventions: a study protocol of a discrete choice experiment. Implement Sci Commun 2021; 2:88. [PMID: 34380575 PMCID: PMC8356451 DOI: 10.1186/s43058-021-00187-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/11/2021] [Indexed: 12/20/2022] Open
Abstract
Background Whereas the value of an evidence-based intervention (EBI) is often determined by its effect on clinical outcomes, the value of implementing and using EBIs in practice is broader, reflecting qualities such as appropriateness, equity, costs, and impact. Reconciling these value conflicts involves a complicated decision process that has received very limited scholarly attention. Inspired by studies on decision-making, the objective of this project is to explore how practitioners appraise the values of different outcomes and to test how this appraisal influences their decisions surrounding the so-called fidelity–adaptation dilemma. This dilemma is related to the balance between using an EBI as it was designed (to ensure its effectiveness) and making appropriate adaptations (to ensure alignment with constraints and possibilities in the local context). Methods This project consists of three sub-studies. The participants will be professionals leading evidence-based parental programs in Sweden and, in Sub-study 1, parents and decision-makers. Sub-study 1 will use sequential focus groups and individual interviews to explore parameters that influence fidelity and adaptation decisions—the dilemmas encountered, available options, how outcomes are valued by practitioners as well as other stakeholders, and value trade-offs. Sub-study 2 is a discrete choice experiment that will test how value appraisals influence decision-making using data from Sub-study 1 as input. Sub-study 3 uses a mixed-method design, with findings from the two preceding sub-studies as input in focus group interviews to investigate how practitioners make sense of findings from optimal decision situations (experiment) and constrained, real-world decision situations. Discussion The project will offer unique insights into decision-making processes that influence how EBIs are used in practice. Such knowledge is needed for a more granular understanding of how practitioners manage the fidelity–adaptation dilemma and thus, ultimately, how the value of EBI implementation can be optimized. This study contributes to our knowledge of what happens once EBIs are adopted—that is, the gap between the way in which EBIs are intended to be used and the way in which they are used in practice.
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Affiliation(s)
- Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden. .,Procome, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Kristoffer Pettersson
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Fabrizia Giannotta
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Pernilla Liedgren
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Henna Hasson
- Procome, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.,Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
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Williams NJ, Candon M, Stewart RE, Byeon YV, Bewtra M, Buttenheim AM, Zentgraf K, Comeau C, Shoyinka S, Beidas RS. Community stakeholder preferences for evidence-based practice implementation strategies in behavioral health: a best-worst scaling choice experiment. BMC Psychiatry 2021; 21:74. [PMID: 33541301 PMCID: PMC7863375 DOI: 10.1186/s12888-021-03072-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community behavioral health clinicians, supervisors, and administrators play an essential role in implementing new psychosocial evidence-based practices (EBP) for patients receiving psychiatric care; however, little is known about these stakeholders' values and preferences for implementation strategies that support EBP use, nor how best to elicit, quantify, or segment their preferences. This study sought to quantify these stakeholders' preferences for implementation strategies and to identify segments of stakeholders with distinct preferences using a rigorous choice experiment method called best-worst scaling. METHODS A total of 240 clinicians, 74 clinical supervisors, and 29 administrators employed within clinics delivering publicly-funded behavioral health services in a large metropolitan behavioral health system participated in a best-worst scaling choice experiment. Participants evaluated 14 implementation strategies developed through extensive elicitation and pilot work within the target system. Preference weights were generated for each strategy using hierarchical Bayesian estimation. Latent class analysis identified segments of stakeholders with unique preference profiles. RESULTS On average, stakeholders preferred two strategies significantly more than all others-compensation for use of EBP per session and compensation for preparation time to use the EBP (P < .05); two strategies were preferred significantly less than all others-performance feedback via email and performance feedback via leaderboard (P < .05). However, latent class analysis identified four distinct segments of stakeholders with unique preferences: Segment 1 (n = 121, 35%) strongly preferred financial incentives over all other approaches and included more administrators; Segment 2 (n = 80, 23%) preferred technology-based strategies and was younger, on average; Segment 3 (n = 52, 15%) preferred an improved waiting room to enhance client readiness, strongly disliked any type of clinical consultation, and had the lowest participation in local EBP training initiatives; Segment 4 (n = 90, 26%) strongly preferred clinical consultation strategies and included more clinicians in substance use clinics. CONCLUSIONS The presence of four heterogeneous subpopulations within this large group of clinicians, supervisors, and administrators suggests optimal implementation may be achieved through targeted strategies derived via elicitation of stakeholder preferences. Best-worst scaling is a feasible and rigorous method for eliciting stakeholders' implementation preferences and identifying subpopulations with unique preferences in behavioral health settings.
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Affiliation(s)
| | - Molly Candon
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca E Stewart
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Y Vivian Byeon
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Meenakshi Bewtra
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Alison M Buttenheim
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Kelly Zentgraf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Carrie Comeau
- Department of Behavioral Health and Intellectual disAbility Services (DBHIDS), Philadelphia, PA, USA
| | - Sonsunmolu Shoyinka
- Department of Behavioral Health and Intellectual disAbility Services (DBHIDS), Philadelphia, PA, USA
| | - Rinad S Beidas
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
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Girio-Herrera E, Egan TE, Owens JS, Evans SW, Coles EK, Holdaway AS, Mixon CS, Kassab HD. Teacher Ratings of Acceptability of a Daily Report Card Intervention Prior to and During Implementation: Relations to Implementation Integrity and Student Outcomes. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-020-09400-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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O'Connor A, Krucien N, Cantillon P, Parker M, McCurtin A. Investigating physiotherapy stakeholders' preferences for the development of performance-based assessment in practice education. Physiotherapy 2020; 108:46-54. [PMID: 32711227 DOI: 10.1016/j.physio.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Discrete choice experiments (DCEs) are used in healthcare to measure the relative importance that stakeholders give to different features (or attributes) of medical treatments or services. They may also help to address research questions in health professional education. Several challenges exist regarding the performance-based assessment process (PBA) employed in physiotherapy practice-based education, a process which determines students' readiness for independent practice. Evidence highlights many commonalities among these challenges, but it is unknown which factors are the most important to stakeholders. The use of DCE methodology may provide answers and help to prioritise areas for development. Thus, this study employed DCE to identify clinical educators', practice tutors and physiotherapy students' preferences for developing the PBA process in physiotherapy. DESIGN Attributes (aspects of the PBA process known to be important to stakeholders) were derived from focus group interviews conducted with three groups; physiotherapy students, clinical educators (practising clinicians) and practice tutors (dedicated educational roles in the workplace). These attributes included the PBA tool, grading mechanisms, assessors involved, and, feedback mechanisms. Preferences for each group were calculated using a logistic regression model. RESULTS Seventy-two students, 124 clinical educators and 49 practice tutors (n=245) participated. Priorities identified centred primarily on the mandatory inclusion of two assessors in the PBA process and on refinement of the PBA tool. CONCLUSION Employment of DCE enabled the prioritisation of stakeholder-informed challenges related to PBA in physiotherapy practice-based education. This corroborates findings from previous qualitative work and facilitates a prioritised pathway for development of this process.
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Affiliation(s)
- A O'Connor
- School of Allied Health, Health Sciences Building, University of Limerick, Castletroy, Limerick V94 T9PX, Ireland; Health Research Institute, University of Limerick, Castletroy, Limerick V94 T9PX, Ireland.
| | - N Krucien
- Health Economics Research Unit, University of Aberdeen, Aberdeen, Scotland AB25 2ZD, United Kingdom.
| | - P Cantillon
- Discipline of General Practice, Clinical Science Institute, National University of Ireland, Galway H91 TK33, Ireland.
| | - M Parker
- Department of Physical Education and Sports Sciences, University of Limerick, Castletroy, Limerick V94 T9PX, Ireland.
| | - A McCurtin
- School of Allied Health, Health Sciences Building, University of Limerick, Castletroy, Limerick V94 T9PX, Ireland; Health Research Institute, University of Limerick, Castletroy, Limerick V94 T9PX, Ireland.
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Cunningham CE, Rimas H, Vaillancourt T, Stewart B, Deal K, Cunningham L, Vanniyasingam T, Duku E, Buchanan DH, Thabane L. What Influences Educators' Design Preferences for Bullying Prevention Programs? Multi-level Latent Class Analysis of a Discrete Choice Experiment. SCHOOL MENTAL HEALTH 2020; 12:22-37. [PMID: 32117478 PMCID: PMC7021664 DOI: 10.1007/s12310-019-09334-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We used a discrete choice conjoint experiment to model the anti-bullying (AB) program preferences of 1080 junior kindergarten to Grade 8 educators. Participants chose between hypothetical AB programs that varied combinations of 12 design attributes. Multi-level latent class analysis yielded three classes: All-in Supervisors (21.5%) preferred that all teaching staff supervise playgrounds and hallways; Facilitators (61.6%) preferred that students take ownership of AB activities with 25% of educators supervising playgrounds and hallways; and Reluctant Delegators (16.9%) preferred delegating the supervision of playgrounds and hallways to non-teaching staff. This class reported higher dispositional reactance, more implementation barriers, and more psychological reactance to these initiatives. They were less sensitive to social influences and less intent on participating in AB activities. Multi-level analysis showed a greater proportion of Reluctant Delegators clustered in one of the two groups of schools. The program choices of all classes were sensitive to the support of principals, colleagues, students, and, to a lesser extent, parents. All classes preferred programs conducted from kindergarten through Grade 12 that addressed the problems underlying bullying while valuing firm and consistent consequences for all students. Educators preferred AB programs selected by individual schools, rather than governments.
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Affiliation(s)
- Charles E Cunningham
- 1Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8 Canada.,Ron Joyce Children's Health Centre, 237 Barton Street East, Hamilton, ON L8L 2X2 USA
| | - Heather Rimas
- 1Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8 Canada
| | - Tracy Vaillancourt
- 2Counselling Psychology, Faculty of Education, University of Ottawa, 145 Jean-Jacques-Lussier, Ottawa, ON K1N 6N5 Canada
| | - Bailey Stewart
- 1Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8 Canada
| | - Ken Deal
- 3DeGroote School of Business, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8 Canada
| | - Lesley Cunningham
- Hamilton-Wentworth District School Board, 20 Education Court, Hamilton, ON L9A 0B9 Canada
| | - Thuva Vanniyasingam
- 5Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8 Canada
| | - Eric Duku
- 1Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8 Canada.,Offord Centre for Child Studies, McMaster Innovation Park, Suite 201A, 175 Longwood Rd. S, Hamilton, ON L8P 0A1 Canada
| | - Don H Buchanan
- Hamilton-Wentworth District School Board, 20 Education Court, Hamilton, ON L9A 0B9 Canada
| | - Lehana Thabane
- 5Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8 Canada
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Cunningham CE, Barwick M, Rimas H, Mielko S, Barac R. Modeling the Decision of Mental Health Providers to Implement Evidence-Based Children's Mental Health Services: A Discrete Choice Conjoint Experiment. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 45:302-317. [PMID: 28918498 PMCID: PMC5809569 DOI: 10.1007/s10488-017-0824-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Using an online, cross sectional discrete choice experiment, we modeled the influence of 14 implementation attributes on the intention of 563 providers to adopt hypothetical evidence-based children’s mental health practices (EBPs). Latent class analysis identified two segments. Segment 1 (12%) would complete 100% of initial training online, devote more time to training, make greater changes to their practices, and introduce only minor modifications to EBPs. Segment 2 (88%) preferred fewer changes, more modifications, less training, but more follow-up. Simulations suggest that enhanced supervisor support would increase the percentage of participants choosing the intensive training required to implement EBPs. The dissemination of EBPs needs to consider the views of segments of service providers with differing preferences regarding EBPs and implementation process design.
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Affiliation(s)
- Charles E Cunningham
- Patient Centered Health Care, Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Melanie Barwick
- CHES Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada
| | - Heather Rimas
- Patient Centered Health Care, Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Stephanie Mielko
- Patient Centered Health Care, Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Raluca Barac
- Child and Youth Mental Health Research Unit, The Hospital for Sick Children, Toronto, Canada
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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 2018; 44:177-194. [PMID: 26289563 DOI: 10.1007/s11414-015-9475-6] [Citation(s) in RCA: 476] [Impact Index Per Article: 79.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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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Zhou M, Thayer WM, Bridges JFP. Using Latent Class Analysis to Model Preference Heterogeneity in Health: A Systematic Review. PHARMACOECONOMICS 2018; 36:175-187. [PMID: 28975582 DOI: 10.1007/s40273-017-0575-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Latent class analysis (LCA) has been increasingly used to explore preference heterogeneity, but the literature has not been systematically explored and hence best practices are not understood. OBJECTIVE We sought to document all applications of LCA in the stated-preference literature in health and to inform future studies by identifying current norms in published applications. METHODS We conducted a systematic review of the MEDLINE, EMBASE, EconLit, Web of Science, and PsycINFO databases. We included stated-preference studies that used LCA to explore preference heterogeneity in healthcare or public health. Two co-authors independently evaluated titles, abstracts, and full-text articles. Abstracted key outcomes included segmentation methods, preference elicitation methods, number of attributes and levels, sample size, model selection criteria, number of classes reported, and hypotheses tests. Study data quality and validity were assessed with the Purpose, Respondents, Explanation, Findings, and Significance (PREFS) quality checklist. RESULTS We identified 2560 titles, 99 of which met the inclusion criteria for the review. Two-thirds of the studies focused on the preferences of patients and the general population. In total, 80% of the studies used discrete choice experiments. Studies used between three and 20 attributes, most commonly four to six. Sample size in LCAs ranged from 47 to 2068, with one-third between 100 and 300. Over 90% of the studies used latent class logit models for segmentation. Bayesian information criterion (BIC), Akaike information criterion (AIC), and log-likelihood (LL) were commonly used for model selection, and class size and interpretability were also considered in some studies. About 80% of studies reported two to three classes. The number of classes reported was not correlated with any study characteristics or study population characteristics (p > 0.05). Only 30% of the studies reported using statistical tests to detect significant variations in preferences between classes. Less than half of the studies reported that individual characteristics were included in the segmentation models, and 30% reported that post-estimation analyses were conducted to examine class characteristics. While a higher percentage of studies discussed clinical implications of the segmentation results, an increasing number of studies proposed policy recommendations based on segmentation results since 2010. CONCLUSIONS LCA is increasingly used to study preference heterogeneity in health and support decision-making. However, there is little consensus on best practices as its application in health is relatively new. With an increasing demand to study preference heterogeneity, guidance is needed to improve the quality of applications of segmentation methods in health to support policy development and clinical practice.
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Affiliation(s)
- Mo Zhou
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, Room 690, Baltimore, MD, 21205, USA.
| | - Winter Maxwell Thayer
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, Room 690, Baltimore, MD, 21205, USA
| | - John F P Bridges
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, Room 690, Baltimore, MD, 21205, USA
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Schultz BK, Zoder-Martell KA, Fischer A, Collier-Meek MA, Erchul WP, Schoemann AM. When Is Teleconsultation Acceptable to School Psychologists? JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2017. [DOI: 10.1080/10474412.2017.1385397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Salloum RG, Shenkman EA, Louviere JJ, Chambers DA. Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review. Implement Sci 2017; 12:140. [PMID: 29169397 PMCID: PMC5701380 DOI: 10.1186/s13012-017-0675-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 11/15/2017] [Indexed: 01/11/2023] Open
Abstract
Background One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE) is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. Methods We conducted a systematic literature search (up to December 2016) of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s), healthcare setting, and implementation outcome. Results Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1) characterizing demand for therapies and treatment technologies (n = 32), (2) comparing implementation strategies (n = 22), (3) incentivizing workforce participation (n = 11), and (4) prioritizing interventions (n = 10). Stakeholders included providers (n = 27), patients (n = 25), caregivers (n = 5), and administrators (n = 2). The remaining studies (n = 16) engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators). The following implementation outcomes were discussed: acceptability (n = 75), appropriateness (n = 34), adoption (n = 19), feasibility (n = 16), and fidelity (n = 3). Conclusions The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the past decade. As DCEs are more widely used as a healthcare assessment tool, there is a wide range of applications for them in stakeholder engagement. The DCE approach could serve as a tool for engaging stakeholders in implementation science. Electronic supplementary material The online version of this article (10.1186/s13012-017-0675-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ramzi G Salloum
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Jordan J Louviere
- Institute for Choice, School of Marketing, University of South Australia, Adelaide, SA, Australia
| | - David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Koenig A, Rodger S, Specht J. Educator Burnout and Compassion Fatigue: A Pilot Study. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2017. [DOI: 10.1177/0829573516685017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sixty-four Canadian educators from Southwestern Ontario took part in a 2-hr voluntary workshop about the emotional labor and consequences that may be experienced by educators. A focus on both burnout and teacher compassion fatigue (CF), an underresearched area with respect to Canadian educators, was taken. The current study hypothesized that this professional development would positively influence educators’ knowledge, skills, and awareness regarding burnout, CF, and self-care; furthermore, it was predicted there would be a positive correlation between burnout and CF. Results supported the efficacy of professional development and partial support was detected for the relationship between burnout and CF. Implications and future research are discussed.
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Fortier A, Lalonde G, Venesoen P, Legwegoh AF, Short KH. Educator mental health literacy to scale: from theory to practice. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/1754730x.2016.1252276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jones DL, Cook R, Potter JE, Miron-Shatz T, Chakhtoura N, Spence A, Byrne MM. Fertility Desires among Women Living with HIV. PLoS One 2016; 11:e0160190. [PMID: 27610626 PMCID: PMC5017599 DOI: 10.1371/journal.pone.0160190] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/14/2016] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Rates of pregnancy among women living with HIV (WLHIV) have increased with the availability of effective HIV treatment. Planning for pregnancy and childbirth is an increasingly important element of HIV care. Though rates of unintended pregnancies are high among women in general, among couples affected by HIV, significant planning and reproductive decisions must be considered to prevent negative health consequences for WLHIV and their neonates. To gain insight into this reproductive decision-making process among WLHIV, this study explored women's knowledge, attitudes and practices regarding fertility planning, reproductive desires, and safer conception practices. It was hypothesized that pregnancy desires would be influenced by partners, families, the potential risk of HIV transmission to infants, and physicians' recommendations. METHODS WLHIV of childbearing age were recruited from urban South Florida, and completed an assessment of demographics (N = 49), fertility desires and a conjoint survey of factors associated with reproductive decision-making. RESULTS Using conjoint analysis, we found that different decision paths exist for different types of women: Younger women and those with less education desired children if their partners wanted children; reproductive desires among those with less education, and with less HIV pregnancy-related knowledge, displayed a trend toward additional emphasis on their family's desires. Conversely, older women and those with more education appeared to place more importance on physician endorsement in their plans for childbearing. CONCLUSIONS Results of this study highlight the importance of ongoing preconception counselling for all women of reproductive age during routine HIV care. Counselling should be tailored to patient characteristics, and physicians should consider inclusion of families and/or partners in the process.
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Affiliation(s)
- Deborah Lynne Jones
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Ryan Cook
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - JoNell Efantis Potter
- Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Talya Miron-Shatz
- Ono Academic College, Kiryat Ono, Israel
- Center for Medicine in the Public Interest, New York, New York, United States of America
| | - Nahida Chakhtoura
- Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Andrew Spence
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Margaret M. Byrne
- Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, Florida, United States of America
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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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