From research to practice: a model for clinical implementation of evidence-based outpatient interventions for eating disorders

Abstract Background A question frequently raised in the field is whether evidence-based interventions have adequate translational capacity for delivery in real-world settings where patients are presumed to be more complex, clinicians less specialized, and multidisciplinary teams less coordinated. The dual purpose of this article is to (a) outline a model for implementing evidence-driven, outpatient treatments for eating disorders in a non-academic clinical setting, and (b) report indicators of feasibility and quality of care. Main Body Since our inception (2015), we have completed nearly 1000 phone intakes, with first-quarter 2021 data suggesting an increase in the context of COVID-19. Our caseload for the practice currently consists of approximately 200 active patients ranging from 6 to 66 years of age. While the center serves a transdiagnostic and trans-developmental eating disorder population, modal concerns for which we receive inquiries are Anorexia Nervosa and Avoidant Restrictive Food Intake Disorder, with the most common age range for prospective patients spanning childhood through late adolescence/emerging adulthood; correspondingly, the modal intervention employed is Family-based treatment. Our team for each case consists, at a minimum, of a primary internal therapist and a physician external to the center. Short Conclusion We will describe our processes of recruiting, training and coordinating team members, of ensuring ongoing fidelity to evidence-based interventions, and of training the next generation of clinicians. Future research will focus on a formal assessment of patient outcomes, with comparison to benchmark outcomes from randomized controlled trials.

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Family-based treatment for children and adolescents with eating disorders: a mixed-methods evaluation of a blended evidence-based implementation approach

Translational Behavioral Medicine ◽

10.1093/tbm/ibz160 ◽

2019 ◽

Author(s):

Jennifer Couturier ◽

Melissa Kimber ◽

Melanie Barwick ◽

Tracy Woodford ◽

Gail Mcvey ◽

...

Keyword(s):

Eating Disorders ◽

Qualitative Interviews ◽

Readiness For Change ◽

Qualitative Description ◽

Evidence Based ◽

Organizational Readiness For Change ◽

Implementation Approach ◽

Fidelity Assessment ◽

Family Based Treatment ◽

Family Based

Abstract In this study, we evaluated a blended implementation approach with teams learning to provide family-based treatment (FBT) to adolescents with eating disorders. Four sites participated in a sequential mixed method pre–post study to evaluate the implementation of FBT in their clinical settings. The implementation approach included: (a) preparatory site visits; (b) the establishment of implementation teams; (c) a training workshop; (d) monthly clinical consultation; (e) monthly implementation consultation; and (f) fidelity assessment. Quantitative measures examining attitudes toward evidence-based practice, organizational learning environment and organizational readiness for change, as well as, individual readiness for change were delivered pre- and postimplementation. Correlational analyses were used to examine associations between baseline variables and therapist fidelity to FBT. Fundamental qualitative description guided the sampling and data collection for the qualitative interviews performed at the conclusion of the study. Seventeen individuals participated in this study (nine therapists, four medical practitioners, and four administrators). The predetermined threshold of implementation success of 80% fidelity in every FBT session was achieved by only one therapist. However, mean fidelity scores were similar to those reported in other studies. Participant attitudes, readiness, and self-efficacy were not associated with fidelity and did not change significantly from pre- to postimplementation. In qualitative interviews, all participants reported that the implementation intervention was helpful in adopting FBT. Our blended implementation approach was well received by participants. A larger trial is needed to determine which implementation factors predict FBT fidelity and impact patient outcomes.

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Music-Based Interventions with Informal Caregivers of Adult Care Recipients: An Integrative Review

Music and Medicine ◽

10.47513/mmd.v12i3.667 ◽

2020 ◽

Vol 12 (3) ◽

pp. 177

Author(s):

Lindsey Wilhelm ◽

Kyle Wilhelm

Keyword(s):

Family Caregivers ◽

Informal Caregivers ◽

Primary Sources ◽

Future Research ◽

Evidence Based ◽

Music Listening ◽

Adult Care ◽

Music Therapists ◽

Care Recipients

Music therapists work with individuals with a wide variety of diagnoses, but minimal attention has been paid to informal caregivers caring for adults with these diagnoses. While some evidence for the use of music-based interventions (MBIs) has been presented in primary sources, a synthesis of current literature is needed to inform evidence-based practice. The purpose of this study was to identify what MBIs have been used with informal caregivers, the effects of these interventions, whether the interventions adequately fulfill the personal needs of caregivers as identified in previous literature, and the quality of MBI reporting. Ten studies met the predetermined criteria. Singing and music listening were the most frequently used interventions. Benefits for caregivers include self- and relationship-focused outcomes. The type of benefit (self- or relationship-focused) appears to be related to the participant unit of delivery of the MBI. Future research is necessary to replicate the outcomes of MBIs for informal caregivers reported in this review, and there is a need for increased transparency in reporting.Keywords: family caregivers, informal caregivers, music, music-based intervention

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Anxiety Disorders

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0044 ◽

2021 ◽

pp. 338-344

Author(s):

Ashley M. Nelson ◽

Chelsea S. Rapoport ◽

Lara Traeger ◽

Joseph A. Greer

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Anxiety Disorders ◽

Multidisciplinary Team ◽

Assessment Methods ◽

Future Research ◽

Evidence Based ◽

Mental Health Clinicians ◽

Patient Centered

The focus of this chapter is on the clinical manifestation of anxiety disorders in patients diagnosed with cancer. We review the prevalence and correlates, presenting characteristics, assessment methods and recommendations, and evidence-based pharmacologic and psychosocial treatments of anxiety in this population. Cancer-related considerations that may impact care and treatment planning are highlighted. Close collaboration between oncology and mental health clinicians as well as between the patient and their multidisciplinary team is essential for developing a patient-centered approach for managing anxiety, improving quality of life, and supporting participation in cancer care. The chapter concludes with discussion of key directions for future research on anxiety disorders in the oncology setting.

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Emotion Regulation and Eating Disorders

Emotion Regulation and Psychopathology in Children and Adolescents ◽

10.1093/med:psych/9780198765844.003.0010 ◽

2017 ◽

pp. 196-209

Author(s):

Julian Baudinet ◽

Lisa Dawson ◽

Sloane Madden ◽

Phillipa Hay

Keyword(s):

Eating Disorders ◽

Emotion Regulation ◽

Anorexia Nervosa ◽

Evidence Based ◽

Improve Treatment ◽

Novel Approach ◽

Evidence Based Treatments ◽

Regulation Strategies ◽

Family Based ◽

Adolescent Eating Disorders

Chapter 10 discusses the prevalence and manifestation of childhood and adolescent eating disorders focusing on Anorexia Nervosa (AN), due to its prevalence. Implementation of maladaptive emotion regulation strategies, with a reduced ability to label and describe emotions leads to the development and propagation of AN. Family based treatments have been widely recognized, as the leading intervention for adolescents with AN, with efficacy rates from 20% to 60%. However, this chapter focuses on a novel approach to AN treatment, centered on emotion regulation in its management, as this may improve treatment outcomes. Programs include: Maudsley Model of Anorexia Nervosa Treatment for Adults and Emotion Acceptance Behavior Therapy, in addition to the modification or adaption of existing, evidence based treatments, such as Radically-Open DBT, although many programs require empirical validation in adolescent samples.

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3.7 SEX DIFFERENCES IN WEIGHT RESTORATION AND QUALITY OF LIFE AFTER FAMILY-BASED TREATMENT OF CHILDREN AND ADOLESCENTS WITH RESTRICTIVE EATING DISORDERS

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2016.09.138 ◽

2016 ◽

Vol 55 (10) ◽

pp. S143-S144

Author(s):

Dallas Argueso ◽

Laurel Weaver ◽

Rebecka Peebles

Keyword(s):

Quality Of Life ◽

Eating Disorders ◽

Sex Differences ◽

Children And Adolescents ◽

Restrictive Eating ◽

Weight Restoration ◽

Family Based Treatment ◽

Family Based

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An Empirical Review of Peer-Mediated Interventions: Implications for Young Children With Autism Spectrum Disorders

Focus on Autism and Other Developmental Disabilities ◽

10.1177/1088357616671295 ◽

2016 ◽

Vol 33 (3) ◽

pp. 131-141 ◽

Cited By ~ 6

Author(s):

Alison L. Zagona ◽

Ann M. Mastergeorge

Keyword(s):

Social Communication ◽

Rating Scale ◽

Children With Autism ◽

Autism Spectrum ◽

Preschool Age ◽

Future Research ◽

Evidence Based ◽

Social Communication Skills ◽

Communication Needs

Peer-mediated instruction and intervention (PMII) is a systematic, evidence-based method for addressing the social-communication needs of children with autism spectrum disorder (ASD). Despite existing research on this practice, gaps remain in the implementation of PMII. The purpose of this empirical review was to examine recent applications of this evidence-based practice and systematically assess the quality of the analytic approaches implemented. Recent studies selected for this review included participants with ASD and targeted social-communication skills. The Scientific Merit Rating Scale (SMRS) was used to review the quality of the research studies, and the results suggest that PMII continues to be an effective practice. These results indicate that future research should focus on larger study Ns, particularly for those who are preschool-age, and include measures of generalization and maintenance as well as treatment integrity measures of peers’ actions. The effectiveness of PMII relative to positive developmental outcomes is discussed.

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The Impact of Malocclusion/Orthodontic Treatment Need on the Quality of Life

The Angle Orthodontist ◽

10.2319/042108-224.1 ◽

2009 ◽

Vol 79 (3) ◽

pp. 585-591 ◽

Cited By ~ 101

Author(s):

Zhijian Liu ◽

Colman McGrath ◽

Urban Hägg

Keyword(s):

Quality Of Life ◽

Orthodontic Treatment ◽

Meta Analysis ◽

Current Evidence ◽

Future Research ◽

Evidence Based ◽

Treatment Need ◽

Methodologic Quality ◽

The Impact

Abstract Objective: To assess the current evidence of the relationship between malocclusion/orthodontic treatment need and quality of life (QoL). Materials and Methods: Four electronic databases were searched for articles concerning the impact of malocclusion/orthodontic treatment need on QoL published between January 1960 and December 2007. Electronic searches were supplemented by manual searches and reference linkages. Eligible literature was reviewed and assessed by methodologic quality as well as by analytic results. Results: From 143 reviewed articles, 23 met the inclusion criteria and used standardized health-related QoL (HRQoL) and orthodontic assessment measures. The majority of studies (18/23) were conducted among child/adolescent populations. Seventeen of the papers were categorized as level 1 or 2 evidence based on the criteria of the Oxford Centre for Evidence-Based Medicine. An observed association between HRQoL and malocclusion/orthodontic treatment need was generally detected irrespective of how they were assessed. However, the strength of the association could be described as modest at best. Key findings and future research considerations are described in the review. Conclusions: Findings of this review suggest that there is an association (albeit modest) between malocclusion/orthodontic treatment need and QoL. There is a need for further studies of their relationship, particularly studies that employ standardized assessment methods so that outcomes are uniform and thus amenable to meta-analysis.

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Evidence-Based Healthcare: The Importance of Effective Interprofessional Working for High Quality Veterinary Services, a UK Example

Veterinary Evidence ◽

10.18849/ve.v1i4.54 ◽

2016 ◽

Vol 1 (4) ◽

Cited By ~ 1

Author(s):

Tierney Kinnison ◽

Stephen A May

Keyword(s):

Service Delivery ◽

Evidence Base ◽

Patient Treatment ◽

Future Research ◽

Evidence Based ◽

Veterinary Services ◽

Interprofessional Working ◽

Evidence Based Healthcare ◽

The Uk

Objective: To highlight the importance of evidence-based research, not only for the consideration of clinical diseases and individual patient treatment, but also for investigating complex healthcare systems, as demonstrated through a focus on veterinary interprofessional working.Background:Evidence-Based Veterinary Medicine (EBVM) was developed due to concerns over inconsistent approaches to therapy being delivered by individuals. However, a focus purely on diagnosis and treatment will miss other potential causes of substandard care including the holistic system. Veterinary services are provided by interprofessional teams; research on these teams is growing.Evidentiary value:This paper outlines results from four articles, written by the current authors, which are unique in their focus on interprofessional practice teams in the UK. Through mixed methods, the articles demonstrate an evidence base of the effects of interprofessional working on the quality of service delivery.Results:The articles explored demonstrate facilitators and challenges of the practice system on interprofessional working and the outcomes, including errors. The results encourage consideration of interprofessional relationships and activities in veterinary organisations. Interprofessional working is an example of one area which can affect the quality of veterinary services.Conclusion: The papers presented on veterinary interprofessional working are an example of the opportunities for future research on various topics within evidence-based healthcare.Application:The results are pertinent to members of veterinary teams seeking to improve their service delivery, to educators looking to enhance their students’ understanding of interprofessional working, and to researchers, who will hopefully be encouraged to consider evidence-based healthcare more holistically. <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />

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REGISTERING AND REPORTING SYSTEMATIC REVIEWS

Central Asian Journal of Medical Hypotheses and Ethics ◽

10.47316/cajmhe.2020.1.2.03 ◽

2021 ◽

Vol 1 (2) ◽

pp. 122-126

Author(s):

Pallavi Patro ◽

Durga Prasanna Misra

Keyword(s):

Systematic Reviews ◽

Observational Studies ◽

Meta Analysis ◽

Future Research ◽

Evidence Based ◽

Extensive Literature ◽

Literature Searches ◽

Review Question ◽

Based Medicine

Systematic reviews are considered as the highest rung in the ladder of evidence-based medicine. They are bound by a pre-defined structure and requirement for extensive literature searches, when compared with the more liberal format of narrative reviews. Systematic review protocols should ideally be pre-registered to avoid duplication or redundancy. After defining clear review question(s), thorough literature searches form the basis of systematic reviews. Presentation of results should be qualitative or quantitative (meta-analysis) if the data is homogenous enough to permit pooling across multiple studies. Quality of individual studies by Cochrane risk of bias 2 tool for interventional studies and other suitable scales for observational studies, as well as appropriate assessment of publication bias are recommended. Certainty of outcomes should be assessed by the GRADE profiler. Finally, systematic reviews should conclude with recommendations for future research, based on their findings.

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Introducing the Q-strip to Quantitatively Measure Nocturnal Perspiration as a Parameter and Predictor: A Review of Literature

10.20944/preprints202004.0418.v1 ◽

2020 ◽

Author(s):

Kasper Jolink ◽

Loussi Bedrosian

Keyword(s):

Clinical Practice ◽

Single Case ◽

Future Research ◽

Evidence Based ◽

Single Case Study ◽

Review Of Literature ◽

Quality Of Sleep ◽

Common Clinical Practice

One third of a person’s life is spent on sleep, therefore the quality and habit of sleep affects health. A single case study indicated that perspiration could serve as a prognostic marker. Diagnosing nocturnal perspiration is common clinical practice, since this serves as a major symptom in many pathologies. Till this day no specific evidence-based approach for diagnosing nocturnal perspiration exists. By introducing the Q-strip, a device which quantitatively measures nocturnal perspiration, this could be acquired. The Q-strip could serve a purpose in diagnosing nocturnal perspiration more efficient without being intrusive. In addition to its health sensing potentials, the Q-strip makes it possible to visualise perspiration patterns. This introduces the possibility to examine the quality of sleep. Future research is recommended to investigate this.

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