Dissemination and Implementation of Evidence-Based Trauma Interventions for Youth

2020 ◽  
Author(s):  
Hilary E. Kratz ◽  
Mary L. Phan ◽  
Jacqueline E. Buck ◽  
Kelsey Sanner ◽  
Alexandra R. Tabachnick ◽  
...  
Keyword(s):  
United States ◽  
Implementation Science ◽  
Large Scale ◽  
The United States ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Trauma Informed ◽  
Practice Gap ◽  
Science Framework

Although a number of trauma treatments for youth have demonstrated efficacy in research settings, the promise of these treatments has not yet been realized via widespread implementation in usual care settings. Implementation science, the scientific study of methods to increase the adoption, uptake, and sustainment of evidence-based practices (EBPs), can help to inform this research-to-practice gap. This chapter applies principles from implementation science to review what has been learned so far about the dissemination and implementation of EBPs for youth impacted by trauma in the United States and the next steps for this field. First, the chapter describes the large-scale efforts that have been made in the United States to disseminate and implement these EBPs. Second, it applies an implementation science framework, the exploration, preparation, implementation, and sustainment framework, to organize what has been learned from these efforts about barriers and facilitators to implementation and sustainability. Third, a case study is presented illustrating how this knowledge was applied to develop a trauma-informed system of care in Philadelphia. Finally, the chapter offers research and practical recommendations to improve the dissemination and implementation of EBPs for trauma-affected youth.

Looking Backward but Moving Forward

2018 ◽  
Vol 39 (4) ◽  
pp. 543-568 ◽  
Author(s):  
Waapalaneexkweew (Nicole R. Bowman-Farrell, Mohican/Lunaape)
Keyword(s):  
United States ◽  
Policy Evaluation ◽  
Culturally Responsive ◽  
The United States ◽  
Evidence Based ◽  
Western Literature ◽  
Responsive Evaluation ◽  
European Contact ◽  
Practice Gap ◽  
Origin Story

Culturally responsive evaluation and culturally responsive Indigenous evaluation (CRIE) within the broader field of evaluation are not often included in Western literature nor are they known or used by the majority of mainstream evaluators. In order to address this literature and practice gap, this article offers an overview and a broader origin story of CRIE prior to colonial or European contact in the United States and gives an overview of the historical, theoretical, and practical foundations for conducting CRIE in a contemporary evaluation context. Examples of evidence-based models, theories, and resources are provided to connect CRIE to Western evaluation designs and provide concrete strategies for the field of evaluation going forward. The article concludes with systemic and policy evaluation considerations as agencies from federal (i.e., United States), tribal, and international governments and partners from private or nonprofit sectors collaborate to carry out Indigenous evaluations in the future. Collectively this multijurisdictional, culturally responsive, and community-centered CRIE approach gives evaluators a new way to move forward.

Unhealthy Politics

2020 ◽  
Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling
Keyword(s):  
United States ◽  
Health Care ◽  
Scientific Evidence ◽  
The United States ◽  
Evidence Base ◽  
Medical Industry ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Delivery Of Medical Care ◽  
Based Medicine

The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. This book sheds new light on why the government's response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy. The book paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor's orders.” It offers vital insights into the limits of science, expertise, and professionalism in American politics. The book explains why evidence-based medicine is important. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.

scholarly journals Implementation of the utility value intervention: An adaptation of implementation science frameworks for higher education teaching and learning research

2020 ◽  
Author(s):  
Raechel N. Soicher ◽  
Kathryn A. Becker-Blease
Keyword(s):  
Higher Education ◽  
Education Research ◽  
Implementation Science ◽  
Teaching And Learning ◽  
Evidence Based ◽  
Higher Education Research ◽  
Research Practice ◽  
Evidence Based Practices ◽  
Practical Applications ◽  
Practice Gap

The research-practice gap refers to the failure of empirical effectiveness research to translate meaningfully into practical applications. In higher education research, this is evident in the low use or uptake of evidence-based practices in college classrooms. To help address the research-practice gap, educational researchers can draw on theories, frameworks, and methodologies from implementation science. Implementation science is a field of research originating in public health specifically designed to study the variables related to the process of getting evidence-based practices into routine use. The present study adapted multiple frameworks and validated measures of implementation outcomes to identify the facilitators to and barriers of implementing a motivational intervention in university-level general psychology courses. The results highlight organizational, instructor, and student-level factors that influence implementation. The study itself provides a demonstration of how to incorporate elements of implementation science into higher education research.

Analysis of antibiotic use in a large network of emergency departments

2019 ◽  
Vol 76 (21) ◽  
pp. 1753-1761 ◽  
Author(s):  
Fredrick O’Neal ◽  
Joan Kramer ◽  
Mandelin Cooper ◽  
Edward Septimus ◽  
Sanya Sharma ◽  
...  
Keyword(s):  
United States ◽  
Health System ◽  
Emergency Departments ◽  
The United States ◽  
Evidence Based ◽  
Prescribing Practices ◽  
Evidence Based Practices ◽  
Infectious Origin ◽  
Tract Infections ◽  
Susceptibility Patterns

Abstract Purpose To assess antibiotic selection, administration, and prescribing practices in emergency departments across a large hospital system using evidence-based practices and susceptibility patterns. Methods This retrospective data review was conducted using health system–level electronic data compiled from 145 emergency departments (EDs) across the United States. Data were examined for national generalizability, most common diagnoses of infectious origin seen in nonadmitted patients in the ED, most commonly administered antibiotics in the ED, and geographically defined areas’ unique patterns of antibiotic resistance and susceptibility. Results More than 627,000 unique patient encounters and 780,000 antibiotic administrations were assessed for trends in patient demographics, antibiotics administered for a diagnosis of infectious origin, and corresponding susceptibility patterns. Results indicated that practices in the EDs of this health system aligned with evidence-based practices for streptococcal pharyngitis, otitis media, cellulitis, and uncomplicated urinary tract infections. Conclusion These results provide a representative sample of the current state of practices within many EDs across the United States for nonadmitted patients. A similar data reconstruction can be completed by other health systems to assess their prescribing practices in the ED to improve and elevate care for patients visiting the emergency room and treated as outpatients.

Who gets coached? A qualitative inquiry into community clinicians’ decisions to use caregiver coaching

Autism ◽  
2021 ◽  
pp. 136236132110594
Author(s):  
Liza Tomczuk ◽  
Rebecca E Stewart ◽  
Rinad S Beidas ◽  
David S Mandell ◽  
Melanie Pellecchia
Keyword(s):  
United States ◽  
Early Intervention ◽  
The United States ◽  
Evidence Based ◽  
Autistic Children ◽  
Evidence Based Practices ◽  
Quality Of Evidence ◽  
Marginalized Groups ◽  
Vulnerable Families

Clinicians’ beliefs about an intervention’s fit with an individual family influence whether they use it with that family. The factors that influence clinicians’ decisions to implement evidence-based practices for young autistic children have yet to be evaluated systematically. These factors may partially account for the significant disparities in quality of and access to early intervention. We examined disparities in clinicians’ reported use of caregiver coaching, an evidence-based practice, with families from minoritized or structurally marginalized groups, and the perceived reasons for those disparities, to assess the factors that influence clinicians’ use of caregiver coaching. We conducted semi-structured interviews with 36 early intervention clinicians from publicly funded early intervention agencies in two distinct geographic regions in the United States. Clinicians identified social and structural factors, including perceived family characteristics and stigma, that influenced their beliefs about the fit of coaching with families from minoritized or structurally marginalized groups. These findings point to the presence of beliefs that likely exacerbate disparities in access to evidence-based practices and reduce the quality of care for minoritized families of young autistic children. These findings highlight the need to develop and deploy equity-focused implementation strategies to improve both access to and quality of evidence-based practices for young autistic children from minoritized groups. Lay abstract Providers’ beliefs about an intervention’s fit with a family can affect whether or not they use that intervention with a family. The factors that affect providers’ decisions to use evidence-based practices for young autistic children have not been studied. These factors may play a role in the major differences we see in the quality of and access to early intervention services in the community. We looked at differences in providers’ use of caregiver coaching, an evidence-based practice, with families from minority or vulnerable backgrounds, and the possible reasons for those differences. We did this to figure out what factors affect providers’ use of caregiver coaching. We interviewed 36 early intervention providers from early intervention agencies in two different parts of the United States. Providers pointed out things like what they thought about a family’s circumstances that affected their beliefs about how well coaching fits with minority and vulnerable families. Our findings bring attention to these beliefs that likely make accessing evidence-based practices for minority and vulnerable families harder and lessen the quality of care for these families of young autistic children. These findings highlight the need to come up with and use strategies to improve both access to and the quality of evidence-based practices for young autistic children from minority and vulnerable groups.

Introduction

2020 ◽  
pp. 1-20
Author(s):  
Eric M. Patashnik ◽  
Alan S. Gerber ◽  
Conor M. Dowling
Keyword(s):  
United States ◽  
Health Care ◽  
Resource Allocation ◽  
Scientific Evidence ◽  
The United States ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Delivery Of Medical Care ◽  
Based Medicine

This introductory chapter explains why evidence-based medicine is important. The sluggish incorporation of medical evidence into clinical practice is a concern for three key reasons: safety, quality, and the efficiency of resource allocation. First, the delivery of unproven care can expose patients to serious risks. Second, the slow integration of evidence can lead to suboptimal outcomes for patients who receive treatments that work less well for their conditions than alternatives. Third, the failure to implement evidence-based practices encourages wasteful spending, causing the health care system to underperform relative to its level of investment. This book assesses whether the delivery of medical care in the United States is evidence based. It argues that by systematically ignoring scientific evidence (or the lack thereof), the United States is substantially out of balance.

Juvenile Homicide in the United States: Sizing Up the Problem and Moving Forward

2021 ◽  
pp. 108876792110438
Author(s):  
Kathleen M. Heide
Keyword(s):  
United States ◽  
The United States ◽  
Evidence Based ◽  
Court Cases ◽  
Evidence Based Practices ◽  
Juvenile Violence ◽  
Us Supreme Court ◽  
Juvenile Homicide ◽  
Juvenile Arrests ◽  
Juvenile Murderers

Juvenile murder arrests in the United States increased dramatically from 1984 to 1993, leading experts to forecast an epidemic of continued violence. Juvenile arrests for murder from 1995 to 2019 are examined to assess whether this prediction was correct. Changes in the laws in response to juvenile violence and US Supreme Court cases that addressed constitutional limitations to the punishment of juvenile murderers are synthesized. The evolution of research on juvenile homicide offenders over the last two decades is highlighted. Recommendations about ways to move forward by using evidence-based practices to prevent juvenile violence and to reduce recidivism are discussed.

scholarly journals Implementation Science Research Examining the Integration of Evidence-Based Practices Into HIV Prevention and Clinical Care: Protocol for a Mixed-Methods Study Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) Model (Preprint)

2018 ◽  
Author(s):  
April Idalski Carcone ◽  
Karin Coyle ◽  
Sitaji Gurung ◽  
Demetria Cain ◽  
Rafael E Dilones ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hiv Prevention ◽  
Implementation Science ◽  
Real World ◽  
Clinical Care ◽  
The United States ◽  
Barriers And Facilitators ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Ebp Implementation

BACKGROUND The Exploration, Preparation, Implementation, and Sustainment (EPIS) model is an implementation framework for studying the integration of evidence-based practices (EBPs) into real-world settings. The EPIS model conceptualizes implementation as a process starting with the earliest stages of problem recognition (Exploration) through the continued use of an EBP in a given clinical context (Sustainment). This is the first implementation science (IS) study of the integration of EBPs into adolescent HIV prevention and care settings. OBJECTIVE This protocol (ATN 153 EPIS) is part of the Scale It Up program, a research program administered by the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN), described in this issue by Naar et al. The EPIS study is a descriptive study of the uptake of 4 EBPs within the Scale It Up program. The goal of EPIS is to understand the barriers and facilitators associated with the Preparation, Implementation, and Sustainment of EBPs into HIV prevention and clinical care settings. METHODS The EPIS study is a convergent parallel mixed-methods IS study. Key implementation stakeholders, that is, clinical care providers and leaders, located within 13 ATN sites across the United States will complete a qualitative interview conducted by telephone and Web-based surveys at 3 key implementation stages. The Preparation assessment occurs before EBP implementation, Implementation occurs immediately after sites finish implementation activities and prepare for sustainment, and Sustainment occurs 1 year postimplementation. Assessments will examine stakeholders’ perceptions of the barriers and facilitators to EBP implementation within their clinical site as outlined by the EPIS framework. RESULTS The EPIS baseline period began in June 2017 and concluded in May 2018; analysis of the baseline data is underway. To date, 153 stakeholders have completed qualitative interviews, and 91.5% (140/153) completed the quantitative survey. CONCLUSIONS The knowledge gained from the EPIS study will strengthen the implementation and sustainment of EBPs in adolescent prevention and clinical care contexts by offering insights into the barriers and facilitators of successful EBP implementation and sustainment in real-world clinical contexts. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11202

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