Kenneth Weingardt

Independent · Audacious Digital Health

Little is known about how to best implement eHealth HIV interventions for adolescent men who have sex with men (AMSM) in real-world settings. In response, our current study describes formative implementation research with community-based organizations (CBOs) in preparation for future implementation of the SMART Program, a stepped-care package of th...

Introduction Family members are important supports for veterans with Posttrauamtic Stress Disroder (PTSD), but they often struggle with their own distress and challenges. The Veterans Affairs—Community Reinforcement and Family Training (VA-CRAFT) website was designed to teach family members of veterans with PTSD effective ways to interact with thei...

In contrast to a top-down dissemination approach, the present approach identified existing clinicians using an evidence-based psychotherapy (EBP), dialectical behavior therapy, throughout the Department of Veterans Affairs (VA) system, and created a virtual community of practice (VCoP) to facilitate sharing of materials, resources, information, and...

Objective: While depression and anxiety are common mental health issues, only a small segment of the population has access to standard one-on-one treatment. The use of smartphone apps can fill this gap. An app recommender system may help improve user engagement of these apps and eventually symptoms. Methods: IntelliCare was a suite of apps for d...

The Department of Veteran Affairs (VA) has been a recognized leader in evidence-based psychotherapy (EBP) training, with 15 different EBP training programs that address posttraumatic stress disorder (PTSD), depression, chronic pain, insomnia, substance use, motivation for treatment, relationship distress, serious mental illness, and problem-solving...

An increasingly large body of randomized controlled trials has demonstrated the efficacy of mental health technologies, such as Web-based and mobile interventions, to prevent and treat mental disorders and increase psychological well-being. However, there is little evidence that these tools can be successfully implemented in clinical settings. The...

Background Digital mental health tools have tended to use psychoeducational strategies based on treatment orientations developed and validated outside of digital health. These features do not map well to the brief but frequent ways that people use mobile phones and mobile phone apps today. To address these challenges, we developed a suite of apps f...

The US Department of Veterans Affairs, in partnership with the Department of Defense, has developed a host of new electronic tools designed to address the mental and behavioral health needs of military service members and veterans. These tools include online self-help programs and companion mobile apps, as well as many of the apps available through...

Evidence based psychotherapies (EBPs) remain underutilized. Models for EBP training and implementation that are cost-effective, minimally disruptive, and sufficiently flexible are needed. Internet-based technology is a promising platform, but questions remain about how this technology can address the barriers to implementation. We developed and exa...

Alcohol misuse and post-traumatic stress disorder (PTSD) are highly prevalent among veterans presenting to primary care. PTSD is associated with depression and increased substance use which can complicate the treatment of alcohol misuse. No studies have examined severity of depressive symptoms, rates and type of illicit drug use, and alcohol use se...

The Veterans Health Administration (VHA) has implemented initiatives to increase rates of brief alcohol counseling (BAC). Half of eligible veterans do not receive such care. Understanding patient characteristics associated with drinking behavior may identify patients for whom BAC may be acceptable. Data collected from veterans between January 2010...

Objective: This study sought to examine whether a web-delivered brief alcohol intervention (BAI) is effective for reducing alcohol misuse in U.S. military veterans presenting to primary care. Method: Veterans (N = 167) screening positive for alcohol misuse during a routine primary care visit were randomized to receive a BAI plus treatment as usu...

BACKGROUND: Alcohol misuse occurs at high rates among U.S. Military Veterans presenting to primary care and is linked to numerous negative social and health consequences. The Veterans Health Administration has recently implemented brief alcohol interventions (BAI) in VA primary care settings. An emerging literature suggests that BAIs that target al...

Objective. Computerized cognitive-behavioural therapy (CCBT) may enhance older adults’ access to evidence-based depression treatment. Our objective was to determine the extent to which adults aged 65 years and older are represented in existing studies of CCBT for depression and describe available data on recruitment, retention, and outcomes. Method...

Ambivalence refers to the experience of simultaneous positive and negative affect toward the same person, object, or behavior that draws us in opposite directions and leads to some level of phenomenological discomfort. In psychology, ambivalence traditionally has been viewed as arising from intrapersonal conflict, that is conflict between dissonant...

To test the efficacy of telephone-administered motivational interviewing (MI) to enhance treatment engagement in Iraq and Afghanistan veterans with mental health (MH) problems. Between April 23, 2008, and February 25, 2011, 73 Iraq and Afghanistan veterans who screened positive for ≥1 MH problem(s) on telephone-administered psychometric assessment,...

Issues: By allowing for the efficient delivery of instructional content and the secure collection of self-report data regarding substance use and related problems, the Internet has tremendous potential to improve the effectiveness and accessibility of Substance Use Disorder (SUD) treatment and recovery-oriented services. Approach: This article d...

Hazardous drinking is a major barrier to antiviral treatment eligibility among hepatitis C (HCV) patients. We evaluated differences in substance-related coping, drinking-related consequences, and importance and confidence in ability to change alcohol use among hazardous drinkers with and without HCV (N = 554; 93.5% male). We examined group differen...

Evidence-based psychological treatments (EBPTs) are clusters of interventions, but it is unclear how providers actually implement these clusters in practice. A disaggregated measure of EBPTs was developed to characterize clinicians' component-level evidence-based practices and to examine relationships among these practices. Survey items captured co...

Many studies have documented the link between substance use and a history of sexual assault in women; however, few studies have examined this relationship in men. The purpose of this study was to explore the rates of sexual assault in a sample of male veterans reporting alcohol misuse and to further explore potential differences in alcohol use patt...

Adults aged 65 years and older stand to benefit from the accumulating wealth of Internet-based health resources, including online interventions to assist in the self-management of chronic health conditions. However, concerns have been expressed that lesser Internet use and familiarity among older adults may limit the utility of web-based health int...

Brief web-based alcohol interventions (BAIs) are effective for reducing binge drinking in college students and civilian adults, and are increasingly being applied to U.S. military populations. However, little is known about factors associated with binge drinking in Veteran populations and therefore some concern remains on the generalizability of st...

This review offers practical recommendations regarding research on training in evidence-based practices for mental health and substance abuse treatment. When designing training research, we recommend: (a) aligning with the larger dissemination and implementation literature to consider contextual variables and clearly defining terminology, (b) criti...

Objective: This pilot project examined the mental health and quality of life outcomes achieved by 17 OIF/OEF (Operation Iraqi Freedom/Operation Enduring Freedom) veterans who participated in the first cohort of the Veterans Conservation Corps (VCC) green jobs training program at Green River Community College in Auburn, Washington. Methods: The VCC...

High voluntary turnover of substance abuse counsellors is a recognised and pervasive problem, likely due in large part to job-related burnout experienced by providers. This article explores the influence of the type of training on three facets of burnout (emotional exhaustion, depersonalisation and a reduced perception of personal accomplishments)...

Personal health records (PHRs) are designed to help people manage information about their health. Over the past decade, there has been a proliferation of PHRs, but research regarding their effects on clinical, behavioral, and financial outcomes remains limited. The potential for PHRs to facilitate patient-centered care and health system transformat...

By allowing for the efficient delivery of instructional content and the secure collection of self-report data regarding substance use and related problems, the Internet has tremendous potential to improve the effectiveness and accessibility of addiction treatment services. This article discusses some of the ways in which Internet technology can fac...

This study compared training outcomes obtained by 147 substance abuse counselors who completed eight self-paced online modules on cognitive-behavioral therapy (CBT) and attended a series of four weekly group supervision sessions using Web conferencing software. Participants were randomly assigned to two conditions that systematically varied the deg...

Historically, clinicians have learned about evidence-based psychotherapies (EBPs) by reading therapy manuals and/or attending clinical training workshops. However, researchers agree that such methods alone are insufficient to support the implementation of EBPs. This article explores the concept of blended learning (BL) and its potential for facilit...

Most alcohol-treatment studies exclude some patients from participation based on particular criteria (e.g., comorbid illegal drug abuse, homelessness). The current study evaluated whether such eligibility criteria can change the outcome results a study obtains. Five widely used treatment research eligibility criteria--(1) psychiatric problems, (2)...

This study involved a content analysis of 261 unique advertisements for psychotherapy workshops that appeared in two bimonthly clinical magazines, Psychotherapy Networker and Counselor, during a 2-year period. Two independent judges coded each advertisement and documented the type and prevalence of advertising appeals used. From the seminal diffusi...

This chapter discusses therapeutic outcome research and dissemination of empirically based treatment for alcohol use disorders. The immediate goals of motivational interventions include empathizing with the client's perspective, resolution of the client's ambivalence about change, and reinforcing the client's statements about change. It is found th...

Information technology (IT) is increasingly being used to facilitate, complement, and support the implementation of evidence-based practices (EBP) in psychology. This article reviews recent randomised trials that evaluate the integration of IT applications into the process of delivering EBP. More specifically, we review 11 studies that illustrate h...

Many alcohol treatment outcome studies exclude some patients with particular problems, such as psychiatric disorders, noncompliance, and homelessness. Such criteria may increase the likelihood of a study being successfully conducted, but may also have the unintended consequence of reducing a study's ability to comply with National Institutes of Hea...

This study examined interventions for substance use disorders within the Department of Veterans Affairs (VA) psychiatric and primary care settings. National random samples of 83 VA psychiatry program directors and 102 primary care practitioners were surveyed by telephone. The survey assessed screening practices to detect substance use disorders, pr...

This study compared the learning outcomes achieved by 166 practicing substance abuse counselors who were randomized to one of three conditions: (1) a Web-Based Training (WBT) module designed to familiarize practitioners with the "Coping with Craving" module from the NIDA treatment manual, "A Cognitive-Behavioral Approach: Treating Cocaine Addiction...

The principles, processes, and tools of instructional design and technology (IDT) can facilitate the translation of paper-based, text-intensive Manual-Based Therapies (MBTs) into media-rich, interactive, Web-based training (WBT) applications. This article outlines available technology-based mechanisms for delivering instructional content, provides...

This study assessed the value of a specific set of client variables in predicting treatment retention and completion of a rehabilitation program for homeless veterans. Participants were 596 (22 female) military veterans admitted to the Palo Alto, California Veterans Administration domicilary program between 1992 and 1995. Information was collected...

To describe the eligibility criteria (i.e. study participant inclusion and exclusion rules) employed in alcohol treatment outcome research and to identify predictors of their use. The eligibility criteria of 683 alcohol treatment outcome studies conducted between 1970 and 1998 were coded reliably into 14 general categories. Predictors of the use of...

Clinical Practice Guidelines (CPGs) constitute a major focus of recent efforts to narrow the gap between research and practice. However, CBGs cannot effectively change clinical practice unless they are effectively disseminated. The present article describes a web-based course designed to teach nurses about a CPG for the management of alcohol withdr...

The principles, processes, and tools of instructional design and technology (IDT) can facilitate the translation of paper-based, text-intensive Manual-Based Therapies (MBTs) into media-rich, interactive, Web-based training (WBT) applications. This article outlines available technology-based mechanisms for delivering instructional content, provides...

Objective: To determine rates of positive screens for psychological and substance use disorders in persons with long-term spinal cord injury (SCI). Study Design: A naturalistic cohort design wherein consecutive admissions during an 8-month period completed the screening battery. Setting: Veterans Affairs SCI Center. Participants: One hundred fiftee...

Objective: To determine rates of positive screens for psychological and substance use disorders in persons with long-term spinal cord injury (SCI). Study Design: A naturalistic cohort design wherein consecutive admissions during an 8-month period completed the screening battery. Setting: Veterans Affairs SCI Center. Participants: One hundred fiftee...

Managed health care systems often use treatment readmission data as an indicator of psychiatric patient outcome and program performance. This study of 3,018 inpatients being treated for substance abuse in Department of Veterans Affairs medical centers found that across a range of measures and patient subpopulations, patient outcomes and program per...

Longitudinal data from 81 undergraduates (47 women and 34 men) were used for concurrent and predictive validation of binge drinking measures. Results suggest relative strengths and weaknesses of different binge definitions. The conventional binge measure of >5 drinks in a row (≥4 drinks in a row for women) yielded higher prevalence estimates and h...

Most cognitive approaches to word association and some theories of social cognition converge on the notion that the performance of repetitive behaviors should predict word association responses. To study this issue, the authors examined the frequencies of free-association responses of 1, 003 subjects to ambiguous words, some of which had subdominan...

Seventy-one subjects with various levels of drinking experience completed a computerized semantic priming task. Prime phrases (describing positive outcomes of drinking alcohol or neutral phrases) were presented immediately before a target word (either alcohol-related or not). The results replicated earlier basic research examining the effects of se...

Seventy-one subjects with various levels of drinking experience completed a computerized semantic priming task. Prime phrases (describing positive outcomes of drinking alcohol or neutral phrases) were presented immediately before a target word (either alcohol-related or not). The results replicated earlier basic research examining the effects of se...

In three experiments involving a total of 623 subjects, a series of slides was shown depicting a student in a college bookstore stealing a variety of items. Next, subjects read a narrative describing the event that contained some misinformation and some neutral information about several critical details. Finally, subjects took a memory test. On thi...

Theoretical predictions involving memory associations between alcohol use and its positive outcomes were examined. In 2 preliminary studies, the availability from memory of outcomes from drinking was investigated. In subsequent studies, a measurement paradigm was used that decreased the accessibility of the association between drinking behavior and...

Adult Eyewitness Testimony: Current Trends and Developments provides an overview of empirical research on eyewitness testimony and identification accuracy, covering both theory and application. The volume is organized to address three important issues. First, what are the cognitive, social and physical factors that influence the accuracy of eyewitn...

present some of the major findings from but 2 of the most heavily researched areas in the eyewitness literature—the effects of misleading postevent information and the relationship between witness accuracy and confidence / explore how a metacognitive perspective can enhance our understanding of both bodies of literature / report the results of a re...