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McCoy K, Moreland-Johnson A, Wade S, Quinones K, Swiecicki C, Hanson R. Therapist Participation in a Learning Collaborative on Trauma-Focused Cognitive Behavioral Therapy: Impact of COVID-related Stressors and Challenges. Community Ment Health J 2024; 60:1006-1016. [PMID: 38619697 DOI: 10.1007/s10597-024-01256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/17/2024] [Indexed: 04/16/2024]
Abstract
The rise in mental health problems during the COVID-19 pandemic amplified the need to improve access to evidence-based treatments (EBT) and necessitated changes in treatment delivery and training of mental health providers (MHPs). There is limited information on how the pandemic may have impacted MHPs' participation in training and treatment delivery. This study included 269 MHPs who participated in a Learning Collaborative (LC) focused on an EBT. Qualitative interviews conducted with 15 MHPs who participated in the LC during the pandemic identified facilitators and barriers to training participation and EBT delivery that included social support, technology challenges, and difficulty completing cases following the transition to telehealth. Quantitative results showed that MHPs in the peri-COVID cohorts completed significantly fewer cases and fewer consultation calls compared to those prior to the pandemic. Findings suggest that providing support to train MHPs and promote EBT delivery may be beneficial during times of heightened stress.
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Affiliation(s)
- Kelsey McCoy
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA.
- Present Address: Milestones Psychology, 28 W. 25th Street 10th Floor, New York, NY, 10010, USA.
| | | | - Shelby Wade
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA
| | - Kathy Quinones
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA
| | - Carole Swiecicki
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA
| | - Rochelle Hanson
- Department of Psychiatry, Medical University of South Carolina, South Carolina, USA
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2
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Usami M, Satake N, Katsuyama H, Okudera K, Uchiyama Y, Imamura M, Hayakawa T, Yanai H, Aoyanagi N. Is children's mental health an important function of newly national organization for health crisis management in Japan? PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e175. [PMID: 38868482 PMCID: PMC11114343 DOI: 10.1002/pcn5.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 06/14/2024]
Abstract
This review discussed analyzing information dissemination and activities related to mental health conducted by the Centers of Disease Control and Prevention (CDC), considering their application in Japan, and disseminating them to the public is necessary for the Japanese New Center for Health Control. The Japanese government also explores the Japanese New Center For Health Control in addressing children's mental health issues potentially under the Japan health crisis. The findings underscore the urgency of prioritizing children's mental health and implementing effective strategies to mitigate the long-term effects of the COVID-19 pandemic.
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Affiliation(s)
- Masahide Usami
- Department of Child and Adolescent Psychiatry, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
- Clinical Center for Children's Mental Health, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Naoko Satake
- Department of Psychiatry Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Hisayuki Katsuyama
- Department of Diabetes, Endocrinology and Metabolism, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Kaori Okudera
- Department of Nursing, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Yumiko Uchiyama
- Department of Nursing, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Masatoshi Imamura
- Department of Gastroenterology and Hepatology, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaChibaJapan
| | - Tatsuro Hayakawa
- Department of Psychiatry Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
| | - Nobuyoshi Aoyanagi
- Department of Surgery, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaJapan
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3
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Raymond IJ. Intentional practice: a common language, approach and set of methods to design, adapt and implement contextualised wellbeing solutions. FRONTIERS IN HEALTH SERVICES 2023; 3:963029. [PMID: 37395993 PMCID: PMC10312088 DOI: 10.3389/frhs.2023.963029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/05/2023] [Indexed: 07/04/2023]
Abstract
Reducing the "science-to-practice" gap has gained significant attention across multi-disciplinary settings, including school psychology and student wellbeing, trauma-informed practice, community and human services, and clinically focused health care. There has been increasing calls for complexity and contextualisation to be integrated within the implementation science literature. This includes the design and implementation of interventions spanning "systems" (whole-of-community capacity building initiatives), "programs" (e.g., evidence-based programs, clinical interventions) and "moment-to-moment" support or care. The latter includes responses and communication designed to deliver specific learning, growth or wellbeing outcomes, as personalised to an individual's presenting needs and context (e.g., trauma-informed practice). Collectively, this paper refers to these interventions as "wellbeing solutions". While the implementation science literature offers a range of theories, models and approaches to reduce the science-to-practice gap in wellbeing solution design and implementation, they do not operationalise interventions into the "moment", in a manner that honours both complexity and contextualisation. Furthermore, the literature's language and content is largely targeted towards scientific or professional audiences. This paper makes the argument that both best-practice science, and the frameworks that underpin their implementation, need to be "sticky", practical and visible for both scientific and non-scientific knowledge users. In response to these points, this paper introduces "intentional practice" as a common language, approach and set of methods, founded upon non-scientific language, to guide the design, adaptation and implementation of both simple and complex wellbeing solutions. It offers a bridge between scientists and knowledge users in the translation, refinement and contextualisation of interventions designed to deliver clinical, wellbeing, growth, therapeutic and behavioural outcomes. A definitional, contextual and applied overview of intentional practice is provided, including its purported application across educational, wellbeing, cross-cultural, clinical, therapeutic, programmatic and community capacity building contexts.
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4
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Penedo FJ, Medina HN, Moreno PI, Sookdeo V, Natori A, Boland C, Schlumbrecht MP, Calfa C, MacIntyre J, Crane TE, Garcia SF. Implementation and Feasibility of an Electronic Health Record-Integrated Patient-Reported Outcomes Symptom and Needs Monitoring Pilot in Ambulatory Oncology. JCO Oncol Pract 2022; 18:e1100-e1113. [PMID: 35290096 PMCID: PMC9287298 DOI: 10.1200/op.21.00706] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/14/2021] [Accepted: 02/11/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Describe the feasibility and implementation of an electronic health record (EHR)-integrated symptom and needs screening and referral system in a diverse racial/ethnic patient population in ambulatory oncology. METHODS Data were collected from an ambulatory oncology clinic at the University of Miami Health System from October 2019 to January 2021. Guided by a Patient Advisory Board and the Exploration, Preparation, Implementation, and Sustainment model, My Wellness Check was developed to assess physical and psychologic symptoms and needs of ambulatory oncology patients before appointments to triage them to supportive services when elevated symptoms (eg, depression), barriers to care (eg, transportation and childcare), and nutritional needs were identified. Patients were assigned assessments at each appointment no more than once in a 30-day period starting at the second visit. Assessments were available in English and Spanish to serve the needs of the predominantly Spanish-speaking Hispanic/Latino population. RESULTS From 1,232 assigned assessments, more than half (n = 739 assessments; 60.0%) were initiated by 506 unique patients. A total of 65.4% of English and 49.9% of Spanish assessments were initiated. Among all initiated assessments, the majority (85.1%) were completed at home via the patient portal. The most common endorsed items were nutritional needs (32.9%), followed by emotional symptoms (ie, depression and anxiety; 27.8%), practical needs (eg, financial concerns; 21.7%), and physical symptoms (17.6%). Across the physical symptom, social work, and nutrition-related alerts, 77.1%, 99.7%, and 78.8%, were addressed, respectively, by the corresponding oncology health professional, social work team member, or nutritionist. CONCLUSION The results demonstrate encouraging feasibility and initial acceptability of implementing an EHR-integrated symptom and needs screening and referral system among diverse oncology patients. To our knowledge, this is the first EHR-integrated symptom and needs screening system implemented in routine oncology care for Spanish-speaking Hispanics/Latinos.
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Affiliation(s)
- Frank J. Penedo
- Departments of Psychology and Medicine and Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables, FL
| | - Heidy N. Medina
- Department of Public Health Sciences, University of Miami, Miami, FL
| | | | - Vandana Sookdeo
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Akina Natori
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL
| | - Cody Boland
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Matthew P. Schlumbrecht
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Miller School of Medicine, Miami, FL
| | - Carmen Calfa
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL
| | | | - Tracy E. Crane
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL
| | - Sofia F. Garcia
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
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McCabe LA, Ruberti MR, Endres T. Sustaining program implementation: A co-constructed technical assistance process to support continuous high-quality implementation of the Therapeutic Crisis Intervention program. EVALUATION AND PROGRAM PLANNING 2022; 91:102049. [PMID: 35217287 DOI: 10.1016/j.evalprogplan.2022.102049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/24/2021] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Strategies for sustaining a program beyond initial implementation remain one of the most poorly understood aspects of high-quality program implementation. This paper describes the Quality Improvement and Fidelity Assessment Process (QIFAP), a program purveyor-agency partnership that uses a unique, multi-step method for supporting sustained implementation of the Therapeutic Crisis Intervention (TCI) system to manage crises in child serving organizations. It outlines the steps of the process and highlights how specific activities are linked to current knowledge and principles from implementation science. The QIFAP occurs over a period of about three months, during which time program developers and agency representatives conduct staff surveys, a two-day site visit, and fidelity assessments in order to gather information, discuss findings, and plan steps for improving the TCI system in the organization. The process is guided by principles that emphasize the importance of organization leadership, building relationships, co-learning, using an individualized approach, data informed decision making, acknowledging risk, and congruence. We describe ways in which the strategies and approaches within the QIFAP are rooted in implementation science literature. Thus, the model represents an illustration of how research-based knowledge can work in practice to support long-term, high-quality program implementation.
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Affiliation(s)
- Lisa A McCabe
- Bronfenbrenner Center for Translational Research, Cornell University, 1201 Martha Van Rensselaer Hall, Ithaca, NY 14853, USA.
| | - Mary R Ruberti
- Bronfenbrenner Center for Translational Research, Cornell University, 1201 Martha Van Rensselaer Hall, Ithaca, NY 14853, USA.
| | - Thomas Endres
- Bronfenbrenner Center for Translational Research, Cornell University, 1201 Martha Van Rensselaer Hall, Ithaca, NY 14853, USA
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6
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Winters A, Hooley C, Gopalan G. Absorptive capacity in child welfare: A qualitative study with child welfare staff eliciting key factors for evidence-based practice adoption. JOURNAL OF PUBLIC CHILD WELFARE 2021; 16:704-723. [PMID: 36386436 PMCID: PMC9642977 DOI: 10.1080/15548732.2021.1959489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 06/16/2023]
Abstract
Child Welfare (CW) provides an array of services to meet the needs of families, requiring agencies to be malleable in their ability to absorb new practices. Absorptive capacity (ACAP) refers to the routines and processes in which an organization acquires, assimilates, and applies new knowledge. ACAP has yet to be the focus of implementation research in CW settings. This exploratory study elicited feedback from CW staff in determining factors to consider when absorbing a new practice. Themes of logistic support, agency culture, and feedback from families emerged. Findings offer insights for CW agencies to consider when adopting a new practice.
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Affiliation(s)
- Andrew Winters
- University of Louisville, Kent School of Social Work, Louisville, KY, 40292
| | - Cole Hooley
- Brigham Young University, School of Social Work, Provo, UT 84602
| | - Geetha Gopalan
- City University of New York, Silberman School of Social Work at Hunter College, New York, NY 10035
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7
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Unertl KM, Walsh CG, Clayton EW. Combatting human trafficking in the United States: how can medical informatics help? J Am Med Inform Assoc 2021; 28:384-388. [PMID: 33120418 DOI: 10.1093/jamia/ocaa142] [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: 03/11/2020] [Revised: 05/11/2020] [Accepted: 06/15/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Human trafficking is a global problem taking many forms, including sex and labor exploitation. Trafficking victims can be any age, although most trafficking begins when victims are adolescents. Many trafficking victims have contact with health-care providers across various health-care contexts, both for emergency and routine care. MATERIALS AND METHODS We propose 4 specific areas where medical informatics can assist with combatting trafficking: screening, clinical decision support, community-facing tools, and analytics that are both descriptive and predictive. Efforts to implement health information technology interventions focused on trafficking must be carefully integrated into existing clinical work and connected to community resources to move beyond identification to provide assistance and to support trauma-informed care. RESULTS We lay forth a research and implementation agenda to integrate human trafficking identification and intervention into routine clinical practice, supported by health information technology. CONCLUSIONS A sociotechnical systems approach is recommended to ensure interventions address the complex issues involved in assisting victims of human trafficking.
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Affiliation(s)
- Kim M Unertl
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Colin G Walsh
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ellen Wright Clayton
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,School of Law, Vanderbilt University, Nashville, Tennessee, USA.,Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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8
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Shanley JR, Armistead LP, Musyimi C, Nyamai D, Ishiekwene M, Mutiso V, Ndetei D. Engaging community voices to assess Kenya's strengths and limitations to support a child maltreatment prevention program. CHILD ABUSE & NEGLECT 2021; 111:104772. [PMID: 33158583 PMCID: PMC7855883 DOI: 10.1016/j.chiabu.2020.104772] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 09/09/2020] [Accepted: 10/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Preventing child maltreatment is a global mission of numerous international organizations, with parent support programs as the critical prevention strategy. In Kenya, 70 % of children are at risk of experiencing abuse and neglect, most often by their parents. Yet, there is a lack of evidence-based parent support programs, and a limited understanding of Kenya's capacity and infrastructures (e.g., policies, funding, service agencies) to support and sustain such programs. OBJECTIVE The purpose of this study was to assess systematically Kenya's strengths and limitations to implement a parent support program using a mixed-methods study design. PARTICIPANTS AND METHODS Twenty-one community stakeholders from Kenya completed the World Health Organization's (WHO) Readiness Assessment for the Prevention of Child Maltreatment to understand Kenya's preparedness to undertake a prevention program. In addition, 91 participants (e.g., parents, community health workers, community leaders) took part in focus group discussions or individual interviews to understand existing support networks around parenting programs. RESULTS Kenya's overall 'readiness' score was comparable to the other countries that completed the WHO survey. The survey results revealed Kenya's strengths and limitations across the ten readiness dimensions. Several themes emerged from the focus groups and interviews, including the diverse sources of support for parents, specific programs available for parents, and gaps in services offered. CONCLUSIONS The results document ways to build upon Kenyan's existing strengths to facilitate implementation of an evidence-based prevention program. These results also highlight the significant need to understand local context when adapting parenting programs for low/middle income countries (LMICs).
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Affiliation(s)
| | - Lisa P Armistead
- Georgia State University, 140 Decatur St., Atlanta, GA 30303, USA.
| | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, PO Box 48423-00100, Nairobi, Kenya.
| | - Darius Nyamai
- Africa Mental Health Research and Training Foundation, PO Box 48423-00100, Nairobi, Kenya.
| | | | - Victoria Mutiso
- Africa Mental Health Research and Training Foundation, PO Box 48423-00100, Nairobi, Kenya.
| | - David Ndetei
- Africa Mental Health Research and Training Foundation, PO Box 48423-00100, Nairobi, Kenya; The University of Nairobi, PO Box 30197-00100, Nairobi, Kenya.
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9
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Jeukens-Visser M, Koldewijn K, van Wassenaer-Leemhuis AG, Flierman M, Nollet F, Wolf MJ. Development and nationwide implementation of a postdischarge responsive parenting intervention program for very preterm born children: The TOP program. Infant Ment Health J 2020; 42:423-437. [PMID: 33336859 PMCID: PMC8247046 DOI: 10.1002/imhj.21902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A previous randomized controlled trial has suggested the effectiveness of a Dutch postdischarge responsive parenting program for very preterm (VPT) infants, indicating that nationwide implementation was justified. This paper describes the development and nationwide implementation of the intervention, known as the TOP program, which consisted of three phases. In the preparation phase (2006-2010), a theory of change and the structure of the TOP program were developed, and funding for phase two, based on a positive Business Case, was obtained. In the pilot implementation phase (2010-2014), intervention strategies were developed for a real-world setting, capacity and adoption were increased, systematic evaluations were incorporated, and sustained funding was obtained. In the full-implementation phase (2014-2019), all Dutch Healthcare Insurers reimbursed the TOP program, enabling VPT infants to participate in the program without charge. By 2018, the number of interventionists that provided the TOP program had increased from 37 to 91, and all level III hospitals and 65% of regional hospitals in the Netherlands referred VPT infants. Currently, the program reaches 70% of the Dutch target population and parental satisfaction with the TOP program is high. After a 12-year implementation period, the TOP program forms part of routine care in the Netherlands.
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Affiliation(s)
- Martine Jeukens-Visser
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Karen Koldewijn
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Aleid G van Wassenaer-Leemhuis
- Emma Children's Hospital, Amsterdam UMC, Department of Neonatology, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique Flierman
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Frans Nollet
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Marie-Jeanne Wolf
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
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10
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Santens T, Hannes K, Levy S, Diamond G, Bosmans G. Barriers and Facilitators to Implementing Attachment-based Family Therapy into a Child Welfare Setting: A Qualitative Process Evaluation. FAMILY PROCESS 2020; 59:1483-1497. [PMID: 31823356 DOI: 10.1111/famp.12504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Child welfare systems (CWSs) worldwide show increased interest in adopting empirically informed clinical strategies to increase treatment effectiveness. Many empirically supported treatments (ESTs) exist, but little is known about EST implementation barriers and facilitators in CWS. This study explored CWS providers' experiences of implementing attachment-based family therapy (ABFT) in home-based services of the Flemish CWS (in Belgium). Sixteen CWS providers (twelve counselors and four supervisors) involved in three home-based services were interviewed. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection, coding, and analysis of interview data. Findings revealed that implementation success was related to ABFT's fit with the CWS's mission, philosophy, and existing practices. CWS providers' belief in the compatibility between ABFT and CWS increased investment in implementation efforts and persistence to overcome challenges and setbacks. Some barriers pertained to the learning of ABFT and some barriers pertained to systems level challenges such as lack of leadership and support, poor coordination with referral sources and other youth care partners, and lack of policy support. For successful expansion of ESTs into CWS settings, various barriers at multiple systemic levels need to be addressed.
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Affiliation(s)
- Tara Santens
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
| | - Karin Hannes
- Center for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Suzanne Levy
- Center for Family Intervention Science, Drexel University, Philadelphia, PA
| | - Guy Diamond
- Center for Family Intervention Science, Drexel University, Philadelphia, PA
| | - Guy Bosmans
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
- Clinical Psychology, KU Leuven, Leuven, Belgium
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11
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Duong BQ, Arwood MJ, Hicks JK, Beitelshees AL, Franchi F, Houder JT, Limdi NA, Cook KJ, Owusu Obeng A, Petry N, Tuteja S, Elsey AR, Cavallari LH, Wiisanen K. Development of Customizable Implementation Guides to Support Clinical Adoption of Pharmacogenomics: Experiences of the Implementing GeNomics In pracTicE (IGNITE) Network. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2020; 13:217-226. [PMID: 32765043 PMCID: PMC7373415 DOI: 10.2147/pgpm.s241599] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/08/2020] [Indexed: 12/13/2022]
Abstract
Introduction Clinical adoption of genomic medicine has lagged behind the pace of scientific discovery. Practice-based resources can help overcome implementation challenges. Methods In 2015, the IGNITE (Implementing GeNomics In pracTicE) Network created an online genomic medicine implementation resource toolbox that was expanded in 2017 to incorporate the ability for users to create targeted implementation guides. This expansion was led by a multidisciplinary team that developed an evidence-based, structured framework for the guides, oversaw the technical process/build, and pilot tested the first guide, CYP2C19-Clopidogrel Testing Implementation. Results Sixty-five resources were collected from 12 institutions and categorized according to a seven-step implementation framework for the pilot CYP2C19-Clopidogrel Testing Implementation Guide. Five months after its launch, 96 CYP2C19-Clopidogrel Testing Implementation Guides had been created. Eighty percent of the resources most frequently selected by users were created by IGNITE to fill an identified resource gap. Resources most often included in guides were from the test reimbursement (22%), Implementation support gathering (22%), EHR integration (17%), and genetic testing workflow steps (17%). Conclusion Lessons learned from this implementation guide development process provide insight for prioritizing development of future resources and support the value of collaborative efforts to create resources for genomic medicine implementation.
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Affiliation(s)
- Benjamin Q Duong
- Department of Precision Medicine, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, USA
| | - Meghan J Arwood
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics & Precision Medicine, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - J Kevin Hicks
- Department of Individualized Cancer Management, Moffitt Cancer Center, Tampa, FL, USA
| | - Amber L Beitelshees
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Francesco Franchi
- Department of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - John T Houder
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics & Precision Medicine, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Nita A Limdi
- University of Alabama School at Birmingham, Birmingham, AL, USA
| | - Kelsey J Cook
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Jacksonville, FL, USA.,Department of Precision Medicine, Nemours Children's Specialty Care, Jacksonville, FL, USA
| | - Aniwaa Owusu Obeng
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Natasha Petry
- Department of Pharmacy Practice, North Dakota State University College of Health Professions, Fargo, ND, USA
| | - Sony Tuteja
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amanda R Elsey
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics & Precision Medicine, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Larisa H Cavallari
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics & Precision Medicine, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Kristin Wiisanen
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics & Precision Medicine, University of Florida College of Pharmacy, Gainesville, FL, USA
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12
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Connors EH, Smith-Millman M, Bohnenkamp JH, Carter T, Lever N, Hoover SA. Can We Move the Needle on School Mental Health Quality Through Systematic Quality Improvement Collaboratives? SCHOOL MENTAL HEALTH 2020; 12:478-492. [PMID: 34322180 DOI: 10.1007/s12310-020-09374-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Learning collaboratives (LCs) have often been used to improve somatic health care quality in hospitals and other medical settings, and to some extent to improve social services and behavioral health care. This initiative is the first demonstration of a national, systematic LC to advance comprehensive school mental health system quality among school district teams. Twenty-four districts representing urban, rural, and suburban communities in 14 states participated in one of two 15-month LCs. Call attendance (M = 73%) and monthly data submission (M = 98% for PDSA cycles and M = 65% for progress measures) indicated active engagement in and feasibility of this approach. Participants reported that LC methods, particularly data submission, helped them identify, monitor and improve school mental health quality in their district. Qualitative feedback expands quantitative findings by detailing specific benefits and challenges reported by participants and informs recommendations for future research on school mental health LCs. Rapid-cycle tests of improvement allowed teams to pursue challenging and meaningful school mental health quality efforts, including mental health screening in schools, tracking the number of students receiving early intervention (Tier 2) and treatment (Tier 3) services, and monitoring psychosocial and academic improvement for students served.
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Affiliation(s)
- Elizabeth H Connors
- Department of Psychiatry, Yale University, 389 Whitney Avenue, Office 106, New Haven, CT 06511, USA.,National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD 21201, USA
| | - Mills Smith-Millman
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD 21201, USA.,McLean Hospital, 799 Concord Avenue, Cambridge, MA 02138, USA
| | - Jill H Bohnenkamp
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD 21201, USA
| | - Taneisha Carter
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD 21201, USA
| | - Nancy Lever
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD 21201, USA
| | - Sharon A Hoover
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4th Floor, Baltimore, MD 21201, USA
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13
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Kinnish K, McCarty C, Tiwari A, Osborne M, Glasheen T, Franchot KK, Kramer C, Self-Brown S. Featured counter-trafficking program: Project intersect. CHILD ABUSE & NEGLECT 2020; 100:104132. [PMID: 31447054 DOI: 10.1016/j.chiabu.2019.104132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/29/2019] [Accepted: 08/01/2019] [Indexed: 06/10/2023]
Abstract
This invited article is one of several comprising part of a special issue of Child Abuse and Neglect focused on child trafficking and health. The purpose of each invited article is to describe a specific program serving trafficked children. Featuring these programs is intended to raise awareness of innovative counter-trafficking strategies emerging worldwide and facilitate collaboration on program development and outcomes research. This article describes Project Intersect, a program of mental health services and behavioral health professional training designed to address trauma-related psychological and behavioral problems experienced by adolescent survivors of commercial sexual exploitation and trafficking. The project is led by the Georgia Center for Child Advocacy in Atlanta, GA, USA. The primary goal of the program is to build a cadre of behavioral health specialists with skills to implement trauma-focused cognitive behavioral therapy to address the unique needs of trafficked/exploited youth. This involves intensive initial training, follow-up consultation, technical support, and program evaluation.
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Affiliation(s)
| | | | - Ashwini Tiwari
- School of Public Health, Georgia State University, Georgia
| | | | | | | | | | - Shannon Self-Brown
- School of Public Health, Mark Chaffin Center for Health Development, Georgia State University, Georgia.
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Pizzirani B, O’Donnell R, Bruce L, Breman R, Smales M, Xie J, Hu H, Skouteris H, Green (nee Cox) R. The large-scale implementation and evaluation of a healthy lifestyle programme in residential out-of-home care: study protocol. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2019. [DOI: 10.1080/02673843.2019.1662317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Bengianni Pizzirani
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
| | - Renée O’Donnell
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
| | - Lauren Bruce
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
| | - Rachel Breman
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
- Heimdall Services , Mt Eliza, Victoria, Australia
| | - Madelaine Smales
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
| | - Jue Xie
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
| | - Hao Hu
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
| | - Rachael Green (nee Cox)
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University , Clayton, Victoria, Australia
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15
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Idalski Carcone A, Coyle K, Gurung S, Cain D, Dilones RE, Jadwin-Cakmak L, Parsons JT, Naar S. Implementation Science Research Examining the Integration of Evidence-Based Practices Into HIV Prevention and Clinical Care: Protocol for a Mixed-Methods Study Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) Model. JMIR Res Protoc 2019; 8:e11202. [PMID: 31124469 PMCID: PMC6552408 DOI: 10.2196/11202] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 12/11/2018] [Accepted: 01/03/2019] [Indexed: 01/24/2023] Open
Abstract
Background The Exploration, Preparation, Implementation, and Sustainment (EPIS) model is an implementation framework for studying the integration of evidence-based practices (EBPs) into real-world settings. The EPIS model conceptualizes implementation as a process starting with the earliest stages of problem recognition (Exploration) through the continued use of an EBP in a given clinical context (Sustainment). This is the first implementation science (IS) study of the integration of EBPs into adolescent HIV prevention and care settings. Objective This protocol (ATN 153 EPIS) is part of the Scale It Up program, a research program administered by the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN), described in this issue by Naar et al. The EPIS study is a descriptive study of the uptake of 4 EBPs within the Scale It Up program. The goal of EPIS is to understand the barriers and facilitators associated with the Preparation, Implementation, and Sustainment of EBPs into HIV prevention and clinical care settings. Methods The EPIS study is a convergent parallel mixed-methods IS study. Key implementation stakeholders, that is, clinical care providers and leaders, located within 13 ATN sites across the United States will complete a qualitative interview conducted by telephone and Web-based surveys at 3 key implementation stages. The Preparation assessment occurs before EBP implementation, Implementation occurs immediately after sites finish implementation activities and prepare for sustainment, and Sustainment occurs 1 year postimplementation. Assessments will examine stakeholders’ perceptions of the barriers and facilitators to EBP implementation within their clinical site as outlined by the EPIS framework. Results The EPIS baseline period began in June 2017 and concluded in May 2018; analysis of the baseline data is underway. To date, 153 stakeholders have completed qualitative interviews, and 91.5% (140/153) completed the quantitative survey. Conclusions The knowledge gained from the EPIS study will strengthen the implementation and sustainment of EBPs in adolescent prevention and clinical care contexts by offering insights into the barriers and facilitators of successful EBP implementation and sustainment in real-world clinical contexts. International Registered Report Identifier (IRRID) DERR1-10.2196/11202
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Affiliation(s)
- April Idalski Carcone
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, United States
| | - Karin Coyle
- Education, Training, and Research, Scotts Valley, CA, United States
| | - Sitaji Gurung
- Center for HIV Educational Studies and Training, Hunter College, City University of New York, New York, NY, United States
| | - Demetria Cain
- Center for HIV Educational Studies and Training, Hunter College, City University of New York, New York, NY, United States
| | - Rafael E Dilones
- Center for HIV Educational Studies and Training, Hunter College, City University of New York, New York, NY, United States
| | - Laura Jadwin-Cakmak
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Jeffrey T Parsons
- Center for HIV Educational Studies and Training, Hunter College, City University of New York, New York, NY, United States.,Hunter Department of Psychology, Hunter College, City University of New York, New York, NY, United States.,Health Psychology and Clinical Science Doctoral Program, Graduate Center, City University of New York, New York, NY, United States
| | - Sylvie Naar
- College of Medicine, Florida State University, Tallahassee, FL, United States
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16
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Kolko DJ, Herschell AD, Baumann BL, Hart JA, Wisniewski SR. AF-CBT for Families Experiencing Physical Aggression or Abuse Served by the Mental Health or Child Welfare System: An Effectiveness Trial. CHILD MALTREATMENT 2018; 23:319-333. [PMID: 30009632 DOI: 10.1177/1077559518781068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The Partnerships for Families project is a randomized clinical trial to evaluate the effectiveness of Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT), an evidence-based treatment (EBT) for families who are at risk of or have histories of child physical abuse. Across 10 agencies whose programs were supported by referrals from the mental health or child welfare system, individual providers were randomized to receive AF-CBT training ( n = 90) in a 6-month learning community or treatment as usual (TAU; n = 92) which provided trainings per agency routine. We recruited families served by providers in the AF-CBT ( n = 122) and TAU ( n = 73) conditions and collected multiple outcomes at up to four time points (0, 6, 12, and 18 months). Using univariate tests and growth curve models, the analyses revealed that AF-CBT (vs. TAU) showed improvements in both service systems (e.g., abuse risk, family dysfunction) or one service system (e.g., threats of force, child to parent minor assault), with some outcomes showing no improvement (e.g., parental anger). These findings are discussed in relation to AF-CBT, service system, provider, and family characteristics, and training/dissemination methods that affect the delivery of an EBT for this population in community settings.
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Affiliation(s)
- David J Kolko
- 1 Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Barbara L Baumann
- 1 Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jonathan A Hart
- 3 Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Stephen R Wisniewski
- 4 University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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Becker-Haimes EM, Franklin M, Bodie J, Beidas RS. Feasibility and acceptability of a toolkit to facilitate clinician use of exposure therapy for youth. ACTA ACUST UNITED AC 2017; 2:165-178. [PMID: 30740525 DOI: 10.1080/23794925.2017.1383867] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Exposure therapy is a key element of cognitive-behavioral therapy for youth with anxiety. However, few clinicians outside of specialty anxiety clinics routinely use exposures with anxious youth. This study reports on the acceptability and feasibility of a clinician support toolkit for exposures with anxious youth in community settings. The toolkit was developed through an extensive literature review of exposure science and cited barriers to exposure therapy, with input from multiple experts in pediatric anxiety (n = 10). Acceptability and feasibility data was gathered via survey from 70 community clinicians attending a training on exposure therapy for youth. Qualitative data was collected from a subset of participants who used the toolkit with youth on their caseload for approximately one month. Survey data suggested that the toolkit was viewed highly favorably. Qualitative interviews indicated that the toolkit was viewed as a feasible therapeutic tool that positively impacted clinician motivation to use exposure. Primary challenges related to exposure use more generally, and included client and service setting barriers. Results suggested initial toolkit acceptability and feasibility. Future work to refine the toolkit and test its efficacy as an implementation strategy to increase clinician use of exposure therapy is warranted. Next steps include development of additional content in partnership with key stakeholders, and testing the toolkit's impact on increasing clinician use of exposure therapy.
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Affiliation(s)
- Emily M Becker-Haimes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614.,Children's Hospital of Philadelphia, 3400 Civic Center Boulevard, Philadelphia, PA, 19104
| | - Martin Franklin
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614
| | - Jessica Bodie
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614.,Children's Hospital of Philadelphia, 3400 Civic Center Boulevard, Philadelphia, PA, 19104
| | - Rinad S Beidas
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3 floor, Philadelphia, PA 19104, USA, 215-573-5614
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18
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Palinkas LA, Saldana L, Chou CP, Chamberlain P. Use of Research Evidence and Implementation of Evidence-Based Practices in Youth-Serving Systems. CHILDREN AND YOUTH SERVICES REVIEW 2017; 83:242-247. [PMID: 29170572 PMCID: PMC5695711 DOI: 10.1016/j.childyouth.2017.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although the effectiveness of interventions for prevention and treatment of mental health and behavioral problems in abused and neglected youth is demonstrated through the accumulation of evidence through rigorous and systematic research, it is uncertain whether use of research evidence (URE) by child-serving systems leaders increases the likelihood of evidence- based practice (EBP) implementation and sustainment. Information on URE was collected from 151 directors and senior administrators of child welfare, mental health and juvenile justice systems in 40 California and 11 Ohio counties participating in an RCT of the use of community development teams (CDTs) to scale up implementation of Treatment Foster Care Oregon over a 3 year period (2010-12). Separate multivariate models were used to assess independent effects of evidence acquisition (input), evaluation (process), application (output), and URE in general (SIEU Total) on two measures of EBP implementation, highest stage reached and proportion of activities completed at pre-implementation, implementation and sustainment phases. Stage of implementation and proportion of activities completed in the implementation and sustainment phases were independently associated with acquisition of evidence and URE in general. Participation in CDTs was significantly associated with URE in general and acquisition of research evidence in particular. Implementation of EBPs for treatment of abused and neglected youth does appear to be associated with use of research evidence, especially during the later phases.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles CA
| | | | - Chih-Ping Chou
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
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19
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Boothroyd RI, Flint AY, Lapiz AM, Lyons S, Jarboe KL, Aldridge WA. Active involved community partnerships: co-creating implementation infrastructure for getting to and sustaining social impact. Transl Behav Med 2017; 7:467-477. [PMID: 28573356 PMCID: PMC5645286 DOI: 10.1007/s13142-017-0503-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Active involved community partnerships (AICPs) are essential to co-create implementation infrastructure and translate evidence into real-world practice. Across varied forms, AICPs cultivate community and tribal members as agents of change, blending research and organizational knowledge with relationships, context, culture, and local wisdom. Unlike selective engagement, AICPs enable active involvement of partners in the ongoing process of implementation and sustainability. This includes defining the problem, developing solutions, detecting practice changes, aligning organizational supports, and nurturing shared responsibility, accountability, and ownership for implementation. This paper builds on previously established active implementation and scaling functions by outlining key AICP functions to close the research-practice gap. Part of a federal initiative, California Partners for Permanency (CAPP) integrated AICP functions for implementation and system change to reduce disproportionality and disparities in long-term foster care. This paper outlines their experience defining and embedding five AICP functions: (1) relationship-building; (2) addressing system barriers; (3) establishing culturally relevant supports and services; (4) meaningful involvement in implementation; and (5) ongoing communication and feedback for continuous improvement. Planning for social impact requires the integration of AICP with other active implementation and scaling functions. Through concrete examples, authors bring multilevel AICP roles to life and discuss implications for implementation research and practice.
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Affiliation(s)
- Renée I Boothroyd
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Campus Box 8180, Chapel Hill, NC, 27599-8180, USA.
| | - Aprille Y Flint
- Child and Family Policy Institute of California, Sacramento, CA, USA
| | - A Mark Lapiz
- Social Services Agency, County of Santa Clara, San Jose, CA, USA
| | - Sheryl Lyons
- Department of Health and Human Services, County of Humboldt, Eureka, CA, USA
| | | | - William A Aldridge
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Campus Box 8180, Chapel Hill, NC, 27599-8180, USA
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20
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Schek G, Silva MRSD, Lacharité C, Bueno MEN. Organization of professional practices against intrafamily violence against children and adolescents in the institutional context. Rev Lat Am Enfermagem 2017; 25:e2889. [PMID: 28591297 PMCID: PMC5479370 DOI: 10.1590/1518-8345.1640.2889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 03/07/2017] [Indexed: 11/21/2022] Open
Abstract
Objective to analyze based on the practitioners' discourse, the way they organize their practices confronting situations of intra-family violence against children and adolescents. Method qualitative research carried out with 15 professionals who work in social and health services located in the southernmost of Brazil. Data were collected through semi-structured interviews, performed at the participants' workplace. We used a theoretical matrix to analyze the data, based on Institutional Ethnography and the technique of discursive textual analysis. Results the practitioners' practices developed in situations of intra-family violence against children and adolescents are organized on the basis of: power relations that take place in services that respond to violence situations; routines instituted to meet the demands of care in services; and the interplay between the conception of violence as a public health problem and the conception of violence as a social problem. Conclusion the way these practices are organized is reflected in actions that are not protective against situations of intra-family violence against children and adolescents.
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Affiliation(s)
- Gabriele Schek
- Doctoral student, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil. Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Carl Lacharité
- PhD, Full Professor, Département de Psychologie, Université du Quebec à Trois-Rivières, Trois-Rivières, QC, Canada
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