Article

A Practical, Robust Implementation and Sustainability Model (PRISM)

Northwest Permanente, Portland, Oregon, USA.
Joint Commission journal on quality and patient safety / Joint Commission Resources 05/2008; 34(4):228-43. DOI: 10.2165/00148365-200806040-00001
Source: PubMed

ABSTRACT

BACKGROUND: Although numerous studies address the efficacy and effectiveness of health interventions, less research addresses successfully implementing and sustaining interventions. As long as efficacy and effectiveness trials are considered complete without considering implementation in nonresearch settings, the public health potential of the original investments will not be realized. A barrier to progress is the absence of a practical, robust model to help identify the factors that need to be considered and addressed and how to measure success. A conceptual framework for improving practice is needed to integrate the key features for successful program design, predictors of implementation and diffusion, and appropriate outcome measures. DEVELOPING PRISM: A comprehensive model for translating research into practice was developed using concepts from the areas of quality improvement, chronic care, the diffusion of innovations, and measures of the population-based effectiveness of translation. PRISM--the Practical, Robust Implementation and Sustainability Model--evaluates how the health care program or intervention interacts with the recipients to influence program adoption, implementation, maintenance, reach, and effectiveness. DISCUSSION: The PRISM model provides a new tool for researchers and health care decision makers that integrates existing concepts relevant to translating research into practice.

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    • "EBPIs tend to be complex, multisession treatment packages that involve provider's skillful selection and execution of a set of interventions (Carroll et al. 2010; Chorpita and Regan 2009). Training prepares providers to deliver EBPIs, and has been shown to increase both consumer access and clinician fidelity (adherence to the protocol and competence , or skill) to EBPIs (Feldstein et al. 2008; Fixsen et al. 2005; Stirman et al. 2004). Comprehensive reviews of research on training have highlighted serious gaps in knowledge regarding best training practices (Beidas and Kendall 2010; Herschell et al. 2010; Rakovshik and McManus 2010). "
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    ABSTRACT: Despite the central role of training and consultation in the implementation of evidence-based psychological interventions (EBPIs), comprehensive reviews of research on training have highlighted serious gaps in knowledge regarding best practices. Consultation after initial didactic training appears to be of critical importance, but there has been very little research to determine optimal consultation format or interventions. This observational study compared two consultation formats that included review of session audio and feedback in the context of a program to train clinicians (n = 85) in community mental health clinics to deliver cognitive therapy (CT). A "gold standard" condition in which clinicians received individual feedback after expert consultants reviewed full sessions was compared to a group consultation format in which short segments of session audio were reviewed by a group of clinicians and an expert consultant. After adjusting for potential baseline differences between individuals in the two consultation conditions, few differences were found in terms of successful completion of the consultation phase or in terms of competence in CT at the end of consultation or after a 2 year follow-up. However, analyses did not support hypotheses regarding non-inferiority of the group consultation condition. While both groups largely maintained competence, clinicians in the group consultation condition demonstrated increases in competence over the follow-up period, while a sub-group of those in the individual condition experienced decreases. These findings, if replicated, have important implications for EBP implementation programs, as they suggest that observation and feedback is feasible in community mental health setting, and that employing this method in a group format is an effective and efficient consultation strategy that may enhance the implementation and sustainability of evidence-based psychotherapies.
    Full-text · Article · Nov 2015 · Administration and Policy in Mental Health and Mental Health Services Research
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    • "That is, schools' ability to accept and use EBPs has been afforded less attention than has been paid to their identification (Cook & Odom, 2013; Odom, 2009). As we have mentioned, considerable literature identifies organizational context factors as one set of factors affecting implementation of EBPs (e.g., Aarons et al., 2011; Aarons & Sawitzky, 2006; Damschroder et al., 2009; Feldstein & Glasgow, 2008; 254 JOSEPH CALVIN GAGNON AND BRIAN R. BARBER Greenhalgh, Glenn, MacFarlane, Bate, & Kyriakidou, 2004; Rogers, 2003). "

    Full-text · Dataset · Aug 2015
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    • "That is, schools' ability to accept and use EBPs has been afforded less attention than has been paid to their identification (Cook & Odom, 2013; Odom, 2009). As we have mentioned, considerable literature identifies organizational context factors as one set of factors affecting implementation of EBPs (e.g., Aarons et al., 2011; Aarons & Sawitzky, 2006; Damschroder et al., 2009; Feldstein & Glasgow, 2008; 254 JOSEPH CALVIN GAGNON AND BRIAN R. BARBER Greenhalgh, Glenn, MacFarlane, Bate, & Kyriakidou, 2004; Rogers, 2003). "
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    ABSTRACT: Alternative education settings (AES; i.e., self-contained alternative schools, therapeutic day treatment and residential schools, and juvenile corrections schools) serve youth with complicated and often serious academic and behavioral needs. The use of evidence-based practices (EBPs) and practices with Best Available Evidence are necessary to increase the likelihood of long-term success for these youth. In this chapter, we define three primary categories of AES and review what we know about the characteristics of youth in these schools. Next, we discuss the current emphasis on identifying and implementing EBPs with regard to both academic interventions (i.e., reading and mathematics) and interventions addressing student behavior. In particular, we consider implementation in AES, where there are often high percentages of youth requiring special education services and who have a significant need for EBPs to succeed academically, behaviorally, and in their transition to adulthood. We focus our discussion on: (a) examining approaches to identifying EBPs; (b) providing a brief review of EBPs and Best Available Evidence in the areas of mathematics, reading, and interventions addressing student behavior for youth in AES; (c) delineating key implementation challenges in AES; and (d) providing recommendations for how to facilitate the use of EBPs in AES.
    Full-text · Chapter · Jan 2015
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