scholarly journals Community Stakeholder Preferences for Evidence-Based Practice Implementation Strategies in Behavioral Health: A Best-Worst Scaling Choice Experiment

2020 ◽  
Author(s):  
Nathaniel Williams ◽  
Molly Candon ◽  
Rebecca Stewart ◽  
Y. Vivian Byeon ◽  
Meenakshi Bewtra ◽  
...  
Keyword(s):  
Behavioral Health ◽  
Performance Feedback ◽  
Financial Incentives ◽  
Choice Experiment ◽  
Latent Class ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Clinical Consultation ◽  
Best Worst Scaling ◽  
Stakeholder Preferences

Abstract Background: Community behavioral health clinicians, supervisors, and administrators play an essential role in implementing new psychosocial evidence-based practices (EBP) for patients receiving psychiatric care; however, little is known about these stakeholders’ values and preferences for implementation strategies that support EBP use, nor how best to elicit, quantify, or segment their preferences. This study sought to quantify clinician, supervisor, and administrator preferences for implementation strategies and to identify segments of these stakeholders with distinct preferences using a rigorous choice experiment method called best-worst scaling (BWS). Methods: A total of 240 clinicians, 74 clinical supervisors, and 29 administrators delivering publicly funded behavioral health services in a large metropolitan behavioral health system participated in a best-worst scaling choice experiment. Participants evaluated 14 implementation strategies developed through extensive elicitation and pilot work within the target system. Preference weights were generated for each strategy using hierarchical Bayesian estimation. Latent class analysis identified segments of stakeholders with unique preference profiles. Results: On average, clinicians, supervisors, and administrators preferred two strategies significantly more than all others—compensation for use of EBP per session and compensation for preparation time to use the EBP; two strategies were preferred significantly less than all others—performance feedback via email and performance feedback via leaderboard. However, latent class analysis identified four distinct segments of stakeholders with unique preferences: Segment 1 (n = 121, 35%) strongly preferred financial incentives over all other approaches; Segment 2 (n = 80, 23%) preferred technology-based strategies; Segment 3 (n = 52, 15%) preferred an improved waiting room to enhance client readiness and strongly disliked any type of clinical consultation; Segment 4 (n = 90, 26%) rejected financial incentives and strongly preferred strategies focused on clinical consultation. Conclusions: The presence of four heterogeneous subpopulations within this large group of behavioral health administrators, supervisors, and clinicians suggests optimal implementation may be achieved through targeted strategies derived via elicitation of stakeholder preferences. Best-worst scaling is a feasible, systematic, and rigorous method for eliciting stakeholders’ implementation preferences and identifying subpopulations with unique preferences in behavioral health settings.

scholarly journals Community stakeholder preferences for evidence-based practice implementation strategies in behavioral health: A best-worst scaling choice experiment

2020 ◽  
Author(s):  
Nathaniel Williams ◽  
Molly Candon ◽  
Rebecca Stewart ◽  
Y. Vivian Byeon ◽  
Meenakshi Bewtra ◽  
...  
Keyword(s):  
Latent Class Analysis ◽  
Behavioral Health ◽  
Performance Feedback ◽  
Choice Experiment ◽  
Latent Class ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Clinical Consultation ◽  
Best Worst Scaling ◽  
Stakeholder Preferences

Abstract Background: Community behavioral health clinicians, supervisors, and administrators play an essential role in implementing new psychosocial evidence-based practices (EBP) for patients receiving psychiatric care; however, little is known about these stakeholders’ values and preferences for implementation strategies that support EBP use, nor how best to elicit, quantify, or segment their preferences. This study sought to quantify these stakeholders’ preferences for implementation strategies and to identify segments of stakeholders with distinct preferences using a rigorous choice experiment method called best-worst scaling. Methods: A total of 240 clinicians, 74 clinical supervisors, and 29 administrators employed within clinics delivering publicly-funded behavioral health services in a large metropolitan behavioral health system participated in a best-worst scaling choice experiment. Participants evaluated 14 implementation strategies developed through extensive elicitation and pilot work within the target system. Preference weights were generated for each strategy using hierarchical Bayesian estimation. Latent class analysis identified segments of stakeholders with unique preference profiles. Results: On average, stakeholders preferred two strategies significantly more than all others—compensation for use of EBP per session and compensation for preparation time to use the EBP (P<.05); two strategies were preferred significantly less than all others—performance feedback via email and performance feedback via leaderboard (P<.05). However, latent class analysis identified four distinct segments of stakeholders with unique preferences: Segment 1 (n = 121, 35%) strongly preferred financial incentives over all other approaches and included more administrators; Segment 2 (n = 80, 23%) preferred technology-based strategies and was younger, on average; Segment 3 (n = 52, 15%) preferred an improved waiting room to enhance client readiness, strongly disliked any type of clinical consultation, and had the lowest participation in local EBP training initiatives; Segment 4 (n = 90, 26%) strongly preferred clinical consultation strategies and included more clinicians in substance use clinics. Conclusions: The presence of four heterogeneous subpopulations within this large group of clinicians, supervisors, and administrators suggests optimal implementation may be achieved through targeted strategies derived via elicitation of stakeholder preferences. Best-worst scaling is a feasible and rigorous method for eliciting stakeholders’ implementation preferences and identifying subpopulations with unique preferences in behavioral health settings.

scholarly journals Community stakeholder preferences for evidence-based practice implementation strategies in behavioral health: a best-worst scaling choice experiment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nathaniel J. Williams ◽  
Molly Candon ◽  
Rebecca E. Stewart ◽  
Y. Vivian Byeon ◽  
Meenakshi Bewtra ◽  
...  
Keyword(s):  
Latent Class Analysis ◽  
Behavioral Health ◽  
Performance Feedback ◽  
Choice Experiment ◽  
Latent Class ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Clinical Consultation ◽  
Best Worst Scaling ◽  
Stakeholder Preferences

Abstract Background Community behavioral health clinicians, supervisors, and administrators play an essential role in implementing new psychosocial evidence-based practices (EBP) for patients receiving psychiatric care; however, little is known about these stakeholders’ values and preferences for implementation strategies that support EBP use, nor how best to elicit, quantify, or segment their preferences. This study sought to quantify these stakeholders’ preferences for implementation strategies and to identify segments of stakeholders with distinct preferences using a rigorous choice experiment method called best-worst scaling. Methods A total of 240 clinicians, 74 clinical supervisors, and 29 administrators employed within clinics delivering publicly-funded behavioral health services in a large metropolitan behavioral health system participated in a best-worst scaling choice experiment. Participants evaluated 14 implementation strategies developed through extensive elicitation and pilot work within the target system. Preference weights were generated for each strategy using hierarchical Bayesian estimation. Latent class analysis identified segments of stakeholders with unique preference profiles. Results On average, stakeholders preferred two strategies significantly more than all others—compensation for use of EBP per session and compensation for preparation time to use the EBP (P < .05); two strategies were preferred significantly less than all others—performance feedback via email and performance feedback via leaderboard (P < .05). However, latent class analysis identified four distinct segments of stakeholders with unique preferences: Segment 1 (n = 121, 35%) strongly preferred financial incentives over all other approaches and included more administrators; Segment 2 (n = 80, 23%) preferred technology-based strategies and was younger, on average; Segment 3 (n = 52, 15%) preferred an improved waiting room to enhance client readiness, strongly disliked any type of clinical consultation, and had the lowest participation in local EBP training initiatives; Segment 4 (n = 90, 26%) strongly preferred clinical consultation strategies and included more clinicians in substance use clinics. Conclusions The presence of four heterogeneous subpopulations within this large group of clinicians, supervisors, and administrators suggests optimal implementation may be achieved through targeted strategies derived via elicitation of stakeholder preferences. Best-worst scaling is a feasible and rigorous method for eliciting stakeholders’ implementation preferences and identifying subpopulations with unique preferences in behavioral health settings.

scholarly journals Establishing the Effectiveness of Enhanced Implementation Methods in Preventative Behavioral Health

2020 ◽  
Author(s):  
Sarah A. Stoddard ◽  
Barrett Wallace Montgomery ◽  
Leah D. Maschino ◽  
Kristen Senters Young ◽  
Julia W. Felton ◽  
...  
Keyword(s):  
Substance Use ◽  
Health Services ◽  
Behavioral Health ◽  
Implementation Strategies ◽  
Great Promise ◽  
Evidence Based ◽  
Behavioral Health Services ◽  
Strengthening Families Program ◽  
Strengthening Families ◽  
Organizational Needs

Background: More than 20 million Americans ages 12 and older have a past-year substance use disorder. Majority-minority cities, including Flint, MI, suffer disproportionately from higher rates of substance use and are less likely to have access to evidence-based prevention and treatment interventions relative to predominately White and wealthier cities. Thus, identifying approaches that can improve implementation of evidence-based substance use practices is a critical public health goal. In the current report, we provide a detailed protocol for the implementation and evaluation of the Strengthening Flint Families initiative, a community-based implementation study of a multi-level behavioral health intervention that includes peer recovery coaching, the Strengthening Families Program, and a multimedia campaign. Our goal is to improve family resilience and reduce behavioral health disparities in the Flint community, as an example of how this could be done in other communities. Our overall strategy includes community-informed implementation enhancements to increase adoption and sustainment of evidence-based behavioral health services. Methods: This project has 4 phases that align with study aims- 1) a systematic assessment of behavioral health organizations in the Flint Area to understand organizational needs and strengths in Flint; 2) tailoring implementation strategies for one individual-level evidence-based practice, peer recovery coaching, and one family-level evidence-based program, the Strengthening Families Program; 3) building capacity and promoting sustainability; and 4) evaluating primary (implementation) and secondary (effectiveness) outcomes. Implementation outcomes are derived from the RE-AIM framework and effectiveness outcomes will be assessed at the individual, family, and community levels. Discussion: Understanding and addressing the behavioral health organizational needs, strengths, and barriers to program adoption and referral in Flint offers great promise to strengthen the behavioral health network of providers serving Flint residents. Moreover, understanding barriers to accessing and implementing behavioral health services in low-resource communities may prove to be a valuable tool for discovering the most effective implementation methods tailored to specific organizations. These evidence informed approaches may prove useful for cities outside of Flint.

Conducting a Community Engagement Studio to Adapt Enhanced Milieu Teaching

2022 ◽  
pp. 1-19
Author(s):  
Emily D. Quinn ◽  
Kathleen Cotter ◽  
Kim Kurin ◽  
Kim Brown
Keyword(s):  
Service Delivery ◽  
Community Engagement ◽  
Performance Feedback ◽  
Text Message ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Language Delays ◽  
Milieu Teaching ◽  
Rural Counties ◽  
Enhanced Milieu Teaching

Purpose: Barriers to implementing evidence-based practices occur at various levels. Stakeholder input is required to identify challenges specific to clinical practice settings, client populations, and service delivery approaches. The purpose of this project was to solicit feedback from stakeholders on the telepractice service delivery and implementation strategies proposed for a future study of enhanced milieu teaching (EMT) in rural counties. Method: A Community Engagement Studio was conducted with 11 caregivers of children with language delays living in rural counties. Caregivers and the researchers discussed early intervention service delivery for children with language delays in rural Oregon and the proposed telepractice EMT procedures. Researchers gathered feedback on three intervention components: session frequency and schedule, implementation strategies to encourage caregivers' use of EMT, and performance feedback techniques to teach caregivers. Results: Findings from the Community Engagement Studio led to four primary modifications to the telepractice EMT study protocol. The principal investigator increased available days and times for intervention sessions and added text-message reminders for parents. A survey was also added for caregivers to identify their preferences for additional implementation strategies (e.g., tip sheets, checklist, e-mailed session summaries) and graphic representations of performance feedback (e.g., bar graph, radial graph, mountain climber infographic). Conclusion: Community Engagement Studios are a promising method for increasing community engagement in clinical research and soliciting stakeholder feedback on evidence-based intervention adaptations. Supplemental Material: https://doi.org/10.23641/asha.17774819

scholarly journals The Role of Trust in Explaining Food Choice: Combining Choice Experiment and Attribute Best–Worst Scaling

Foods ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 45
Author(s):  
Ching-Hua Yeh ◽  
Monika Hartmann ◽  
Nina Langen
Keyword(s):  
Latent Class Analysis ◽  
Food Choice ◽  
Logit Model ◽  
Choice Experiment ◽  
Latent Class ◽  
Class Analysis ◽  
Class Membership ◽  
Credence Attributes ◽  
Best Worst Scaling

This paper presents empirical findings from a combination of two elicitation techniques—discrete choice experiment (DCE) and best–worst scaling (BWS)—to provide information about the role of consumers’ trust in food choice decisions in the case of credence attributes. The analysis was based on a sample of 459 Taiwanese consumers and focuses on red sweet peppers. DCE data were examined using latent class analysis to investigate the importance and the utility different consumer segments attach to the production method, country of origin, and chemical residue testing. The relevance of attitudinal and trust-based items was identified by BWS using a hierarchical Bayesian mixed logit model and was aggregated to five latent components by means of principal component analysis. Applying a multinomial logit model, participants’ latent class membership (obtained from DCE data) was regressed on the identified attitudinal and trust components, as well as demographic information. Results of the DCE latent class analysis for the product attributes show that four segments may be distinguished. Linking the DCE with the attitudinal dimensions reveals that consumers’ attitude and trust significantly explain class membership and therefore, consumers’ preferences for different credence attributes. Based on our results, we derive recommendations for industry and policy.

scholarly journals Implementation Science and Implementation Science Communications: a refreshed description of the journals’ scope and expectations

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Michel Wensing ◽  
Anne Sales ◽  
Paul Wilson ◽  
Rebecca Armstrong ◽  
Roman Kislov ◽  
...  
Keyword(s):  
Implementation Science ◽  
Professional Education ◽  
Financial Incentives ◽  
Empirical Studies ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Organizational Changes ◽  
Evidence Based Practices ◽  
Central Interest ◽  
Time Reading

AbstractThis editorial provides a comprehensive consolidated overview of the scope and expectations of Implementation Science and Implementation Science Communications. We remain most interested in rigorous empirical studies of the implementation of evidence-based healthcare practices (including interventions, technologies, and policies) and the de-implementation of practices that are demonstrated to be of low or no benefit. Implementation strategies (e.g., continuing professional education, organizational changes, and financial incentives to enhance the uptake of evidence-based practices) are of central interest to the journals. We see the field as large and complex, with a wide literature that is published in many venues. We urge people for whom it is new to spend some time reading the existing literature, and learning the scope of the work that has already been done, and published, in our journals and in an increasing number of other journals in the field.

Tailored interventions to support the implementation of the German national guideline on screening, diagnosis and treatment of alcohol-related disorders: a project protocol

2019 ◽  
Vol 65 (6) ◽  
pp. 373-381 ◽  
Author(s):  
Bernd Schulte ◽  
Christina Lindemann ◽  
Angela Buchholz ◽  
Anke Rosahl ◽  
Martin Härter ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Guideline Implementation ◽  
Implementation Strategies ◽  
Organizational Factors ◽  
Diagnosis And Treatment ◽  
Primary Data ◽  
Routine Practice ◽  
Evidence Based ◽  
Advisory Boards ◽  
Prevention And Treatment

Abstract. Background: The German Guideline on Screening, Diagnosis and Treatment of Alcohol Use Disorders aims to increase the uptake of evidence-based interventions for the early identification, diagnosis, prevention and treatment of alcohol-related disorders in relevant healthcare settings. To date, dissemination has not been accompanied by a guideline implementation strategy. The aim of this study is to develop tailored guideline implementation strategies and to field-test these in relevant medical and psycho-social settings in the city of Bremen, Germany. Methods: The study will conduct an impact and needs assessment of healthcare provision for alcohol use orders in Bremen, drawing on a range of secondary and primary data to: evaluate existing healthcare services; model the potential impact of improved care on public health outcomes; and identify potential barriers and facilitators to implementing evidence-based guidelines. Community advisory boards will be established for the selection of single-component or multi-faceted guideline implementation strategies. The tailoring approach considers guideline, provider and organizational factors shaping implementation. In field tests quality outcome indicators of the delivery of evidence-based interventions will be evaluated accompanied by a process evaluation to examine patient, provider and organizational factors. Outlook: This project will support the translation of guideline recommendations for the identification, prevention and treatment of AUD in routine practice and therefore contributes to the reduction of alcohol-related burden in Germany. The project is running since October 2017 and will provide its main outcomes by end of 2020. Project results will be published in scientific journals and presented at national and international conferences.

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