首页 > 最新文献

Translational Behavioral Medicine最新文献

英文 中文
Moving psychedelic-assisted therapies from promising research into routine clinical practice: Lessons from the field of implementation science. 将迷幻辅助疗法从有前景的研究成果转化为常规临床实践:实施科学领域的经验教训。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/tbm/ibae053
Danielle R Adams, Heidi Allen, Ginger E Nicol, Leopoldo J Cabassa

Psychedelics (e.g., 3,4-Methylenedioxymethamphetamine [MDMA], lysergic acid diethylamide [LSD], psilocybin) are molecules that have the potential to produce rapid therapeutic effects when paired with psychotherapy. Randomized clinical trials of psychedelic-assisted psychotherapy (PAT) have shown promising results for post-traumatic stress disorder (PTSD), depression, and substance use disorders. The U.S. Food and Drug Administration has acknowledged the promise of PAT, signaling potential approval of psilocybin-assisted therapy for depression by 2026. Given this timeline, implementation scientists must engage with PAT researchers, policymakers, and practitioners to think critically about bringing these promising new treatments into routine practice settings while maintaining quality and safety. This commentary aims to initiate a dialogue between implementation scientists and PAT researchers and practitioners on addressing these questions with a lens toward equity. Specifically, we discuss how the field of implementation science can support PAT stakeholders to accelerate the translational process from research into practice, focusing specifically on safety-net settings (i.e., Federally Qualified Health Centers and Veterans Affairs health systems) that serve historically marginalized populations. We use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework to illustrate five critical areas where implementation science can help move PAT from research into real-world practice. For each RE-AIM dimension, we highlight ways the field of implementation science can contribute tools (e.g., implementation strategies), methodologies (e.g., pragmatic hybrid implementation-effectiveness trials), and approaches (community-based participatory research) for establishing the safety, effectiveness, and accessibility of PAT for historically underserved communities.

迷幻剂(如 3,4-亚甲二氧基甲基苯丙胺 [MDMA]、麦角酰二乙胺 [LSD]、迷幻药)是一种分子,与心理疗法搭配可产生快速治疗效果。迷幻药辅助心理疗法(PAT)的随机临床试验显示,对创伤后应激障碍(PTSD)、抑郁症和药物使用障碍的治疗效果很好。美国食品和药物管理局已经承认了 PAT 的前景,表示可能在 2026 年之前批准使用迷幻药辅助疗法治疗抑郁症。考虑到这一时间表,实施科学家必须与 PAT 研究人员、政策制定者和从业人员合作,批判性地思考如何在保证质量和安全的前提下将这些前景广阔的新疗法引入常规实践环境。本评论旨在启动实施科学家与 PAT 研究人员和从业人员之间的对话,以公平的视角解决这些问题。具体来说,我们讨论了实施科学领域如何支持 PAT 的利益相关者加快从研究到实践的转化过程,特别关注服务于历史上被边缘化人群的安全网环境(即联邦合格卫生中心和退伍军人事务卫生系统)。我们使用 "覆盖、效果、采用、实施和维护"(RE-AIM)框架来说明实施科学可以帮助将 PAT 从研究转化为现实世界实践的五个关键领域。对于 RE-AIM 的每一个维度,我们都强调了实施科学领域可以提供工具(如实施策略)、方法(如务实的混合实施效果试验)和途径(基于社区的参与式研究)的方式,以便为历史上服务不足的社区建立起 PAT 的安全性、有效性和可及性。
{"title":"Moving psychedelic-assisted therapies from promising research into routine clinical practice: Lessons from the field of implementation science.","authors":"Danielle R Adams, Heidi Allen, Ginger E Nicol, Leopoldo J Cabassa","doi":"10.1093/tbm/ibae053","DOIUrl":"10.1093/tbm/ibae053","url":null,"abstract":"<p><p>Psychedelics (e.g., 3,4-Methylenedioxymethamphetamine [MDMA], lysergic acid diethylamide [LSD], psilocybin) are molecules that have the potential to produce rapid therapeutic effects when paired with psychotherapy. Randomized clinical trials of psychedelic-assisted psychotherapy (PAT) have shown promising results for post-traumatic stress disorder (PTSD), depression, and substance use disorders. The U.S. Food and Drug Administration has acknowledged the promise of PAT, signaling potential approval of psilocybin-assisted therapy for depression by 2026. Given this timeline, implementation scientists must engage with PAT researchers, policymakers, and practitioners to think critically about bringing these promising new treatments into routine practice settings while maintaining quality and safety. This commentary aims to initiate a dialogue between implementation scientists and PAT researchers and practitioners on addressing these questions with a lens toward equity. Specifically, we discuss how the field of implementation science can support PAT stakeholders to accelerate the translational process from research into practice, focusing specifically on safety-net settings (i.e., Federally Qualified Health Centers and Veterans Affairs health systems) that serve historically marginalized populations. We use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework to illustrate five critical areas where implementation science can help move PAT from research into real-world practice. For each RE-AIM dimension, we highlight ways the field of implementation science can contribute tools (e.g., implementation strategies), methodologies (e.g., pragmatic hybrid implementation-effectiveness trials), and approaches (community-based participatory research) for establishing the safety, effectiveness, and accessibility of PAT for historically underserved communities.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"744-752"},"PeriodicalIF":3.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identifying and supporting vaccine champions in pediatric primary care: a qualitative interview study. 在儿科初级保健中识别和支持疫苗卫士:一项定性访谈研究。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/tbm/ibae054
Wei Yi Kong, Jennifer Heisler-MacKinnon, Nul Loren Oh, Mary Catharine McKeithen, Samantha R Stalford, Meghan B Brennan, Christopher M Shea, Amy Liu, Nisha Gottfredson O'Shea, Sachiko Ozawa, Noel T Brewer, Melissa B Gilkey

Implementation science research identifies clinical champions as instrumental in aligning healthcare professionals' (HCPs) behavior with practice guidelines for delivering health services, including vaccinations. However, we know relatively little about identifying or supporting champions. To characterize who vaccine champions are, what they do, and how to support their work in pediatric primary care. In 2022, we interviewed a purposive sample of peer-nominated or self-identified vaccine champions (n=20) and HCPs who worked with vaccine champions (n=4). We thematically analyzed qualitative data. Vaccine champions' defining characteristics were firsthand primary care experience, whether as providers or nursing staff, and a strong belief in vaccinations as uniquely effective tools for primary prevention. Participants noted these beliefs were "part of the DNA" of specialties like pediatrics and infectious disease, where they perceived champions as especially common. Being "insatiable in their quest for knowledge," champions primarily conceptualized their role as understanding and sharing complex information and performance metric data related to vaccine administration. Champions' role in leading other implementation strategies, such as communication training, was more peripheral. Champions reported that dedicated time and staff support helped them "go above and beyond" to improve vaccination rates. Our findings suggest that vaccine champions can be found among providers and nursing staff with deep clinical experience and commitment to primary prevention through vaccination, including through providing vaccine education to colleagues. Healthcare systems can allocate resources to support champions as educators, while exploring opportunities to extend their role in other implementation strategies to improve vaccination rates.

实施科学研究发现,临床带头人有助于使医疗保健专业人员(HCPs)的行为与提供医疗服务(包括疫苗接种)的实践指南保持一致。然而,我们对识别或支持拥护者却知之甚少。为了了解谁是疫苗接种倡导者、他们在做什么以及如何支持他们在儿科初级保健中的工作。2022 年,我们有目的性地对同行提名或自我认定的疫苗接种带头人(20 人)以及与疫苗接种带头人共事的保健医生(4 人)进行了访谈。我们对定性数据进行了专题分析。疫苗接种倡导者的显著特点是拥有第一手初级保健经验,无论是作为医疗服务提供者还是护理人员,并坚信疫苗接种是初级预防的独特有效工具。与会者指出,这些信念是儿科和传染病等专科的 "DNA 的一部分",他们认为在这些专科,疫苗接种倡导者尤为常见。由于 "求知欲极强",冠军们将自己的角色主要视为理解和分享与疫苗管理相关的复杂信息和绩效指标数据。倡导者在领导其他实施策略(如交流培训)方面的作用则较为次要。冠军们表示,专门的时间和员工支持帮助他们 "超越自我",提高疫苗接种率。我们的研究结果表明,疫苗接种倡导者可以在具有丰富临床经验并致力于通过疫苗接种进行初级预防的医疗服务提供者和护理人员中找到,包括通过向同事提供疫苗教育。医疗保健系统可以分配资源支持疫苗接种倡导者作为教育者,同时寻找机会扩大他们在其他实施策略中的作用,以提高疫苗接种率。
{"title":"Identifying and supporting vaccine champions in pediatric primary care: a qualitative interview study.","authors":"Wei Yi Kong, Jennifer Heisler-MacKinnon, Nul Loren Oh, Mary Catharine McKeithen, Samantha R Stalford, Meghan B Brennan, Christopher M Shea, Amy Liu, Nisha Gottfredson O'Shea, Sachiko Ozawa, Noel T Brewer, Melissa B Gilkey","doi":"10.1093/tbm/ibae054","DOIUrl":"10.1093/tbm/ibae054","url":null,"abstract":"<p><p>Implementation science research identifies clinical champions as instrumental in aligning healthcare professionals' (HCPs) behavior with practice guidelines for delivering health services, including vaccinations. However, we know relatively little about identifying or supporting champions. To characterize who vaccine champions are, what they do, and how to support their work in pediatric primary care. In 2022, we interviewed a purposive sample of peer-nominated or self-identified vaccine champions (n=20) and HCPs who worked with vaccine champions (n=4). We thematically analyzed qualitative data. Vaccine champions' defining characteristics were firsthand primary care experience, whether as providers or nursing staff, and a strong belief in vaccinations as uniquely effective tools for primary prevention. Participants noted these beliefs were \"part of the DNA\" of specialties like pediatrics and infectious disease, where they perceived champions as especially common. Being \"insatiable in their quest for knowledge,\" champions primarily conceptualized their role as understanding and sharing complex information and performance metric data related to vaccine administration. Champions' role in leading other implementation strategies, such as communication training, was more peripheral. Champions reported that dedicated time and staff support helped them \"go above and beyond\" to improve vaccination rates. Our findings suggest that vaccine champions can be found among providers and nursing staff with deep clinical experience and commitment to primary prevention through vaccination, including through providing vaccine education to colleagues. Healthcare systems can allocate resources to support champions as educators, while exploring opportunities to extend their role in other implementation strategies to improve vaccination rates.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"722-731"},"PeriodicalIF":3.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Maternity care coordinator's experiences at the department of Veteran Affairs. 退伍军人事务部产妇护理协调员的经验。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-16 DOI: 10.1093/tbm/ibae052
Florine Ndakuya-Fitzgerald, Amy Farkas, Alexa A Lopez, Jeff Whittle, Kristin O Haeger, Qiyan Mu

The Veterans Health Administration (VHA) provides maternity care by paying for Veterans to receive pregnancy-related care in community settings and by utilizing maternity care coordinators (MCCs) at each medical facility. The purpose of this qualitative descriptive study was to understand the MCC's experiences performing their role across VA facilities. Thirty MCCs were recruited and interviewed virtually using Microsoft Teams. Interviews were recorded and transcribed verbatim. Using thematic analysis, transcripts were coded, and themes were derived. MCC's roles include being a liaison, care coordinator, and supporter. MCCs improve Veterans' care during pregnancy and postpartum by education, monitoring health status, and connecting Veterans to providers within VA and the community. Across VA facilities, there was variation in how MCCs engaged with Veterans and in the services provided. A challenge shared was the lack of dedicated time to the role. In the VA, MCCs are valuable in ensuring high-quality care coordination of pregnant/postpartum Veterans despite the fragmentation of care between VA and community providers. To improve inconsistencies in how the MCC program is implemented, systematic strategies such as ensuring dedicated time are needed.

退伍军人健康管理局(VHA)通过支付退伍军人在社区环境中接受孕期相关护理的费用,以及在各医疗机构使用孕产妇护理协调员(MCC)来提供孕产妇护理。这项定性描述性研究的目的是了解产科护理协调员在退伍军人医疗机构中履行职责的经验。我们招募了 30 名 MCC,并使用 Microsoft Teams 进行了虚拟访谈。对访谈进行了录音和逐字记录。采用主题分析法对记录誊本进行编码,并得出主题。MCC 的角色包括联络员、护理协调员和支持者。产妇协调中心通过教育、监测健康状况以及将退伍军人与退伍军人事务部和社区内的医疗服务提供者联系起来,改善退伍军人在孕期和产后的护理。在退伍军人事务部的各个机构中,产妇陪护中心与退伍军人接触的方式和提供的服务各不相同。共同面临的一个挑战是缺乏专门的时间来履行这一职责。在退伍军人事务部,尽管退伍军人事务部和社区医疗服务提供者之间的医疗服务是分散的,但母婴传播中心在确保对怀孕/产后退伍军人进行高质量的医疗协调方面是非常有价值的。为了改善 MCC 计划实施过程中的不一致性,需要采取系统性策略,如确保专职时间。
{"title":"Maternity care coordinator's experiences at the department of Veteran Affairs.","authors":"Florine Ndakuya-Fitzgerald, Amy Farkas, Alexa A Lopez, Jeff Whittle, Kristin O Haeger, Qiyan Mu","doi":"10.1093/tbm/ibae052","DOIUrl":"10.1093/tbm/ibae052","url":null,"abstract":"<p><p>The Veterans Health Administration (VHA) provides maternity care by paying for Veterans to receive pregnancy-related care in community settings and by utilizing maternity care coordinators (MCCs) at each medical facility. The purpose of this qualitative descriptive study was to understand the MCC's experiences performing their role across VA facilities. Thirty MCCs were recruited and interviewed virtually using Microsoft Teams. Interviews were recorded and transcribed verbatim. Using thematic analysis, transcripts were coded, and themes were derived. MCC's roles include being a liaison, care coordinator, and supporter. MCCs improve Veterans' care during pregnancy and postpartum by education, monitoring health status, and connecting Veterans to providers within VA and the community. Across VA facilities, there was variation in how MCCs engaged with Veterans and in the services provided. A challenge shared was the lack of dedicated time to the role. In the VA, MCCs are valuable in ensuring high-quality care coordination of pregnant/postpartum Veterans despite the fragmentation of care between VA and community providers. To improve inconsistencies in how the MCC program is implemented, systematic strategies such as ensuring dedicated time are needed.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"684-691"},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reviewer Thank You 2024. 评论员感谢你 2024。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-16 DOI: 10.1093/tbm/ibae062
{"title":"Reviewer Thank You 2024.","authors":"","doi":"10.1093/tbm/ibae062","DOIUrl":"https://doi.org/10.1093/tbm/ibae062","url":null,"abstract":"","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"14 11","pages":"635-636"},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Designing for data sharing: Considerations for advancing health equity in data management and dissemination. 设计数据共享:在数据管理和传播中促进健康公平的考虑因素。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-16 DOI: 10.1093/tbm/ibae049
Borsika A Rabin, Justin D Smith, Emily V Dressler, Deborah J Cohen, Rebekka M Lee, Melody S Goodman, Heather D'Angelo, Wynne E Norton, April Y Oh

Data sharing, the act of making scientific research data available to others, can accelerate innovation and discoveries, and ultimately enhance public health. The National Cancer Institute Implementation Science Centers in Cancer Control convened a diverse group of research scientists, practitioners, and community partners in three interactive workshops (May-June 2022) to identify and discuss factors that must be considered when designing research for equitable data sharing with a specific emphasis on implementation science and social, behavioral, and population health research. This group identified and operationalized a set of seven key considerations for equitable data sharing-conceptualized as an inclusive process that fairly includes the perspectives and priorities of all partners involved in and impacted by data sharing, with consideration of ethics, history, and benefits-that were integrated into a framework. Key data-sharing components particularly important for health equity included: elevating data sharing into a core research activity, incorporating diverse perspectives, and meaningfully engaging partners in data-sharing decisions throughout the project lifecycle. As the process of data sharing grows in research, it is critical to continue considering the potential positive and adverse impact of data sharing on diverse beneficiaries of health data and research.

数据共享,即向他人提供科研数据的行为,可以加速创新和发现,并最终提高公众健康水平。美国国家癌症研究所癌症控制实施科学中心在三个互动研讨会(2022 年 5 月至 6 月)上召集了一批研究科学家、从业人员和社区合作伙伴,以确定和讨论在设计公平数据共享研究时必须考虑的因素,并特别强调实施科学以及社会、行为和人口健康研究。该小组确定并实施了公平数据共享的七项关键考虑因素--将其概念化为一个包容的过程,公平地纳入参与数据共享和受数据共享影响的所有合作伙伴的观点和优先事项,同时考虑道德、历史和利益--并将其纳入一个框架。对健康公平尤为重要的数据共享关键要素包括:将数据共享提升为一项核心研究活动,纳入不同的观点,以及在整个项目生命周期中让合作伙伴有意义地参与数据共享决策。随着数据共享进程在研究中的发展,继续考虑数据共享对健康数据和研究的不同受益者可能产生的积极和消极影响至关重要。
{"title":"Designing for data sharing: Considerations for advancing health equity in data management and dissemination.","authors":"Borsika A Rabin, Justin D Smith, Emily V Dressler, Deborah J Cohen, Rebekka M Lee, Melody S Goodman, Heather D'Angelo, Wynne E Norton, April Y Oh","doi":"10.1093/tbm/ibae049","DOIUrl":"10.1093/tbm/ibae049","url":null,"abstract":"<p><p>Data sharing, the act of making scientific research data available to others, can accelerate innovation and discoveries, and ultimately enhance public health. The National Cancer Institute Implementation Science Centers in Cancer Control convened a diverse group of research scientists, practitioners, and community partners in three interactive workshops (May-June 2022) to identify and discuss factors that must be considered when designing research for equitable data sharing with a specific emphasis on implementation science and social, behavioral, and population health research. This group identified and operationalized a set of seven key considerations for equitable data sharing-conceptualized as an inclusive process that fairly includes the perspectives and priorities of all partners involved in and impacted by data sharing, with consideration of ethics, history, and benefits-that were integrated into a framework. Key data-sharing components particularly important for health equity included: elevating data sharing into a core research activity, incorporating diverse perspectives, and meaningfully engaging partners in data-sharing decisions throughout the project lifecycle. As the process of data sharing grows in research, it is critical to continue considering the potential positive and adverse impact of data sharing on diverse beneficiaries of health data and research.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"637-642"},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Practitioner perspectives on equitable implementation of evidence-based interventions for cancer prevention and control. 从业人员对公平实施癌症预防和控制循证干预措施的看法。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-16 DOI: 10.1093/tbm/ibae048
Ariella R Korn, April Y Oh, Nanmathi Manian, Sophia Tsakraklides, Lori Carter-Edwards

Longstanding inequities in cancer prevention and control require novel approaches to improve evidence-based intervention implementation. Exploring and elevating the perspectives of cancer prevention and control practitioners working to advance health equity and equitably implement evidence-based interventions is an important yet underutilized step among researchers working in this space. The purpose of this study was to explore practitioners' perspectives of how health equity is defined and integrated into their work, challenges of advancing health equity for implementation in local settings, and associated strategies. We conducted virtual key informant interviews and focus groups with 16 US practitioners (e.g. clinicians, health administrators, public health professionals) in 2021-2022. Interviews and focus groups were audio recorded and transcribed. Data were coded using inductive content analysis and summarized into themes. Four major themes emerged: (i) how health equity is conceptualized as a process and outcome; (ii) need to shift equity mindsets; (iii) importance of community partnerships; (iv) organizational policies and strategies for fostering equity in implementation. Respondents noted the need for research and medical communities to learn about the importance and benefits of allowing communities to shape implementation to advance equity in the delivery of evidence-based interventions and outcomes. Additionally, respondents emphasized that institutional leaders should initiate changes regarding equitable implementation at the organizational- and system-levels. Respondents endorsed the need to address equity issues related to the implementation of cancer prevention and control programs, practices, and policies. Many findings can be applied beyond cancer prevention and control to support equitable implementation and outcomes more generally.

癌症防控中长期存在的不公平现象需要新的方法来改善循证干预措施的实施。探索和提升癌症预防和控制从业人员的视角,以促进健康公平和公平地实施循证干预措施,是这一领域研究人员迈出的重要一步,但尚未得到充分利用。本研究的目的是探讨从业人员如何定义健康公平并将其融入工作中的观点、在当地环境中实施健康公平所面临的挑战以及相关策略。2021-2022 年,我们对 16 名美国从业人员(如临床医生、卫生管理人员、公共卫生专业人员)进行了虚拟关键信息访谈和焦点小组讨论。我们对访谈和焦点小组进行了录音和转录。采用归纳式内容分析法对数据进行编码,并归纳成主题。出现了四大主题:(i) 如何将健康公平概念化为一个过程和结果;(ii) 需要转变公平心态;(iii) 社区伙伴关系的重要性;(iv) 在实施过程中促进公平的组织政策和战略。受访者指出,研究界和医学界需要了解让社区影响实施工作的重要性和益处,以促进在提供循证干预措施和成果方面的公平。此外,受访者还强调,机构领导者应在组织和系统层面发起有关公平实施的变革。受访者赞同有必要解决与癌症预防和控制计划、实践和政策的实施相关的公平问题。许多发现可以应用于癌症预防和控制以外的领域,以支持更广泛的公平实施和结果。
{"title":"Practitioner perspectives on equitable implementation of evidence-based interventions for cancer prevention and control.","authors":"Ariella R Korn, April Y Oh, Nanmathi Manian, Sophia Tsakraklides, Lori Carter-Edwards","doi":"10.1093/tbm/ibae048","DOIUrl":"10.1093/tbm/ibae048","url":null,"abstract":"<p><p>Longstanding inequities in cancer prevention and control require novel approaches to improve evidence-based intervention implementation. Exploring and elevating the perspectives of cancer prevention and control practitioners working to advance health equity and equitably implement evidence-based interventions is an important yet underutilized step among researchers working in this space. The purpose of this study was to explore practitioners' perspectives of how health equity is defined and integrated into their work, challenges of advancing health equity for implementation in local settings, and associated strategies. We conducted virtual key informant interviews and focus groups with 16 US practitioners (e.g. clinicians, health administrators, public health professionals) in 2021-2022. Interviews and focus groups were audio recorded and transcribed. Data were coded using inductive content analysis and summarized into themes. Four major themes emerged: (i) how health equity is conceptualized as a process and outcome; (ii) need to shift equity mindsets; (iii) importance of community partnerships; (iv) organizational policies and strategies for fostering equity in implementation. Respondents noted the need for research and medical communities to learn about the importance and benefits of allowing communities to shape implementation to advance equity in the delivery of evidence-based interventions and outcomes. Additionally, respondents emphasized that institutional leaders should initiate changes regarding equitable implementation at the organizational- and system-levels. Respondents endorsed the need to address equity issues related to the implementation of cancer prevention and control programs, practices, and policies. Many findings can be applied beyond cancer prevention and control to support equitable implementation and outcomes more generally.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"643-652"},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The development and evaluation of the Designing for Dissemination and Implementation Learning Hub. 传播和实施设计学习中心的开发和评估。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-16 DOI: 10.1093/tbm/ibae036
Michaela S McCarthy, Marina McCreight, Deisy Hernandez Lujan, Heidi Sjoberg, Catherine Battaglia

There is a growing emphasis on reducing the gap between research and routine practice. Dissemination and Implementation (D&I) science offers theories, models, and frameworks to enhance the implementation, impact, and sustainment of new programs and interventions. Few training opportunities are available that help leaders, researchers, clinicians, and staff (implementers) translate original research into practice settings in a more timely and effective manner without requiring significant time away from their primary clinical duties. To address these needs, we designed a virtual Designing for Dissemination and Implementation (D4D&I) Learning Hub that offered foundational D&I knowledge and opportunities for skill building. We developed the D4D&I Learning Hub curricula to train novice participants in the multicomponent D4D&I implementation strategy bundle when implementing new programs or innovations. The components of the D4D&I strategy bundle include (i) Pre-implementation assessment for proactive planning and multilevel contextual assessment, (ii) Multilevel partner engagement to learn what is important to end-users and obtain buy-in, (iii) Implementation and adaptations guided by a pre-implementation assessment while retaining program fidelity, and (iv) Program evaluation. We utilized a virtual e-learning platform, expert trainers, mentorship, and a Virtual Learning Collaborative to deliver the six-module curricula to support participants' growth and success. We used quantitative and qualitative methods informed by the Kirkpatrick Evaluation Model to evaluate the D4D&I Learning Hub. Thirty-one participants completed the D4D&I Learning Hub across four cohorts. Participants found the D4D&I curricula relevant and favorable, indicating they acquired the intended knowledge and skills. In presentations of their key takeaways, participants cited a greater understanding of how to apply various D&I theories, models, and frameworks to their research, engage multilevel partners during all phases of implementation and evaluation, and assess fidelity and adaptations. Participants planned to incorporate the acquired D&I knowledge and skills in future publications, grant applications, and when implementing new programs and projects in clinical settings. The D4D&I Learning Hub provides foundational education for novice participants of D&I science. It promotes designing, disseminating, implementing, and evaluating effective programs in clinical settings. This article discusses the development and implementation of the D4D&I Learning Hub. In addition, we evaluated the first four cohorts using the Kirkpatrick Evaluation Model.

人们越来越重视缩小研究与日常实践之间的差距。传播与实施(D&I)科学提供了理论、模型和框架,以加强新计划和干预措施的实施、影响和持续性。目前,很少有培训机会可以帮助领导者、研究人员、临床医生和工作人员(实施者)更及时、更有效地将原创研究成果转化到实践环境中,而不需要占用他们大量的时间来完成主要的临床工作。为了满足这些需求,我们设计了一个虚拟的 "传播与实施设计(D4D&I)学习中心",提供传播与实施的基础知识和技能培训机会。我们开发了 D4D&I 学习中心课程,在实施新项目或创新时,对新手进行多组件 D4D&I 实施策略捆绑培训。D4D&I 战略包的组成部分包括:(i) 实施前评估,以进行前瞻性规划和多层次背景评估;(ii) 多层次合作伙伴参与,以了解对最终用户的重要性并获得认同;(iii) 在实施前评估的指导下实施和调整,同时保持计划的忠实性;(iv) 计划评估。我们利用虚拟电子学习平台、专家培训师、指导和虚拟学习合作组织来提供六个模块的课程,以支持参与者的成长和成功。我们根据柯克帕特里克评估模型,采用定量和定性方法对 D4D&I 学习中心进行评估。31 名参与者完成了 D4D&I 学习中心的四期课程。学员们认为 D4D&I 课程具有相关性且效果良好,表明他们获得了预期的知识和技能。在介绍他们的主要收获时,参与者提到,他们更加了解如何将各种 D&I 理论、模型和框架应用到他们的研究中,如何在实施和评估的各个阶段让多层次的合作伙伴参与进来,以及如何评估忠实性和适应性。与会者计划在今后的出版物、拨款申请以及在临床环境中实施新计划和项目时,将获得的 D&I 知识和技能融入其中。D4D&I 学习中心为 D&I 科学新手提供基础教育。它促进了临床环境中有效项目的设计、传播、实施和评估。本文讨论了 D4D&I 学习中心的开发和实施。此外,我们还采用柯克帕特里克评估模型对前四批学员进行了评估。
{"title":"The development and evaluation of the Designing for Dissemination and Implementation Learning Hub.","authors":"Michaela S McCarthy, Marina McCreight, Deisy Hernandez Lujan, Heidi Sjoberg, Catherine Battaglia","doi":"10.1093/tbm/ibae036","DOIUrl":"10.1093/tbm/ibae036","url":null,"abstract":"<p><p>There is a growing emphasis on reducing the gap between research and routine practice. Dissemination and Implementation (D&I) science offers theories, models, and frameworks to enhance the implementation, impact, and sustainment of new programs and interventions. Few training opportunities are available that help leaders, researchers, clinicians, and staff (implementers) translate original research into practice settings in a more timely and effective manner without requiring significant time away from their primary clinical duties. To address these needs, we designed a virtual Designing for Dissemination and Implementation (D4D&I) Learning Hub that offered foundational D&I knowledge and opportunities for skill building. We developed the D4D&I Learning Hub curricula to train novice participants in the multicomponent D4D&I implementation strategy bundle when implementing new programs or innovations. The components of the D4D&I strategy bundle include (i) Pre-implementation assessment for proactive planning and multilevel contextual assessment, (ii) Multilevel partner engagement to learn what is important to end-users and obtain buy-in, (iii) Implementation and adaptations guided by a pre-implementation assessment while retaining program fidelity, and (iv) Program evaluation. We utilized a virtual e-learning platform, expert trainers, mentorship, and a Virtual Learning Collaborative to deliver the six-module curricula to support participants' growth and success. We used quantitative and qualitative methods informed by the Kirkpatrick Evaluation Model to evaluate the D4D&I Learning Hub. Thirty-one participants completed the D4D&I Learning Hub across four cohorts. Participants found the D4D&I curricula relevant and favorable, indicating they acquired the intended knowledge and skills. In presentations of their key takeaways, participants cited a greater understanding of how to apply various D&I theories, models, and frameworks to their research, engage multilevel partners during all phases of implementation and evaluation, and assess fidelity and adaptations. Participants planned to incorporate the acquired D&I knowledge and skills in future publications, grant applications, and when implementing new programs and projects in clinical settings. The D4D&I Learning Hub provides foundational education for novice participants of D&I science. It promotes designing, disseminating, implementing, and evaluating effective programs in clinical settings. This article discusses the development and implementation of the D4D&I Learning Hub. In addition, we evaluated the first four cohorts using the Kirkpatrick Evaluation Model.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"653-660"},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of an internet-based insomnia intervention on suicidal ideation and associated correlates in veterans at elevated suicide risk. 基于互联网的失眠干预对自杀风险较高的退伍军人的自杀意念及相关联因素的影响。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-16 DOI: 10.1093/tbm/ibae032
Sarra Nazem, Shengnan Sun, Sean M Barnes, Lindsey L Monteith, Trisha A Hostetter, Jeri E Forster, Lisa A Brenner, Hanga Galfalvy, Fatemeh Haghighi

Improving public health approaches to suicide prevention requires scalable evidence-based interventions that can be easily disseminated. Given empirical data supporting the association between insomnia and suicide risk, internet-delivered insomnia interventions are promising candidates to meet this need. The purpose of this study was to examine whether an unguided internet-delivered cognitive-behavioral therapy for insomnia (iCBT-I) improved insomnia severity, suicidal ideation (SI), and suicide risk correlates (depression, post-traumatic stress disorder, anxiety, hostility, belongingness, hopelessness, agitation, irritability, concentration) in a sample of veterans. Secondary data analysis of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (n = 50) with clinically significant insomnia and elevated SI drawn from a larger randomized controlled trial (RCT) of an iCBT-I, Sleep Healthy Using the Internet (SHUTi). Two-sample t-tests or Wilcoxon rank sum tests were used to evaluate between-group differences (SHUTi vs. Insomnia Education Website control) in symptom improvement from baseline to post-intervention. SHUTi participants experienced a significant improvement in insomnia severity (P < .001; d = -1.08) and a non-significant with small (subthreshold medium) effect size reduction of SI (P = .17, d = 0.40), compared to control participants. Significant improvement in hopelessness was observed (medium effect size), with non-significant small to medium effect size reductions in most remaining suicide risk correlates. Self-administered iCBT-I was associated with improvements in insomnia severity in veterans at elevated risk for suicide. These preliminary findings suggest that SI and suicide risk correlates may improve following an iCBT-I intervention, demonstrating the need for future well-powered iCBT-I RCTs targeted for populations at elevated suicide risk.

要改进预防自杀的公共卫生方法,就必须采取易于推广的可扩展循证干预措施。鉴于实证数据支持失眠与自杀风险之间的关联,通过互联网提供的失眠干预措施有望满足这一需求。本研究的目的是在退伍军人样本中研究一种无指导的互联网传播失眠认知行为疗法(iCBT-I)是否能改善失眠严重程度、自杀意念(SI)和自杀风险相关因素(抑郁、创伤后应激障碍、焦虑、敌意、归属感、绝望、烦躁、易怒、注意力不集中)。对 "持久自由行动"、"伊拉克自由行动 "和 "新曙光行动 "的退伍军人(50 人)进行二次数据分析,这些退伍军人在临床上有明显的失眠症状,且 SI 升高,这些数据来自于一项更大规模的 iCBT-I 随机对照试验(RCT),即 "使用互联网实现健康睡眠"(SHUTi)。采用双样本 t 检验或 Wilcoxon 秩和检验来评估从基线到干预后症状改善情况的组间差异(SHUTi 与失眠教育网站对照组)。与对照组相比,SHUTi 参与者的失眠严重程度有明显改善(P < .001;d =-1.08),而 SI 的减少则不明显,只有很小(亚阈值中等)的影响大小(P = .17,d = 0.40)。与对照组相比,无望感有显著改善(中等效应),其余大多数自杀风险相关因素均有非显著性的小到中等效应降低。在自杀风险较高的退伍军人中,自我管理的 iCBT-I 与失眠严重程度的改善相关。这些初步研究结果表明,在接受 iCBT-I 干预后,SI 和自杀风险相关因素可能会得到改善,这表明今后有必要针对自杀风险较高的人群进行有充分证据支持的 iCBT-I RCT 研究。
{"title":"Impact of an internet-based insomnia intervention on suicidal ideation and associated correlates in veterans at elevated suicide risk.","authors":"Sarra Nazem, Shengnan Sun, Sean M Barnes, Lindsey L Monteith, Trisha A Hostetter, Jeri E Forster, Lisa A Brenner, Hanga Galfalvy, Fatemeh Haghighi","doi":"10.1093/tbm/ibae032","DOIUrl":"10.1093/tbm/ibae032","url":null,"abstract":"<p><p>Improving public health approaches to suicide prevention requires scalable evidence-based interventions that can be easily disseminated. Given empirical data supporting the association between insomnia and suicide risk, internet-delivered insomnia interventions are promising candidates to meet this need. The purpose of this study was to examine whether an unguided internet-delivered cognitive-behavioral therapy for insomnia (iCBT-I) improved insomnia severity, suicidal ideation (SI), and suicide risk correlates (depression, post-traumatic stress disorder, anxiety, hostility, belongingness, hopelessness, agitation, irritability, concentration) in a sample of veterans. Secondary data analysis of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (n = 50) with clinically significant insomnia and elevated SI drawn from a larger randomized controlled trial (RCT) of an iCBT-I, Sleep Healthy Using the Internet (SHUTi). Two-sample t-tests or Wilcoxon rank sum tests were used to evaluate between-group differences (SHUTi vs. Insomnia Education Website control) in symptom improvement from baseline to post-intervention. SHUTi participants experienced a significant improvement in insomnia severity (P < .001; d = -1.08) and a non-significant with small (subthreshold medium) effect size reduction of SI (P = .17, d = 0.40), compared to control participants. Significant improvement in hopelessness was observed (medium effect size), with non-significant small to medium effect size reductions in most remaining suicide risk correlates. Self-administered iCBT-I was associated with improvements in insomnia severity in veterans at elevated risk for suicide. These preliminary findings suggest that SI and suicide risk correlates may improve following an iCBT-I intervention, demonstrating the need for future well-powered iCBT-I RCTs targeted for populations at elevated suicide risk.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"673-683"},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Scalable and successful patient portal lifestyle coaching training for primary care clinical staff. 为初级保健临床人员提供可扩展的、成功的患者门户生活方式指导培训。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-16 DOI: 10.1093/tbm/ibae047
Maribel Cedillo, Jesell Zepeda, Bernadette Kiraly, Michael Flynn, Paulina Larios Elizalde, Emily Zheutlin, Elizabeth A Rudd, Polina V Kukhareva, Jorie M Butler, Rachel Hess, Kensaku Kawamoto, Paul Estabrooks, Molly B Conroy

Maintaining a healthy weight postintentional weight loss is crucial for preventing chronic health conditions, yet many regain weight postintervention. Electronic health record (EHR) portals offer a promising avenue for weight management interventions, leveraging patient-primary care relationships. Our previous research demonstrated that coaching alongside self-monitoring improves weight maintenance compared to monitoring alone. Integrating weight management into routine clinical practice by training existing staff could enhance scalability and sustainability. However, challenges such as inconsistent staff qualifications and high coach turnover rates could affect intervention effectiveness. Standardizing services, training, and coaching continuity seem crucial for success. To report on developing, testing, and evaluating an EHR-based coaching training program for clinical staff, guided by an implementation tool for the MAINTAIN PRIME study. Conducted across 14 University of Utah primary care sites, we developed, tested, and evaluated a coaching training for clinical staff. Guided by a planning model and the Predisposing, Enabling, and Reinforcing (PER) tool, stakeholders actively participated in planning, ensuring alignment with clinic priorities. All clinical staff were invited to participate voluntarily. Evaluation measures included staff interest, training effectiveness, confidence, and readiness. Data collection utilized REDCap, with survey results analyzed using descriptive statistics. Despite increased clinical workload and reassignments posed by coronavirus disease 2019, we were able to train 39 clinical staff, with 34 successfully coaching patients. Feedback indicated high readiness and positive perceptions of coaching feasibility. Coaches reported satisfaction with training, support, and enjoyed establishing connections with patients. The PER strategies allowed us to implement a well-received training program found effective by primary care coaches.

有意减肥后保持健康体重对预防慢性疾病至关重要,但许多人在干预后体重又会反弹。电子健康记录(EHR)门户网站为体重管理干预提供了一个前景广阔的途径,充分利用了患者与初级保健的关系。我们之前的研究表明,与单独监测相比,在进行自我监测的同时进行指导可改善体重维持情况。通过培训现有员工将体重管理纳入常规临床实践,可以提高可扩展性和可持续性。然而,员工资质不一致、教练流失率高等挑战可能会影响干预效果。标准化服务、培训和指导的连续性似乎是成功的关键。报告在 MAINTAIN PRIME 研究实施工具的指导下,为临床工作人员开发、测试和评估基于电子病历的辅导培训计划的情况。我们在犹他大学的 14 个初级医疗点开展了针对临床人员的辅导培训,并对其进行了测试和评估。在规划模型和倾向性、促成性和强化性(PER)工具的指导下,利益相关者积极参与规划,确保与诊所的优先事项保持一致。所有临床工作人员都被邀请自愿参加。评估措施包括员工兴趣、培训效果、信心和准备情况。数据收集使用了 REDCap,调查结果使用描述性统计进行分析。尽管 2019 年冠状病毒疾病增加了临床工作量并带来了重新分配,但我们仍培训了 39 名临床员工,其中 34 人成功辅导了患者。反馈显示,培训准备度很高,并对辅导的可行性持积极看法。教练们对培训和支持表示满意,并乐于与患者建立联系。PER 策略使我们能够实施一项广受欢迎的培训计划,初级保健教练认为该计划非常有效。
{"title":"Scalable and successful patient portal lifestyle coaching training for primary care clinical staff.","authors":"Maribel Cedillo, Jesell Zepeda, Bernadette Kiraly, Michael Flynn, Paulina Larios Elizalde, Emily Zheutlin, Elizabeth A Rudd, Polina V Kukhareva, Jorie M Butler, Rachel Hess, Kensaku Kawamoto, Paul Estabrooks, Molly B Conroy","doi":"10.1093/tbm/ibae047","DOIUrl":"10.1093/tbm/ibae047","url":null,"abstract":"<p><p>Maintaining a healthy weight postintentional weight loss is crucial for preventing chronic health conditions, yet many regain weight postintervention. Electronic health record (EHR) portals offer a promising avenue for weight management interventions, leveraging patient-primary care relationships. Our previous research demonstrated that coaching alongside self-monitoring improves weight maintenance compared to monitoring alone. Integrating weight management into routine clinical practice by training existing staff could enhance scalability and sustainability. However, challenges such as inconsistent staff qualifications and high coach turnover rates could affect intervention effectiveness. Standardizing services, training, and coaching continuity seem crucial for success. To report on developing, testing, and evaluating an EHR-based coaching training program for clinical staff, guided by an implementation tool for the MAINTAIN PRIME study. Conducted across 14 University of Utah primary care sites, we developed, tested, and evaluated a coaching training for clinical staff. Guided by a planning model and the Predisposing, Enabling, and Reinforcing (PER) tool, stakeholders actively participated in planning, ensuring alignment with clinic priorities. All clinical staff were invited to participate voluntarily. Evaluation measures included staff interest, training effectiveness, confidence, and readiness. Data collection utilized REDCap, with survey results analyzed using descriptive statistics. Despite increased clinical workload and reassignments posed by coronavirus disease 2019, we were able to train 39 clinical staff, with 34 successfully coaching patients. Feedback indicated high readiness and positive perceptions of coaching feasibility. Coaches reported satisfaction with training, support, and enjoyed establishing connections with patients. The PER strategies allowed us to implement a well-received training program found effective by primary care coaches.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"661-672"},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pre-implementation planning to enhance integration of HIV and behavioral health care services at two Ryan White-funded HIV care centers. 实施前规划,以加强两个瑞安-怀特资助的艾滋病毒护理中心的艾滋病毒和行为健康护理服务的整合。
IF 3.6 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-06 DOI: 10.1093/tbm/ibae046
Sophia A Hussen, Rosalind N Byrd, Kamini Doraivelu, Shamia J Moore, Daniel M Camp, Drew Wood-Palmer, Ameeta S Kalokhe, Eugene W Farber, Mohammed K Ali

Behavioral health conditions are disproportionately experienced by people living with Human immunodeficiency virus (HIV), including young Black gay, bisexual, and other men who have sex with men (GBMSM). Left unaddressed, these symptoms can adversely impact HIV care outcomes. Improving the integration of behavioral health and HIV care services has been proposed as a strategy to address this challenge. To conduct a pre-implementation study exploring barriers and facilitators to improving HIV and behavioral health care integration at two HIV clinics in Atlanta, Georgia. We conducted a mixed-methods study guided by the Consolidated Framework for Implementation Research (CFIR). Sixty (60) HIV care providers, behavioral health care providers, and social service providers participated in cross-sectional surveys, and a subset of survey participants (15) also participated in a qualitative in-depth interview to explore CFIR constructs in greater depth. We focused on Intervention Characteristics, Outer Setting, and Inner Setting as the most relevant CFIR domains. Within each of these domains, we identified both facilitators and barriers to improving HIV and behavioral care integration in the two clinics. Participants agreed that enhancing integration would provide a relative advantage over current practice, would address young Black GBMSM and other patient needs, and would be compatible with the organizational mission. However, they also expressed concerns about complexity, resource availability, and priority relative to other clinic initiatives. Participants were enthusiastic about improving care integration but also invoked practical challenges to translating this idea into practice. Future research should test specific implementation strategies and their potential effectiveness for improving the integration of behavioral health and HIV care, as a strategy for improving well-being among young Black GBMSM and other people living with HIV.

人类免疫缺陷病毒(HIV)感染者,包括年轻的黑人男同性恋、双性恋和其他男男性行为者(GBMSM)的行为健康状况尤为严重。这些症状如果得不到解决,会对艾滋病护理结果产生不利影响。改善行为健康与 HIV 护理服务的整合已被提出作为应对这一挑战的策略。我们在佐治亚州亚特兰大市的两家艾滋病诊所开展了一项实施前研究,以探索改善艾滋病和行为健康护理整合的障碍和促进因素。我们在实施研究综合框架 (CFIR) 的指导下开展了一项混合方法研究。六十(60)名艾滋病医疗服务提供者、行为医疗服务提供者和社会服务提供者参与了横断面调查,调查参与者的一部分(15 人)还参与了定性深入访谈,以更深入地探讨 CFIR 构建。我们将重点放在干预特征、外部环境和内部环境上,将其作为最相关的 CFIR 领域。在每个领域中,我们都确定了在两家诊所中加强艾滋病和行为治疗整合的促进因素和障碍。与会人员一致认为,与目前的做法相比,加强整合将提供相对优势,可以满足年轻黑人 GBMSM 和其他患者的需求,并且符合组织使命。然而,他们也表达了对复杂性、资源可用性以及相对于其他诊所计划的优先性的担忧。与会者对改善护理整合充满热情,但也提出了将这一想法付诸实践所面临的实际挑战。未来的研究应该检验具体的实施策略及其在改善行为健康与 HIV 护理整合方面的潜在有效性,以此作为改善年轻黑人 GBMSM 及其他 HIV 感染者福祉的策略。
{"title":"Pre-implementation planning to enhance integration of HIV and behavioral health care services at two Ryan White-funded HIV care centers.","authors":"Sophia A Hussen, Rosalind N Byrd, Kamini Doraivelu, Shamia J Moore, Daniel M Camp, Drew Wood-Palmer, Ameeta S Kalokhe, Eugene W Farber, Mohammed K Ali","doi":"10.1093/tbm/ibae046","DOIUrl":"10.1093/tbm/ibae046","url":null,"abstract":"<p><p>Behavioral health conditions are disproportionately experienced by people living with Human immunodeficiency virus (HIV), including young Black gay, bisexual, and other men who have sex with men (GBMSM). Left unaddressed, these symptoms can adversely impact HIV care outcomes. Improving the integration of behavioral health and HIV care services has been proposed as a strategy to address this challenge. To conduct a pre-implementation study exploring barriers and facilitators to improving HIV and behavioral health care integration at two HIV clinics in Atlanta, Georgia. We conducted a mixed-methods study guided by the Consolidated Framework for Implementation Research (CFIR). Sixty (60) HIV care providers, behavioral health care providers, and social service providers participated in cross-sectional surveys, and a subset of survey participants (15) also participated in a qualitative in-depth interview to explore CFIR constructs in greater depth. We focused on Intervention Characteristics, Outer Setting, and Inner Setting as the most relevant CFIR domains. Within each of these domains, we identified both facilitators and barriers to improving HIV and behavioral care integration in the two clinics. Participants agreed that enhancing integration would provide a relative advantage over current practice, would address young Black GBMSM and other patient needs, and would be compatible with the organizational mission. However, they also expressed concerns about complexity, resource availability, and priority relative to other clinic initiatives. Participants were enthusiastic about improving care integration but also invoked practical challenges to translating this idea into practice. Future research should test specific implementation strategies and their potential effectiveness for improving the integration of behavioral health and HIV care, as a strategy for improving well-being among young Black GBMSM and other people living with HIV.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":"598-610"},"PeriodicalIF":3.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Translational Behavioral Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1