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84
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Introduction
Miya Barnett is an Associate Professor of Clinical Psychology in the Department of Counseling, Clinical, and School Psychology and a licensed psychologist. Her research interests include dissemination and implementation, strategies to decrease mental health service disparities for ethnic minority children and families, and the impact of therapist behaviors on treatment outcomes.
Additional affiliations
September 2009 - September 2014
Publications
Publications (84)
Objective:
Parent-Child Interaction Therapy (PCIT) is a parenting program in which caregivers must achieve "skill criteria" in using Do Skills and avoiding Don't Skills to complete treatment. Despite PCIT's emphasis on these skills, little is known about how Latinx caregivers acquire these Western-based parenting practices and whether cultural mis...
Therapist anxious distress when delivering child mental health treatment has been understudied as a factor that contributes to the underuse of some evidence-based interventions (EBIs), such as time-out for children with disruptive behaviors. This study investigated therapist anxious avoidance of time-out using a three-part, vignette-based survey de...
Background
Family Navigation (FN) is an evidence-based care management intervention designed to reduce disparities in access to care by providing families with individually tailored support and care coordination. Early data suggest FN is effective, but effectiveness is significantly influenced by both contextual (e.g. setting) and individual (e.g.,...
Mental health needs and disparities are widespread and have been exacerbated by the COVID-19 pandemic, with the greatest burden being on marginalized individuals worldwide. The World Health Organization developed the Mental Health Gap Action Programme to address growing global mental health needs by promoting task sharing in the delivery of psychos...
Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth of color experience high rates of mental health disorders, yet they experience challenges to accessing mental health services. Community health worker (CHW) models of care have potential to promote equitable mental health services among LGBTQ youth. Our aim was to understand how CHW model...
In recent years, the prevalence rates of children's mental health disorders have increased with current estimates identifying that as many as 15-20% of children meet criteria for a mental health disorder. Unfortunately, the same robust parenting interventions which have long targeted some of the most common and the most treatable child concerns (e....
Unlabelled:
We propose that common elements approaches can advance implementation research and practice and facilitate pragmatic use of intervention and implementation evidence. Common elements are practices or processes frequently shared by interventions or implementations. Traditional common elements methodologies use synthesis, distillation, an...
Growing evidence suggests that Teacher-Child Interaction Training-Universal (TCIT-U) is effective for increasing teachers' use of strategies that promote positive child behavior, but more rigorous research with larger, diverse samples is needed to understand the effects of TCIT-U on teacher and child outcomes in early childhood special education. U...
Implementation strategies are methods or techniques used to adopt, implement, and sustain evidence-based practices (EBPs). Implementation strategies are dynamic and may require adaptation to fit implementation contexts, especially in low-resource settings, which are most likely to serve racially and ethnically diverse patients. The framework for re...
Objective:
Parent-child interaction therapy (PCIT) is an effective intervention to address child externalizing behaviors. However, disparities in access and retention are pervasive, which relate to the availability of PCIT in low-income communities, inadequate workforces to provide culturally appropriate care, and distrust in services due to syste...
Background: In recent years, the United States has witnessed increased transphobic rhetoric and legislation aimed at restricting the rights of transgender youth, ranging from banning transgender youth from school sports, to denying access to gender-affirming care. This climate has a detrimental impact on the mental health of transgender youth - a c...
Childhood exposure to adversity and its consequences is a significant public health challenge. Schools are beginning to understand the impact of adverse childhood experiences (ACEs) and some schools are considering screening for ACEs. However, dissemination of the ACEs screener and subsequent interventions may lead to challenges and iatrogenic outc...
The sudden onset of COVID-19 forced mental health therapists to rapidly transition to telehealth services. While some therapists and organizations were able to achieve an expeditious transition, others struggled. Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, which outlines key phases that guide the implementa...
Lay Health Workers Engaging Latino Fathers: A qualitative study
Behavioral Parent Training programs (BPTs) are evidence-based interventions that have been shown to be effective when implemented in various contexts and with different racial/ethnic minority families. Despite evidence showing their effectiveness within the Latinx community, disparitie...
This paper posits that a clinician's own anxious reaction to delivering specific evidence-based interventions (EBIs) should be better accounted for within implementation science frameworks. A key next step for implementation science is to delineate the causal processes most likely to influence successful implementation of evidence-based interventio...
Parent-Child Interaction Therapy (PCIT) is an evidence-based practice (EBP) for young children with challenging behaviors. PCIT has been adapted to treat varying presentations and culturally diverse families. Although efforts have been made to disseminate PCIT into community settings, which often serve clinically complex, socio-culturally diverse,...
Although engaging fathers effectively can bolster and sustain treatment outcomes, fathers participate in their children’s treatment at lower rates than mothers and have been left out of the literature on caregiver engagement. Because provider attitudes and behaviors shape the course of treatment, therapist perspectives on father attendance and enga...
Parent–child interaction therapy (PCIT) is a best-practice treatment for behavior problems in young children. In PCIT, therapists coach parents during in-vivo interactions to strengthen the parent–child relationship and teach parents effective ways of managing difficult child behaviors. Past research has found that different therapist coaching styl...
Progress measures are an evidence-based technique for improving the quality of mental health care, however, clinicians rarely incorporate them into treatment. Research into how measure type impacts clinician preference has been recommended to help improve measure implementation. Parent–Child Interaction Therapy (PCIT) is an assessment-driven treatm...
Disparities in care for low-income children of color call for innovative culturally and linguistically responsive solutions to better engage marginalized populations in evidence-based interventions. In partnership with a community organization, the addition of natural helper support as an adjunct to Parent-Child Interaction Therapy (PCIT+NH) was ex...
Background
Understanding the costs and economic benefits of implementation has been identified by policymakers and researchers as critical to increase the uptake and sustainment of evidence-based practices, but this topic remains relatively understudied. Conducting team science with health economists has been proposed as a solution to increase econ...
The authors and the journal regret that the printed version of the above article contained a number of errors. The correct and final version follows. The authors would like to apologise for any inconvenience caused.
Purpose
Training therapists in evidence-based treatments (EBTs) is a strategy for improving the quality of mental health care. State and county-wide initiatives have focused on increasing EBT implementation, however, many clients seen in community mental health agencies do not fit into the age or diagnostic requirements of available EBTs. Given the...
Engaging caregivers in their children’s mental health treatment is critical for delivering high quality, evidence-based care, particularly for young children with externalizing behaviors. Lay health workers (LHWs), including peer providers and promotoras de salud, have been identified as important workforces in addressing structural and stigma-rela...
Measuring classroom behavior among young children is important to guide assessment and intervention decisions, yet there is limited literature on appropriate direct observation tools for this purpose. This article describes the psychometric properties of the Behavior Assessment System for Children, Student Observation System (BASC-3 SOS) with 135 c...
Nearly half of children meeting criteria for a mental health disorder in the United States (U.S.) do not receive the treatment they need. Unfortunately, lack of access to and engagement in mental health services can be seen at even higher rates for historically marginalized groups, including low-income, racial, and ethnic minority youth. Lay Health...
Objective: Community therapists inevitably adapt evidence-based practices (EBPs) to meet the needs of their clients and practice settings. Yet, the implications of spontaneous, therapist-driven adaptations for EBP implementation outcomes are not well understood. We used a sequential QUAN → qual mixed-methods design to examine how different types of...
Promotoras de salud are community health workers that mostly help the underserved members of Latinx communities. They seek to reduce health disparities through community engagement and work that is voluntary or mostly unpaid. While there is evidence that promotoras aid in prevention, follow-up care, and treatment adherence, little is known about pr...
Purpose
Training therapists in evidence-based treatments (EBTs) is a strategy for improving the quality of mental health care. State and county-wide initiatives have focused on increasing EBT implementation, however, many clients seen in community mental health agencies do not fit into the age or diagnostic requirements of available EBTs. Given the...
It has been widely recognized that access to mental health treatment is imperative to address current and long-term stressors for children and parents during COVID-19. Internet-delivered Parent-Child Interaction Therapy (iPCIT, previously referred to as I-PCIT) is a strong model for remote service delivery during social distancing restrictions due...
Effective mentoring is a key mechanism propelling successful research and academic careers, particularly for early career scholars. Most mentoring programs focus on models pairing senior and early career researchers, with limited focus on peer mentoring. Peer mentoring may be especially advantageous within emerging areas such as implementation scie...
Background
Implementation strategies are necessary to ensure that evidence-based practices are successfully incorporated into routine clinical practice. Such strategies, however, are frequently modified to fit local populations, settings, and contexts. While such modifications can be crucial to implementation success, the literature on documenting...
Disruptive behavior in young children is one of the most common referrals to behavioral health providers. While numerous effective parenting programs, such as parent-child interaction therapy (PCIT), exist for improving children's behaviors, challenges with treatment engagement and retention limit the intended positive impact on child and caregiver...
Widespread implementation of adverse childhood experiences (ACEs) screening is occurring in the United States in response to policies and practice recommendations. However, limited research has established how these screening efforts impact the health care system and ultimately health outcomes. This article examines the current knowledge base on sc...
Sustainment of evidence-based practices is necessary to ensure their public health impact. The current study examined predictors of sustainment of Parent–Child Interaction Therapy (PCIT) within a large-scale system-driven implementation effort in Los Angeles County. Data were drawn from PCIT training data and county administrative claims between Ja...
Pragmatic measures of therapist delivery of evidence-based practice (EBP) are critical to assessing the impact of large-scale, multiple EBP implementation efforts. As an initial step in the development of pragmatic measurement, the current study examined the concordance between therapist and observer ratings of items assessing delivery of EBP strat...
Dissemination and implementation (D&I) research is a transdisciplinary field that emerged to facilitate the uptake and sustainment of evidence-based practices within real world settings. As opposed to traditional clinical research, which focuses on client level outcomes (e.g., symptom checklists), D&I research focuses on outcomes related to clinici...
Background
Implementation research infrequently addresses economic factors, despite the importance of understanding the costs of implementing evidence-based practices (EBPs). Though partnerships with health economists have the potential to increase attention to economic factors within implementation science, barriers to forming these collaborations...
Objective: Adverse childhood experiences (ACEs) have demonstrable negative
effects on long-term physical and mental health. Racial and ethnic minority
children disproportionally experience ACEs due to the impacts of structural inequality
and discrimination, which could drive health disparities. Pediatric settings
offer an opportune context to addre...
Background and purpose:
Access to evidence-based mental health care for children is an international priority. However, there are significant challenges to advancing this public health priority in an efficient and equitable manner. The purpose of this international colloquium was to convene a multidisciplinary group of health researchers to build...
Using a pilot matched-pairs cluster-randomized control trial, we evaluated the acceptability and preliminary outcomes of universal Teacher-Child Interaction Training (TCIT-U) with students with disabilities in early special education programs. Twelve classrooms (clusters) were paired by age and type and then randomly assigned within pairs to either...
Background
School-based trauma-informed care (TIC) represents a novel way of supporting children with trauma histories. However, minimal research has focused on how TIC impacts teacher wellbeing, which is concerning given the relationship between occupational stress and turnover from education.
Objective
This study investigated teacher characteris...
The study sought to (a) characterize the types and frequency of session-level adaptations made to multiple evidence-based practices (EBPs) and (b) identify therapist-, client-, and session-level predictors of adaptations. Within the community implementation of multiple EBPs, 103 community mental health therapists reported on 731 therapy sessions fo...
Objectives
Parent-Child Interaction Therapy (PCIT) is an effective therapy to treat early onset disruptive behavior problems and child physical maltreatment. In order to support the successful implementation and sustainment of PCIT, strategies are needed to recruit parents into care, especially for racial and ethnic minority families, who often hav...
Objective:
This study investigated a quality indicator for children's mental health, caregiver attendance in youth psychotherapy sessions, within a system-driven implementation of multiple evidence-based practices (EBPs) in children's community mental health services.
Method:
Administrative claims from nine fiscal years were analyzed to characte...
It is important to understand racial/ethnic differences in adverse childhood experiences (ACEs), given their relationship to long‐term physical and mental health, and the public health cost of the significant disparities that exist. Moreover, in order to inform interventions and promote resilience, it is critical to examine protective factors that...
Highlights
This study focused on implementation processes, and facilitators and barriers to ACEs screenings.
There was high feasibility and acceptability of ACEs screenings at infants’ pediatric visits.
Almost half of families at well‐child pediatric visits indicated positive for ACEs.
A majority of families with ACEs accepted prevention services i...
Introduction
Behavioural parent training (BPT) programmes are effective in preventing and treating early-onset conduct problems and child maltreatment. Unfortunately, pervasive mental health service disparities continue to limit access to and engagement in these interventions. Furthermore, challenges with parental engagement can impede the successf...
Background
The implementation of evidence-based practices (EBPs) in community settings appears to result in reduced benefit relative to controlled trials. This difference in outcomes may be attributable in part to engagement challenges therapists encounter when delivering EBPs to low-income ethnic minority youth and families.
Objective
The current...
Most crimes committed by adolescents in the United States are linked to gang activity, which is disproportionally present in Latina/o communities. Although most gang-involved teenage fathers wish that their children would not join gangs, their parenting tends to foster gang involvement in their children. An improved understanding of fatherhood amon...
This study analyzed qualitative therapist reports of adaptations to the delivery of multiple evidence-based practices (EBPs) within the context of a system-driven reform of children’s community mental health services to understand how therapists adapt EBPs as well as contexts of these adaptations to identify when these adaptations are made. The stu...
Objective: This study examined associations between ethnic minority therapists’ reports of acculturation and adaptations made to multiple evidence-based practices (EBPs) in children’s community mental health services. Multilevel modeling was used to analyze therapist- and practice-level predictors of Augmenting and Reducing/Reordering adaptations,...
Mobilizing lay health workers (LHWs) to deliver evidence-based treatments (EBTs) is a workforce strategy to address mental health disparities in underserved communities. LHWs can be leveraged to support access to EBTs in a variety of ways, from conducting outreach for EBTs delivered by professional providers to serving as the primary treatment prov...
Agency leaders and therapists are essential stakeholders in implementation of evidence-based practices (EBPs) within publicly-funded mental health services. Little is known about how these stakeholders differ in their perceptions of specific EBPs and which individual and organizational factors differentially influence these perceptions. Within the...
This study investigated therapist reports of client engagement challenges in delivering evidence-based practices (EBPs), within the context of a large-scale implementation of multiple practices in children’s mental health services. Data were drawn from an online survey of 668 therapists (88% female, 35.0% Non-Hispanic White). The majority of therap...
Burnout among community mental health (CMH) therapists has been associated with poorer therapist health, higher agency turnover, poorer client outcomes, and compromised quality of care. Recent mandates to learn and implement multiple evidence-based practices (EBPs) within CMH settings are intended to improve the quality of community care, yet there...
This systematic review evaluates efforts to date to involve community health workers (CHWs) in delivering evidence-based mental health interventions to underserved communities in the United States and in low- and middle-income countries. Forty-three articles (39 trials) were reviewed to characterize the background characteristics of CHW, their role...
To facilitate rigorous research on community programs to promote positive intergroup relations among youth, 2 studies were conducted to establish the psychometric properties of the Youth Diversity Acceptance Scale (YoDA). In Study 1, a unifactorial structure was identified for the YoDA using data provided by 126 high school youth involved in a comm...
Therapists’ perceptions toward evidence-based practices (EBPs) are important in implementation efforts, however little is known about characteristics of EBPs associated with more positive attitudes. This mixed-methods study examined how intervention and implementation characteristics of six EBPs related to therapist attitudes. Quantitative analysis...
Background
Large mental health systems are increasingly using fiscal policies to encourage the implementation of multiple evidence-based practices (EBPs). Although many implementation strategies have been identified, little is known about the types and impacts of strategies that are used by organizations within implementation as usual. This study e...
Objective:
This study examined clinical adaptations reported by community therapists to multiple evidence-based practices (EBPs) currently implemented in children's mental health services. Based on an item set informed by Stirman and colleagues' model (2015), 2 factors emerged describing Augmenting adaptations and Reducing/Reordering adaptations....
Examining sustainment of multiple evidence-based practices is crucial to understanding the processes and outcomes of system-driven implementation efforts that are increasingly common. This study used administrative claims data to characterize volume and penetration of six practices over 19 fiscal quarters following initial implementation within the...
Table of contents
Introduction to the 3rd Biennial Conference of the Society for Implementation Research Collaboration: advancing efficient methodologies through team science and community partnerships
Cara Lewis, Doyanne Darnell, Suzanne Kerns, Maria Monroe-DeVita, Sara J. Landes, Aaron R. Lyon, Cameo Stanick, Shannon Dorsey, Jill Locke, Brigid Ma...
Objective:
Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of...
Although behavioral parent training is considered efficacious treatment for childhood conduct problems, not all families benefit equally from treatment. Some parents take longer to change their behaviors and others ultimately drop out. Understanding how therapist behaviors impact parental engagement is necessary to improve treatment utilization. Th...
We investigated readiness for change (RFC), a construct that may contribute to the discrepancies between fathers' and mothers’ rates of participation in behavioral parent training. One hundred and twenty fathers and mothers of 2- to 7-year-old children with conduct problems completed standardized measures of RFC, child behavior problems, and parent...
The behavioral assessment of parent-child interactions is an important component of treatment planning and evaluation in many evidence-based parent training programs. However, numerous factors unrelated to the parent-child interaction may add error to the assessment. This study investigated the impact of task instructions on parents’ behaviors duri...
Left untreated, conduct problems can have significant and long-lasting negative effects on children's development. Despite the existence of many effective interventions, U.S. Latina/o children are less likely to access or receive evidence-based services. Seeking to build the foundation to address these service disparities, the current study used a...
This paper describes the initial evaluation of the Therapist-Parent Interaction Coding System (TPICS), a measure of in vivo therapist coaching for the evidence-based behavioral parent training intervention, parent-child interaction therapy (PCIT). Sixty-one video-recorded treatment sessions were coded with the TPICS to investigate (1) the variety o...
The incorporation of natural helpers into services has been suggested as an innovative strategy to address disparities for historically underserved children with conduct problems. In order to inform incorporation efforts, this study examined the perceptions of natural helpers serving one U.S. Latina/o community regarding need for services for child...
Although gang-involved Latino youth in the United States are uniquely at risk of adverse consequences from sexual behavior, little research is available that can guide those who wish to develop interventions to reduce sexual risk among these youth. To facilitate the development of effective interventions, we identified cultural and contextual facto...
In response to the high levels of unmet need among historically underserved young children with conduct problems, this paper outlines some of the key issues involved in incorporating natural helpers into the delivery of parenting interventions for the treatment of conduct problems among historically underserved children. Strategies for the selectio...
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