1
|
Pervin M, Hansmann NM, Hagmayer Y. Attitudes Toward and Usage of Evidence-Based Mental Health Practices for Autistic Youth in Bangladesh and Germany: A Cross-Cultural Comparison. J Autism Dev Disord 2024:10.1007/s10803-023-06223-z. [PMID: 38277076 DOI: 10.1007/s10803-023-06223-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/27/2024]
Abstract
The implementation of evidence-based practices (EBPs) for autistic youth is a critical concern worldwide. Research examining factors facilitating the implementation of EBPs found that providers' attitudes are an important factor. In this study, we evaluated cross-cultural differences in attitudes toward and use of EBPs. We tested socio-demographic factors as predictors of attitudes, and attitudes as predictors of EBPs use among mental health professionals working with autistic youth in Bangladesh and Germany. We used purposeful sampling. Two-hundred-ninety-two professionals who worked in a clinical setting responded to the survey and fulfilled the inclusion criteria (101 in Bangladesh, 191 in Germany). Participants were asked to respond to nine subscales of the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), to indicate which of nine types of treatments they used, and to provide sociodemographic data. Measurement invariance across countries could be established for four subscales of the EBPAS-36. Comparative analyses of attitudes showed that professionals in both countries were open to using EBPs, but German practitioners were more likely to use EBPs when they appealed to them. By contrast, Bangladeshi professionals claimed to be more likely to adopt an EBP when required and to be more willing to learn EBPs to enhance job security. The relationship between caseload and attitudes varied between countries. A broader variety of EBPs was used in Germany. The findings highlight the importance of considering country-specific factors when implementing EBPs. Directions for conducting comparative studies on mental health professionals' attitudes towards EBP including methodological considerations are discussed.
Collapse
Affiliation(s)
- Maleka Pervin
- Institute of Psychology, Georg August University of Göttingen, Göttingen, Germany.
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh.
| | - Nina Marie Hansmann
- Institute of Psychology, Georg August University of Göttingen, Göttingen, Germany
| | - York Hagmayer
- Institute of Psychology, Georg August University of Göttingen, Göttingen, Germany
| |
Collapse
|
2
|
Giraldo-Santiago N, Gearing RE, Carr C, Orengo-Aguayo R, Narendorf SC. Needs and Attitudes Related to the Adoption of Evidence-Based Practices Among Latinx Mental Health Professionals. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:781-791. [PMID: 37347371 DOI: 10.1007/s10488-023-01278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/23/2023]
Abstract
Empirically supported interventions are warranted to achieve desired clinical outcomes and improve service delivery. Thus, efforts to identify, adopt, and implement Evidence-Based Practices (EBPs) are underway across various Latinx communities, including Puerto Ricans, where there is a growing recognition and prevalence of mental health and substance use disorders. This study investigated the needs and attitudes toward EBPs among an interdisciplinary sample of mental health professionals in Puerto Rico. An anonymous survey was distributed to social workers, psychologists, and professional counselors (N = 237). Using structural equation modeling, four dimensions of attitudes towards EBPs (openness, divergence, appeal, and requirement) were regressed on various individual and organizational factors. Some socio-demographic characteristics, educational opportunities, and organizational factors significantly contributed to specific attitudes related to the adoption of EBPs. Female participants and those working in rural settings scored higher in the openness to innovation dimension. Greater organizational support and graduating from a private institution were associated with more divergence from research, while married individuals and those trained on EBPs scored lower on this dimension. The lack of exposure to EBPs in college and younger age predicted greater interest in the appeal of adopting an EBP intervention (i.e., would adopt an EBP if it made sense). No differences in attitudes toward EBPs were found by professional discipline or work setting (i.e., clinical, community, and schools). Recommendations to increase openness and interest in the appeal of EBPs among Spanish-speaking professional communities in Latin America are highlighted.
Collapse
Affiliation(s)
- Natalia Giraldo-Santiago
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, 8th floor, suite 830, Boston, MA, 02114, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Robin E Gearing
- Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Christian Carr
- Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Rosaura Orengo-Aguayo
- Department of Psychiatry & Behavioral Sciences, National Crime Victims Research & Treatment Center, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah C Narendorf
- Graduate College of Social Work, University of Houston, Houston, TX, USA
| |
Collapse
|
3
|
Hyzak KA, Bunger AC, Bogner J, Davis AK, Corrigan JD. Implementing traumatic brain injury screening in behavioral health treatment settings: results of an explanatory sequential mixed-methods investigation. Implement Sci 2023; 18:35. [PMID: 37587532 PMCID: PMC10428542 DOI: 10.1186/s13012-023-01289-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a complex condition common among individuals treated in behavioral healthcare, but TBI screening has not been adopted in these settings which can affect optimal clinical decision-making. Integrating evidence-based practices that address complex health comorbidities into behavioral healthcare settings remains understudied in implementation science, limited by few studies using theory-driven hypotheses to disentangle relationships between proximal and medial indicators on distal implementation outcomes. Grounded in the Theory of Planned Behavior, we examined providers' attitudes, perceived behavioral control (PBC), subjective norms, and intentions to adopt The Ohio State University TBI Identification Method (OSU TBI-ID) in behavioral healthcare settings. METHODS We used an explanatory sequential mixed-methods design. In Phase I, 215 providers from 25 organizations in the USA completed training introducing the OSU TBI-ID, followed by a survey assessing attitudes, PBC, norms, and intentions to screen for TBI. After 1 month, providers completed another survey assessing the number of TBI screens conducted. Data were analyzed using structural equation modeling (SEM) with logistic regressions. In Phase II, 20 providers were purposively selected for semi-structured interviews to expand on SEM results. Qualitative data were analyzed using thematic analysis, integrated with quantitative results, and combined into joint displays. RESULTS Only 25% (55/215) of providers adopted TBI screening, which was driven by motivations to trial the intervention. Providers who reported more favorable attitudes (OR: 0.67, p < .001) and greater subjective norms (OR: 0.12, p < .001) toward TBI screening demonstrated increased odds of intention to screen, which resulted in greater TBI screening adoption (OR: 0.30; p < .01). PBC did not affect intentions or adoption. Providers explained that although TBI screening can improve diagnostic and clinical decision-making, they discussed that additional training, leadership engagement, and state-level mandates are needed to increase the widespread, systematic uptake of TBI screening. CONCLUSIONS This study advances implementation science by using theory-driven hypothesis testing to disentangle proximal and medial indicators at the provider level on TBI screening adoption. Our mixed-methods approach added in-depth contextualization and illuminated additional multilevel determinants affecting intervention adoption, which guides a more precise selection of implementation strategies.
Collapse
Affiliation(s)
- Kathryn A Hyzak
- Department of Physical Medicine and Rehabilitation, The Ohio State University College of Medicine, Columbus, OH, 43210-1234, USA.
| | - Alicia C Bunger
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Jennifer Bogner
- Department of Physical Medicine and Rehabilitation, The Ohio State University College of Medicine, Columbus, OH, 43210-1234, USA
| | - Alan K Davis
- College of Social Work, The Ohio State University, Columbus, OH, USA
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University Baltimore, Baltimore, MD, USA
- Department of Psychiatry, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - John D Corrigan
- Department of Physical Medicine and Rehabilitation, The Ohio State University College of Medicine, Columbus, OH, 43210-1234, USA
- Ohio Valley Center for Brain Injury Prevention and Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| |
Collapse
|
4
|
Pervin M, Hagmayer Y. Attitudes Towards Evidence-Based Practice of Professionals Working with Children and Adolescents with Autism Spectrum Disorder in Bangladesh. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:861-880. [PMID: 35773439 PMCID: PMC9393150 DOI: 10.1007/s10488-022-01205-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 11/04/2022]
Abstract
Like in many lower-middle-income countries (LMIC), progress in implementing evidence-based practices (EBPs) for children with autism spectrum disorder (ASD) has been slow in Bangladesh. This cross-sectional study examined professionals' attitudes towards evidence-based practice (EBP) for children and adolescents with ASD and explored how providers' demographic factors are related to attitudes to and adoption of EBPs in Bangladesh. The sample consisted of 150 mental health professionals and special teachers from the urban area of Dhaka. Attitudes were assessed by the Evidence-based Practice Attitude Scale-36. Findings indicated that professionals have favorable attitudes towards EBP. Their attitudes varied depending on service settings (public clinical, private clinical, and special school) and caseload per year. Professionals who work in private and special school settings claimed to be more willing to adopt an EBP when required and perceived a higher fit of EBPs and their work than those in public clinical settings. The number of different EBPs used also differed by service setting. Every type of intervention (except medication) was used by more professionals in special schools than in private and public clinical settings. Many professionals reported few barriers to the implementation of EBPs. These findings indicate conditions that are often conducive to the implementation of EBPs. However, these results do not reflect the situation in rural areas, in which poverty is more widespread and the number of specialized professionals is low.
Collapse
Affiliation(s)
- Maleka Pervin
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh
- Institute of Psychology, Georg August University of Göttingen, Göttingen, Germany
| | - York Hagmayer
- Institute of Psychology, Georg August University of Göttingen, Göttingen, Germany
| |
Collapse
|
5
|
Frank HE, Milgram L, Freeman JB, Benito KG. Expanding the reach of evidence-based mental health interventions to private practice: Qualitative assessment using a policy ecology framework. FRONTIERS IN HEALTH SERVICES 2022; 2:892294. [PMID: 36925863 PMCID: PMC10012822 DOI: 10.3389/frhs.2022.892294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022]
Abstract
Background Evidence-based interventions (EBIs) for mental health disorders are underutilized in routine clinical practice. Exposure therapy for anxiety disorders is one particularly difficult-to-implement EBI that has robust empirical support. Previous research has examined EBI implementation determinants in publicly funded mental health settings, but few studies have examined EBI implementation determinants in private practice settings. Private practice clinicians likely face unique barriers to implementation, including setting-specific contextual barriers to EBI use. The policy ecology framework considers broad systemic determinants, including organizational, regulatory, social, and political contexts, which are likely relevant to EBI implementation in private practice settings but have not been examined in prior research. Methods Qualitative interviews were conducted to assess private practice clinicians' perceptions of EBI implementation determinants using the policy ecology framework. Clinicians were asked about implementing mental health EBIs broadly and exposure therapy specifically. Mixed methods analyses compared responses from clinicians working in solo vs. group private practice and clinicians who reported high vs. low organizational support for exposure therapy. Results Responses highlight several barriers and facilitators to EBI implementation in private practice. Examples include determinants related to organizational support (e.g., colleagues using EBIs), payer restrictions (e.g., lack of reimbursement for longer sessions), fiscal incentives (e.g., payment for attending training), and consumer demand for EBIs. There were notable differences in barriers faced by clinicians who work in group private practices compared to those working in solo practices. Solo private practice clinicians described ways in which their practice setting limits their degree of colleague support (e.g., for consultation or exposure therapy planning), while also allowing for flexibility (e.g., in their schedules and practice location) that may not be available to clinicians in group practice. Conclusions Using the policy ecology framework provides a broad understanding of contextual factors that impact private practice clinicians' use of EBIs, including exposure therapy. Findings point to potential implementation strategies that may address barriers that are unique to clinicians working in private practice.
Collapse
Affiliation(s)
- Hannah E Frank
- Warren Alpert Medical School of Brown University, Providence, RI, United States.,Bradley Hospital, East Providence, RI, United States
| | - Lauren Milgram
- Warren Alpert Medical School of Brown University, Providence, RI, United States.,Bradley Hospital, East Providence, RI, United States
| | - Jennifer B Freeman
- Warren Alpert Medical School of Brown University, Providence, RI, United States.,Bradley Hospital, East Providence, RI, United States
| | - Kristen G Benito
- Warren Alpert Medical School of Brown University, Providence, RI, United States.,Bradley Hospital, East Providence, RI, United States
| |
Collapse
|
6
|
Hassiotis A, Langdon P, Courtenay K, Hall I, Lloyd-Evans B, Romeo R, Kouroupa A, Crossey V, Taggart L. Expanding capacity in mental health research in intellectual disabilities. BJPsych Bull 2021; 45:317-320. [PMID: 33208218 PMCID: PMC8727378 DOI: 10.1192/bjb.2020.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Although the research base on mental health in intellectual disabilities is advancing, there are long-standing barriers that hinder successful completion of funded studies. A variety of stakeholders hold the key to mitigating the challenges and arriving at sustainable solutions that involve researchers, experts by experience, clinicians and many others in the research pathway. Lessons learned during the COVID-19 pandemic can also contribute to improvements in the conduct of research in the medium to long term. People with an intellectual disability and mental health conditions deserve high standards of evidence-based care.
Collapse
Affiliation(s)
| | | | | | - Ian Hall
- East London NHS Foundation Trust, UK
| | | | | | | | | | | |
Collapse
|
7
|
Asi Karakaş S, Şahi N Altun Ö, Polat H, Öztürk Z. Examination of evidence-based nursing attitudes and the relationship with professional self-concept in nurses working in a psychiatric hospital. Perspect Psychiatr Care 2021; 57:1425-1432. [PMID: 33330977 DOI: 10.1111/ppc.12708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/15/2020] [Accepted: 12/02/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The study was carried out with nurses working in a psychiatric clinic to examine their attitudes toward evidence-based practices and levels of professional self-concept. DESIGN AND METHODS This study was carried out using a descriptive and correlational search design. We used a Personal Information Form developed by the authors and Evidence-Based Nursing Attitude Scale (EBNAS) and Professional Self-Concept Scale for Clinical Nurses (PSCSCN) to obtain data. Percentages and averages, and the Pearson correlation coefficient was used for data analysis. FINDINGS The mean scores of the total and subdimensions of EBNAS and PSCSCN were high for the participating nurses. A positive relationship was found between EBNAS and PSCSCN. PRACTICE IMPLICATIONS The positive attitude of the nurses toward evidence-based nursing is related to their high professional self-concept.
Collapse
Affiliation(s)
- Sibel Asi Karakaş
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Özlem Şahi N Altun
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Hatice Polat
- Malatya Education and Research Hospital, Malatya, Turkey
| | - Zeynep Öztürk
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| |
Collapse
|
8
|
Szota K, Thielemann JFB, Christiansen H, Rye M, Aarons GA, Barke A. Cross-cultural adaption and psychometric investigation of the German version of the Evidence Based Practice Attitude Scale (EBPAS-36D). Health Res Policy Syst 2021; 19:90. [PMID: 34078387 PMCID: PMC8173815 DOI: 10.1186/s12961-021-00736-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/12/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The implementation of evidence-based practice (EBP) in mental health care confers many benefits to patients, and research into factors facilitating the implementation of EBP is needed. As an important factor affecting the implementation of EBP, service providers' attitudes toward EBP emerged. The Evidence-Based Practice Attitude Scale (EBPAS-36) is an instrument with good psychometric characteristics that measures positive and ambivalent attitudes toward EBP. However, a German version is missing. The present study therefore aims to provide a validated German translation of the EBPAS-36. METHODS The scale was translated and back-translated as recommended by standard procedures. German psychotherapists were recruited to participate in an online survey. They provided demographic and professional information, completed the EBPAS-36, the Implementation Climate Scale (ICS) and the Intention Scale for Providers (ISP). Standard item and reliability analyses were conducted. Construct validity was evaluated with exploratory (EFA) and confirmatory factor analyses (CFA) in two subsamples (random split). Convergent validity was tested by predicting a high positive correlation of the EBPAS-36D with two scores of attitudes of the ISP and an interest in EBP score. It was tested whether the EBPAS-36D predicts the intention to use EBP. RESULTS N = 599 psychotherapists participated in the study. The item analyses showed a mean item difficulty of pi = 0.64, a mean inter-item correlation of r = 0.18, and a mean item-total correlation of ritc = 0.40. The internal consistency was very good for the total scale (α = 0.89) and ranged from adequate to very good for the subscales (0.65-0.89), indicating high reliability. The original factor structure showed an acceptable model fit (RMSEA = 0.064 (90% CI = 0.059-0.068); SRMR = 0.0922; AIC = 1400.77), confirming the 12-factor structure of the EBPAS-36. However, a second-order factor structure derived by the EFA had an even better model fit (RMSEA = 0.057 (90% CI = 0.052-0.062); SRMR = 0.0822; AIC = 1274.56). When the EBPAS-36D was entered in a hierarchical regression model with the criterion Intention to use EBP, the EBPAS-36D contributed significantly to the prediction (Change in R2 = 0.28, p < 0.001) over and above gender, age and participants' report of ever having worked in a university context. CONCLUSIONS The present study confirms good psychometric properties and validity of a German version of the EBPAS-36 in a sample of psychotherapists.
Collapse
Affiliation(s)
- Katharina Szota
- Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, 35032, Marburg, Germany.
| | - Jonathan F B Thielemann
- Department of Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049, Ingolstadt, Germany
| | - Hanna Christiansen
- Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, 35032, Marburg, Germany
| | - Marte Rye
- Faculty of Health Sciences, UiT The Arctic University of Norway, Regional Centre for Child and Youth Mental Health and Child Welfare, 9037, Tromsø, Norway
| | - Gregory A Aarons
- Department of Psychiatry, University of California, 9500 Gilman Drive (0812), La Jolla, San Diego, CA, 92093-0812, USA
| | - Antonia Barke
- Department of Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049, Ingolstadt, Germany
| |
Collapse
|
9
|
Finne J, Malmberg-Heimonen I. Norwegian Social Work and Child Welfare Students' Attitudes Toward Research-Supported Treatments. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:340-352. [PMID: 33393451 DOI: 10.1080/26408066.2020.1865227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: Evidence-based practice (EBP) has increasingly become a part of social work education, but there is a lack of knowledge about students' attitudes toward it. This study evaluated Norwegian social work students' attitudes toward research-supported treatments (RSTs).Method: Attitudes were measured with the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), a validated measure including 12 subscales.Results: The findings suggest that master's students are more positive toward RSTs compared to bachelor's students. Having less educational training in EBP was associated with more skepticism toward the concept, suggesting that educational training in EBP contributes to facilitating a positive attitude toward RSTs.Discussion: These findings indicate a need to emphasize EBP in social work education. To enable EBP engagement in practice, we argue that emphasis should be put on teaching students to critically appraise research.
Collapse
Affiliation(s)
- Joakim Finne
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
| | - Ira Malmberg-Heimonen
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
10
|
Møller JE, Møller A, Ledderer L. Dilemmas in delivering health promotion activities: findings from a qualitative study of mental health nurses in Denmark. BMJ Open 2020; 10:e036403. [PMID: 33361070 PMCID: PMC7768968 DOI: 10.1136/bmjopen-2019-036403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Recent studies have shown that people with mental illnesses have higher mortality and morbidity rates due to long-term conditions and lifestyle diseases. This knowledge has led to health promotion initiatives in mental health care to improve the physical health of people with mental illness. This article explores how mental health nurses experience working with health promotion activities in mental healthcare practices. DESIGN We adopted a qualitative research design using an interactive approach. Qualitative content analysis was used to develop the analytical framework. PARTICIPANTS Focus groups (n=7; n=5) were conducted with two groups of mental health nurses who attended health specialist training sessions in Denmark in the spring and fall of 2018. RESULTS The findings showed that working with health promotion activities in mental health care created two dilemmas for the mental health nurses: (1) dilemmas related to health promotion that involved discrepancies between the health promotion activities that were offered and patients' autonomy and wishes, and (2) system-related dilemmas stemming from working with screening for risk factors and documentation programmes. The mental health nurses developed different strategies to navigate these dilemmas, such as devising interview techniques for the screening questions and bending guidelines. CONCLUSIONS Mental health nurses found it challenging to implement health promotion activities in mental health care, although they generally found these activities meaningful. The findings show that new health promotion activities need to be adapted to nurses' existing mental healthcare practices; however, this may require some adaptation of existing nursing practices.
Collapse
Affiliation(s)
- Jane Ege Møller
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anne Møller
- Department of Public Health, Section of Health Promotion and Health Services, Aarhus University, Aarhus, Denmark
| | - Loni Ledderer
- Department of Public Health, Section of Health Promotion and Health Services, Aarhus University, Aarhus, Denmark
| |
Collapse
|
11
|
Santesson AHE, Bäckström M, Holmberg R, Perrin S, Jarbin H. Confirmatory factor analysis of the Evidence-Based Practice Attitude Scale (EBPAS) in a large and representative Swedish sample: is the use of the total scale and subscale scores justified? BMC Med Res Methodol 2020; 20:254. [PMID: 33054717 PMCID: PMC7557010 DOI: 10.1186/s12874-020-01126-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/18/2020] [Indexed: 11/24/2022] Open
Abstract
Background There is a call for valid and reliable instruments to evaluate implementation of evidence-based practices (EBP). The 15-item Evidence-Based Practice Attitude Scale (EBPAS) measures attitude toward EBP, incorporating four lower-order factor subscales (Appeal, Requirements, Openness, and Divergence) and a Total scale (General Attitudes). It is one of a few measures of EBP attitudes evaluated for its psychometric properties. The reliability of the Total scale has been repeatedly supported, but also the multidimensionality of the inventory. However, whether all of the items contribute to the EBPAS Total beyond their subscales has yet to be demonstrated. In addition, the Divergence subscale has been questioned because of its low correlation with the other subscales and low inter-item correlations. The EBPAS is widely used to tailor and evaluate implementation efforts, but a Swedish version has not yet been validated. This study aimed to contribute to the development and cross-validation of the EBPAS by examining the factor structure of t a Swedish-language version in a large sample of mental health professionals. Methods The EBPAS was translated into Swedish and completed by 570 mental health professionals working in child and adolescent psychiatry settings spread across Sweden. The factor structure was examined using first-order, second-order and bifactor confirmatory factor analytic (CFA) models. Results Results suggested adequate fit for all CFA models. The EBPAS Total was strongly supported in the Swedish version. Support for the hierarchical second-order model was also strong, while the bifactor model gave mixed support for the subscales. The Openness and Requirements subscales came out best, while there were problems with both the Appeal (e.g. not different from the General Attitudes factor) and the Divergence subscales (e.g. low reliability). Conclusions Overall, the psychometric properties were on par with the English version and the total score appears to be a valid measure of general attitudes towards EBP. This is the first study supporting this General Attitudes factor based on a bifactor model. Although comparatively better supported in this Swedish sample, we conclude that the use of the EBPAS subscale scores may result in misleading conclusions. Practical implications and future directions are discussed.
Collapse
Affiliation(s)
| | - Martin Bäckström
- Department of Psychology, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Robert Holmberg
- Department of Psychology, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Sean Perrin
- Department of Psychology, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Håkan Jarbin
- Department of Clinical Sciences, Faculty of Medicine, Lund University, BMC F12, S-, 221 84, Lund, Sweden
| |
Collapse
|
12
|
Rye M, Rognmo K, Aarons GA, Skre I. Attitudes Towards the Use of Routine Outcome Monitoring of Psychological Therapies Among Mental Health Providers: The EBPAS-ROM. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:833-846. [PMID: 31485816 DOI: 10.1007/s10488-019-00968-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Implementation of routine outcome monitoring (ROM) in mental health care is progressing slowly. Knowledge about factors influencing ROM implementation, including health providers' attitudes towards ROM, is necessary. Based on a survey of 662 psychologists and nurses, this article describes (1) the development of a short instrument measuring provider attitudes towards ROM, derived from the Evidence-based Practice Attitude Scale (EBPAS), and (2) how attitudinal domains relate to clinicians' current use of standardized instruments for treatment evaluation. The EBPAS-ROM showed concurrent validity in predicting aspects important for the implementation of ROM, including perceived limitations and the value of organizational support.
Collapse
Affiliation(s)
- Marte Rye
- Department of Psychology, UIT The Arctic University of Norway, 9037, Tromsö, Norway.
- Department of General Psychiatry and Addiction, University Hospital of North Norway, 9038, Tromsö, Norway.
- Regional Centre for Child and Youth Mental Health and Child Welfare, UIT The Arctic University of Norway, 9037, Tromsö, Norway.
| | - Kamilla Rognmo
- Department of Psychology, UIT The Arctic University of Norway, 9037, Tromsö, Norway
| | - Gregory A Aarons
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Ingunn Skre
- Department of Psychology, UIT The Arctic University of Norway, 9037, Tromsö, Norway
- Department of General Psychiatry and Addiction, University Hospital of North Norway, 9038, Tromsö, Norway
| |
Collapse
|
13
|
Elling DL, Wennberg P, Almquist YB, Sundqvist K. Workplace alcohol prevention: are managers' individual characteristics associated with organisational alcohol policy knowledge and inclination to initiate early alcohol interventions? INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2020. [DOI: 10.1108/ijwhm-09-2019-0118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeIndividual factors associated with managers' organisational alcohol policy knowledge and inclination to initiate early alcohol interventions have been understudied. This study aims to examine differences in managers' policy knowledge and inclination across a range of socio-demographic, work-related and health characteristics, and it aims to examine the association between policy knowledge and inclination to intervene, net of these characteristics.Design/methodology/approachQuestionnaire data were collected from 430 managers. Organisational alcohol policy knowledge and inclination to intervene were measured using a 5-point Likert scale ranging from 1 (very low) to 5 (very high). Socio-demographic, work-related and health characteristics included gender, age, education, managerial responsibility, years in current position, self-rated health and alcohol consumption. Associations were examined using multilevel ordinal regression analysis.FindingsManagers with a greater number of employees demonstrated the highest level of organisational alcohol policy knowledge and were more inclined to initiate early alcohol interventions. Alcohol policy knowledge was associated with inclination to intervene, net of individual characteristics.Practical implicationsConsidering how managers' characteristics might influence efforts to decrease hazardous alcohol consumption is potentially important when designing future workplace alcohol prevention programmes.Originality/valueSeveral individual factors related to managers' organisational alcohol policy knowledge and inclination to initiate early alcohol interventions were identified, particularly managerial responsibility. However, the association between policy knowledge and inclination to intervene remained strong after accounting for these individual factors. Future studies should explore alternative explanations at the individual and organisational levels.
Collapse
|
14
|
European clinical practice guidelines for depression in adults: Are they good enough? J Affect Disord 2020; 263:382-385. [PMID: 31969268 DOI: 10.1016/j.jad.2019.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/30/2019] [Accepted: 12/04/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite the increasing attention given to evidence-based practice, little research has focused on the quality of clinical practice guidelines (CPGs) involving psychotherapy. The goal of the present study was to evaluate the quality of national CPGs for psychological treatments for depression in European countries. METHODS A search of the Guidelines International Network's library was conducted. Four guidelines met inclusion criteria for the study and were assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) platform. RESULTS Overall, the guidelines included in the study were found to be of good quality, although two guidelines received low scores for applicability, and some did not provide information on competing interests or potential influences from funding bodies. LIMITATIONS Although guidelines were retrieved from a well-known international library, some European guidelines for depression published elsewhere may have been overlooked. CONCLUSIONS Results of this study provide support for the high quality of the guidelines reviewed, but also raise some concerns regarding editorial independence and the applicability of the guidelines, areas that should be the focus of improvement in future versions of these guidelines.
Collapse
|