Psychological Services最新文献

A religious lifestyle can be a powerful factor in predicting and promoting healthy functioning following trauma exposure. Previous research has demonstrated that higher levels of religiosity significantly predict posttraumatic growth following exposure to trauma. Firefighters are a population associated with routine exposure to potentially traumatic events, as well as high levels of occupational stress. While the relationship between religiosity and posttraumatic growth is well documented, the interaction of religious belief, occupational stress, and posttraumatic growth is less clear. The objective of this secondary analysis was to determine if religious belief moderates the relationship between occupational stress and posttraumatic growth in a sample of firefighters. The sample for this analysis was comprised of 109 firefighters who were assessed at various time points before fire service and throughout their first 3 years of fire service. A religious lifestyle did moderate the relationship between occupational stress and overall posttraumatic growth. However, a religious lifestyle and occupational stress were not significantly related. A religious lifestyle did moderate the relationship between occupational stress and the subdomains of spiritual enhancement and appreciation of life. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Practical, Robust Implementation and SustainabilityModel (PRISM) is an implementation science framework that incorporates multilevel contextual considerations and key implementation outcomes that can be used to support program planning, implementation, and sustainment. The PRISM has been applied to diverse populations, settings, and implementation strategies. Tools to rapidly assess the PRISM's contextual determinants of implementation success are needed to support implementation efforts. The objectives of this study were to describe the development and preliminary psychometric and pragmatic properties of the PRISM Contextual Survey Instrument (PCSI) and to demonstrate its use to inform implementation and sustainment in health care settings. The 29-item survey was developed based on refinement of existing questions, expert feedback, and pilot testing. Three to six items were included for each of the six PRISM context domains, each rated on a 5-point Likert scale. Implementors completed the PRISM survey and quantitative measures of implementation outcomes (acceptability, feasibility, and appropriateness; Weiner et al., 2017) to establish concurrent validity. Survey results were used to tailor subsequent implementation efforts. The PCSI took 14 min on average to complete. The mean overall score across participants and sites was 3.95 (SD = 0.42). The PCSI exhibited good psychometric and pragmatic properties. Internal consistency for the subscales ranged from 0.53 to 0.82, and concurrent validity with the other implementation outcomes varied from r = 0.70 (p < .001) for feasibility to r = 0.80 (p < .001) for appropriateness. Pragmatic ratings ranged from the "minimal/emerging" to "excellent" category (Lewis et al., 2021), and provided examples illustrate the practical application of the survey results for implementation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Detecting depression in primary care patients is suboptimal, especially among historically excluded populations. To improve depression screening rates, a primary care clinic integrated the Patient Health Questionnaire (PHQ) in the Electronic Health Record (EHR) and clinical workflow. Patients completed the PHQ on a tablet in the waiting room, and responses were available in real time for staff to review with patients. This study examined implementation science outcomes using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework 3.0. First, we calculated the percentage of patients who completed a PHQ ("Reach"). Second, we examined "Inequitable Reach" by determining if demographic characteristics were associated with the probability of not completing a PHQ. Third, we conducted 13 interviews with care team members (three physicians, five staff) and the health system's implementation team (two practice coaches, three EHR analysts) to identify barriers to Reach. Of the 8,765 patients seen in the clinic between November 2019 through September 2021, Reach was satisfactory at 71% (6,261/8,765 completed a PHQ) but inequitable because patients who did not complete PHQ screening (n = 2,502, 29%) had higher odds of being age 65+ (OR = 1.40), Black (OR = 1.37), or had Medicaid or no insurance (OR = 1.90; all p < .001). In interviews, barriers to Reach included inefficient EHR workflow, time constraints to help patients use the tablet and check if a PHQ was completed, and lack of clarity on how to talk with patients about PHQ responses. Our findings provide a roadmap for health systems to examine whether they have Inequitable Reach in depression screening. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This explanatory sequential mixed methods hybrid Type 1 study examined the efficacy and implementation of Connect2Test, a brief motivational enhancement intervention to increase SARS-CoV-2 testing among people experiencing houselessness and people who inject drugs. We conducted a randomized controlled trial with participants randomly assigned to Connect2Test (n = 105) or services as usual (n = 100). Most participants self-identified as male (65%), White (72%), and not Hispanic (87%). There were no intervention effects on immediate testing rates, χ²(1, n = 205) = 0.23, p = .6298, OR [95% CI] = 1.18 [0.61, 2.27], or at 1-month, χ²(1, n = 205) = 0.05, p = .8263, OR [95% CI] = 0.93 [0.51, 1.72], or 2-month follow-ups, χ²(1, n = 205) = 0.04, p = .8368, OR [95% CI] = 1.08 [0.52, 2.22]. We interviewed staff and volunteers (n = 17) affiliated with our community partner to examine implementation barriers and facilitators. Barriers included (a) intervention complexity, (b) no established relationship between the interventionist and participants, (c) Connect2Test's misalignment with priorities of people experiencing houselessness, and (d) incompatibility with community partner resources. Facilitators included (a) congruency between motivational interviewing and harm reduction values, (b) collaboration with a trusted community partner, and (c) intervention alignment with the community partner's mission. Although Connect2Test did not increase testing rates, our qualitative assessment highlighted barriers reflecting intervention and implementation failure. Facilitators highlighted Connect2Test adaptations to enhance efficacy. Juxtaposing qualitative implementation assessments with randomized controlled trials can discern implementation and intervention factors impacting efficacy to inform redesign. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Within mental health services, persons in recovery from their own experiences of mental health challenges (peers) are increasingly being trained to provide peer support. This study describes individual and organizational outcomes related to engaging peers in a multisite demonstration project in California that sought to integrate them as cocreators throughout planning and implementation of digital mental health interventions. We collected data from key informants across 11 sites. Quarterly online surveys invited key informants to report perceived outcomes of the peer component. Biannual interviews elicited details regarding survey-reported outcomes. Quantitative data provided indications of outcome prevalence and consistency, and quotes from the interviews illustrated the complex realities underlying survey responses. One hundred three quarterly surveys and 39 biannual interviews were completed between Summer 2020 and Fall 2022. Key informants reported diverse outcomes, including integration of peer input into local decision making, mental health benefits to peers and community members, reduced workplace mental health stigma, and new cross-site collaborations. Five sites reported outcomes with greater consistency compared to the other six sites. Reports of increased peer visibility in the workplace coincided with reports of reduced stigma and increased value of peer input by mental health professionals. This study offers encouragement for the potential positive impact of engaging peers as cocreators of mental health interventions. Data suggest integrating peers does not increase mental health stigma and may instead result in various positive outcomes. The degree to which these outcomes manifest in a specific setting, however, may vary. Future research should seek to identify contextual factors that support actualization of positive outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Research on the implementation of community gatekeeper training interventions for suicide prevention in Spanish-speaking countries is limited. Gatekeepers identify warning signs of suicidal behavior in at-risk population and refer them to specialized mental health care. To identify factors that influence the implementation of evidence-based practices, standardized measures are needed in Spanish. We culturally adapted and evaluated the factor structure and reliability of two measures for use in the Mexican population: the final version of Acceptability, Appropriateness, and Feasibility of the Intervention (Weiner et al., 2017), and the Organizational Readiness for Implementing Change (ORIC; Shea et al., 2014). Our study consisted of two consecutive phases. The first addressed the cross-cultural adaptation. In the second phase, we administered an online survey to a nonrandom sample of 453 middle school personnel and performed a confirmatory factor analysis (CFA). Participants were 73.95% female, 25.17% male, and 0.88% nonbinary/other and came from the 32 Mexican states. CFA indices for the Mexican Spanish version of the acceptability, appropriateness, and feasibility measure yielded values of comparative fit index (CFI) = 0.96, Tucker-Lewis fit index (TLI) = 0.94, root-mean-square error of approximation (RMSEA) = 0.05, and standardized root-mean-square residual (SRMR) = 0.03. Internal consistency was Ω = 0.95. CFA indices of the Mexican Spanish version of the ORIC were CFI = 0.95, TLI = 0.93, RMSEA = 0.08, and SRMR = 0.03, and internal consistency was Ω = 0.94. We conclude that both instruments show preliminary psychometric properties that support their validity and reliability in the Mexican Spanish-speaking context. These findings promise to drive research on the implementation of gatekeeper interventions and other evidence-based practices in Spanish-speaking school settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The Individualized Positive Psychosocial Interaction (IPPI) is an evidence-based program that supports engaging people living with dementia and their care partners in the nursing home (NH). IPPIs are brief, one-to-one, preference-based activities to improve well-being and decrease behavioral and psychological symptoms of dementia. The purpose of this study was to understand barriers and facilitators to implementing the IPPI program from the perspective of NH provider champions. Semistructured interviews (n = 62) were completed with implementation champions (n = 20) who led a quality improvement project to implement the IPPI with three to five residents per NH. Interviews were audio recorded, transcribed verbatim, and coded using the Innovation Domain of the updated Consolidated Framework for Implementation Research. Constructs coded included cost, design, complexity, adaptability, relative advantage, trialability, and evidence base. Implementation champions spoke about the IPPI program's relative advantage of effectively reducing resident's behavioral and psychological symptoms of dementia based on meaningful, personalized content. Champions voiced that the IPPI program was cost-effective, adaptable to their local contexts, and provided training to staff to support residents experiencing distress. Champions acknowledged the complexity of identifying implementation team members and completing initial education and training. In addition, they appreciated the chance to build capacity by trialing IPPIs with a small number of residents for initial efforts (e.g., trialability). Utilizing the Consolidated Framework for Implementation Research allowed for the systematic identification of facilitators and barriers to IPPI implementation. Overall, the IPPI program goals are aligned with nursing home organization goals, supporting staff in providing comfort to residents communicating distress, and can be feasibly implemented. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Although jails are the largest provider of mental health care nationally, access to treatment in U.S. jails is limited. Limited empirical information on factors impacting the implementation of mental health services in jail may be contributing to low treatment rates. We documented potential barriers impacting the provision of a brief cognitive-behavioral group-based intervention for people with serious mental illness in jail, including the rates of participants' recruitment, as well as starting and completing the intervention; time required for each group from recruitment to completion; and the types and frequencies of obstacles encountered during treatment sessions. We organized the barriers according to the Consolidated Framework for Implementation Research. All potential treatment recipients' questions prior to treatment, and reasons provided for not starting the treatment, were also logged and analyzed using content analysis and frequency counts; tables of the themes, frequencies, and examples of participant concerns are presented. These results suggest that although many participants were interested in and incarcerated for sufficient time to complete the intervention, relatively few participants were able to begin the groups (44%). Over 150 obstacles to treatment were encountered during treatment provision (including recurring issues with client transportation within the facility and facility lockdown). Understanding participants' progression through the study (recruitment, start, completion), their questions and reasons for not participating, and interruptions to the sessions provide important information for increasing the usability of mental health care in jails. The current findings can improve the implementation of needed evidence-based treatment in this carceral setting. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The comorbidity of obsessive compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) is common and leads to worse clinical and psychosocial outcomes than PTSD alone. Yet, OCD remains underdiagnosed and undertreated among veterans, a population with high rates of PTSD. This qualitative descriptive study aimed to understand Veterans Affairs providers' current practices for assessing and treating OCD in veterans with PTSD, as well as barriers to and needs for assessment and treatment. Twelve clinical psychologists were recruited to participate in semistructured interviews. The qualitative interview guide and analysis were informed by the consolidated framework for implementation research. Rapid, matrix, and team-based qualitative techniques were used to facilitate analysis. Psychologists across general mental health clinics (n = 7) and a trauma-focused specialty clinic (n = 5) were interviewed. Findings revealed most psychologists in general mental health clinics had assessed for and treated OCD in veterans with PTSD. Yet, across clinics, providers held misconceptions about OCD diagnosis and treatment. Providers reported barriers to assessment and treatment including a perceived lack of knowledge and training, access to consultation and resources, and time. Trauma-focused specialty clinic providers also noted national mandates as a barrier to OCD assessment and treatment in veterans with PTSD. Providers identified needs including time for and access to education, training, consultation, and resources. Findings from this study detail current practices and strategies to facilitate assessment and treatment of OCD in PTSD. Addressing current barriers and needs would increase accessibility of services and potentially improve the lives of thousands of veterans at Veterans Affairs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Broadband personality measures, such as the Minnesota Multiphasic Personality Inventory (MMPI) family of instruments, are commonly used as diagnostic aids within the Veterans Affairs (VA) health care system. However, research on how military experiences (i.e., era of service and combat exposure) affect scores on these measures has yielded mixed findings regarding both the magnitude and pattern of symptom profiles. Additionally, concerns remain about the generalizability of these findings, as many studies have drawn samples from similar treatment settings, such as VA PTSD Clinical Teams. Conclusions reached by this line of research vary in how clinicians should integrate past experiences into expected response patterns. This study continues this line of work by providing the first comparison of service era differences in a nonposttraumatic stress disorder-focused VA sample undergoing a variety of assessment-related referrals. We examine differences on the MMPI-2-Restructured Form while controlling for known demographic influences (i.e., sex and service connection). Participants (n_{total sample} = 356) were compared for elevation rates on the content-based validity scales, and then, after excluding invalid protocols, we computed differences across the substantive scales using an analysis of covariance design. Despite the validity scale multivariate differences evident only on infrequent psychopathology responses and only on substantive scales substance abuse and disconstraint-revised, broader between-era contrasts suggest a similarity in Vietnam and Gulf veterans in their symptom experience, which may have implications for treatment planning and organizational expectations in the coming years. Results support the notion that demographic factors are critical to understanding service era influence and contextualizing their magnitude effectively. Clinical practice and research implications are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).