scholarly journals Use of Human-Centered Design to Improve Implementation of Evidence-Based Psychotherapies in Low-Resource Communities: Protocol for Studies Applying a Framework to Assess Usability

10.2196/14990 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e14990 ◽  
Author(s):  
Aaron R Lyon ◽  
Sean A Munson ◽  
Brenna N Renn ◽  
David C Atkins ◽  
Michael D Pullmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Implementation Strategy ◽  
Relative Effectiveness ◽  
Implementation Strategies ◽  
Psychosocial Interventions ◽  
Evidence Based ◽  
Human Centered Design ◽  
Patient Reported ◽  
The Impact

Background This paper presents the protocol for the National Institute of Mental Health (NIMH)–funded University of Washington’s ALACRITY (Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness) Center (UWAC), which uses human-centered design (HCD) methods to improve the implementation of evidence-based psychosocial interventions (EBPIs). We propose that usability—the degree to which interventions and implementation strategies can be used with ease, efficiency, effectiveness, and satisfaction—is a fundamental, yet poorly understood determinant of implementation. Objective We present a novel Discover, Design/Build, and Test (DDBT) framework to study usability as an implementation determinant. DDBT will be applied across Center projects to develop scalable and efficient implementation strategies (eg, training tools), modify existing EBPIs to enhance usability, and create usable and nonburdensome decision support tools for quality delivery of EBPIs. Methods Stakeholder participants will be implementation practitioners/intermediaries, mental health clinicians, and patients with mental illness in nonspecialty mental health settings in underresourced communities. Three preplanned projects and 12 pilot studies will employ the DDBT model to (1) identify usability challenges in implementing EBPIs in underresourced settings; (2) iteratively design solutions to overcome these challenges; and (3) compare the solution to the original version of the EPBI or implementation strategy on usability, quality of care, and patient-reported outcomes. The final products from the center will be a streamlined modification and redesign model that will improve the usability of EBPIs and implementation strategies (eg, tools to support EBPI education and decision making); a matrix of modification targets (ie, usability issues) that are both common and unique to EBPIs, strategies, settings, and patient populations; and a compilation of redesign strategies and the relative effectiveness of the redesigned solution compared to the original EBPI or strategy. Results The UWAC received institutional review board approval for the three separate studies in March 2018 and was funded in May 2018. Conclusions The outcomes from this center will inform the implementation of EBPIs by identifying cross-cutting features of EBPIs and implementation strategies that influence the use and acceptability of these interventions, actively involving stakeholder clinicians and implementation practitioners in the design of the EBPI modification or implementation strategy solution and identifying the impact of HCD-informed modifications and solutions on intervention effectiveness and quality. Trial Registration ClinicalTrials.gov NCT03515226 (https://clinicaltrials.gov/ct2/show/NCT03515226), NCT03514394 (https://clinicaltrials.gov/ct2/show/NCT03514394), and NCT03516513 (https://clinicaltrials.gov/ct2/show/NCT03516513). International Registered Report Identifier (IRRID) DERR1-10.2196/14990

scholarly journals Usability Evaluation for Evidence-Based Psychosocial Interventions (USE-EBPI): A methodology for assessing complex intervention implementability

2020 ◽  
Vol 1 ◽  
pp. 263348952093292 ◽  
Author(s):  
Aaron R Lyon ◽  
Kelly Koerner ◽  
Julie Chung
Keyword(s):  
Mental Health ◽  
Psychosocial Interventions ◽  
Usability Evaluation ◽  
Evidence Based ◽  
Plain Language ◽  
Point Scale ◽  
Design Quality ◽  
Human Centered Design ◽  
Intervention Protocol ◽  
User Groups

Background: Most evidence-based practices in mental health are complex psychosocial interventions, but little research has focused on assessing and addressing the characteristics of these interventions, such as design quality and packaging, that serve as intra-intervention determinants (i.e., barriers and facilitators) of implementation outcomes. Usability—the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction—is a key indicator of design quality. Drawing from the field of human-centered design, this article presents a novel methodology for evaluating the usability of complex psychosocial interventions and describes an example “use case” application to an exposure protocol for the treatment of anxiety disorders with one user group. Method: The Usability Evaluation for Evidence-Based Psychosocial Interventions (USE-EBPI) methodology comprises four steps: (1) identify users for testing; (2) define and prioritize EBPI components (i.e., tasks and packaging); (3) plan and conduct the evaluation; and (4) organize and prioritize usability issues. In the example, clinicians were selected for testing from among the identified user groups of the exposure protocol (e.g., clients, system administrators). Clinicians with differing levels of experience with exposure therapies (novice, n =3; intermediate, n = 4; advanced, n = 3) were sampled. Usability evaluation included Intervention Usability Scale (IUS) ratings and individual user testing sessions with clinicians, and heuristic evaluations conducted by design experts. After testing, discrete usability issues were organized within the User Action Framework (UAF) and prioritized via independent ratings (1–3 scale) by members of the research team. Results: Average IUS ratings (80.5; SD = 9.56 on a 100-point scale) indicated good usability and also room for improvement. Ratings for novice and intermediate participants were comparable (77.5), with higher ratings for advanced users (87.5). Heuristic evaluations suggested similar usability (mean overall rating = 7.33; SD = 0.58 on a 10-point scale). Testing with individual users revealed 13 distinct usability issues, which reflected all four phases of the UAF and a range of priority levels. Conclusion: Findings from the current study suggested the USE-EBPI is useful for evaluating the usability of complex psychosocial interventions and informing subsequent intervention redesign (in the context of broader development frameworks) to enhance implementation. Future research goals are discussed, which include applying USE-EBPI with a broader range of interventions and user groups (e.g., clients). Plain language abstract: Characteristics of evidence-based psychosocial interventions (EBPIs) that impact the extent to which they can be implemented in real world mental health service settings have received far less attention than the characteristics of individuals (e.g., clinicians) or settings (e.g., community mental health centers), where EBPI implementation occurs. No methods exist to evaluate the usability of EBPIs, which can be a critical barrier or facilitator of implementation success. The current article describes a new method, the Usability Evaluation for Evidence-Based Psychosocial Interventions (USE-EBPI), which uses techniques drawn from the field of human-centered design to evaluate EBPI usability. An example application to an intervention protocol for anxiety problems among adults is included to illustrate the value of the new approach.

The impact of COVID-19 quarantine measures on the mental health of families

2021 ◽  
pp. 146801732110117
Author(s):  
Fakir Al Gharaibeh ◽  
Laura Gibson
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
Digital Media ◽  
Mental Health Problems ◽  
Eating Habits ◽  
Strong Shock ◽  
Psychosocial Interventions ◽  
Snowball Sampling ◽  
Long Term Effects ◽  
The Impact

Summary COVID-19 is shaping all aspects of life throughout the world. The unexpected number of people who have been infected with and died from coronavirus disease (COVID-19) is evidence that the pandemic has affected families and societies. The strong shock wave that has resulted in the international response has focused more on medical rather than psychosocial interventions. Little has been written or studied about the impact of COVID-19 on families. This article explores the impact of the COVID-19 quarantine on the mental health of families. We conducted 20 in-depth interviews with Jordanian families through snowball sampling. Findings The results show that 20 interviewees described varied and new experiences. Many of the families we interviewed displayed symptoms of mental health problems, including disrupted sleep patterns, changes in eating habits, excessive digital media use, anxiety, depression, excessive smoking, stomach aches, bedwetting among children, and persistent headaches. The study also demonstrated the psychological stress partners felt during the lockdown due to their worries about job security. They also communicated their hope that renewed family commitments might bring more stability to their relationships. During the lockdown, family members spent more time together, and it became harder to conceal any issues from each other. Applications The findings of this research demonstrate a critical need for social workers, and it is hoped that future legislation will include a role for social workers in various fields of crisis. Moreover, social workers should encourage families to ask for intervention to overcome the long-term effects that may result from COVID-19.

scholarly journals Provider self-efficacy in delivering evidence-based psychosocial interventions: A scoping review

2021 ◽  
Vol 2 ◽  
pp. 263348952098825
Author(s):  
Cheri J Shapiro ◽  
Kathleen Watson MacDonell ◽  
Mariah Moran
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Implementation Research ◽  
Self Efficacy ◽  
Psychosocial Interventions ◽  
Health Interventions ◽  
Evidence Based ◽  
Health Providers ◽  
Plain Language ◽  
Mental Health Interventions

Background: Among the many variables that affect implementation of evidence-based interventions in real-world settings, self-efficacy is one of the most important factors at the provider level of the social ecology. Yet, research on the construct of provider self-efficacy remains limited. Objectives: This scoping review was conducted to enhance understanding of the construct of provider self-efficacy and to examine how the construct is defined and measured in the context of implementation of evidence-based mental health interventions. Design: Online databases were used to identify 190 papers published from 1999 to June of 2018 that included search terms for providers, evidence-based, and self-efficacy. To be eligible for the scoping review, papers needed to focus on the self-efficacy of mental health providers to deliver evidence-based psychosocial interventions. A total of 15 publications were included in the review. Results: The construct of provider self-efficacy is not clearly defined but is typically described as confidence to deliver a specific intervention or practice. A range of measures are used to assess provider self-efficacy across both provider and intervention types. Conclusions: Standardized definition and measurement of provider self-efficacy is needed to advance practice and implementation research. Plain language abstract: Provider self-efficacy is known to influence implementation of evidence-based mental health interventions. However, the ways in which provider self-efficacy is defined and measured in implementation research literature is not well understood; furthermore, it is not clear what types of providers and interventions are represented in this literature. This scoping review adds to current research by revealing that there is no agreed upon definition or measure of provider self-efficacy in the context of implementation of evidence-based interventions, and that the research includes multiple types of providers (e.g., social workers, counselors, psychologists) and interventions. Self-efficacy appears to change as a function of training and support. To further research in this area, a common definition and agreed upon measures of this construct are needed.

T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S2-S3
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
National Database ◽  
Time Points ◽  
Patient Reported ◽  
Burn Survivors ◽  
Population Demographic ◽  
The Impact ◽  
Over Time

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

scholarly journals Exploring the impact of a decision support algorithm to improve clinicians’ chemotherapy-induced peripheral neuropathy assessment and management practices: a two-phase, longitudinal study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robert Knoerl ◽  
Emanuele Mazzola ◽  
Fangxin Hong ◽  
Elahe Salehi ◽  
Nadine McCleary ◽  
...  
Keyword(s):  
Decision Support ◽  
Peripheral Neuropathy ◽  
Management Practices ◽  
Management Strategies ◽  
Clinic Visit ◽  
Evidence Based ◽  
Two Phase ◽  
Assessment Index ◽  
Patient Reported ◽  
The Impact

Abstract Background Chemotherapy-induced peripheral neuropathy (CIPN) negatively affects physical function and chemotherapy dosing, yet, clinicians infrequently document CIPN assessment and/or adhere to evidence-based CIPN management in practice. The primary aims of this two-phase, pre-posttest study were to explore the impact of a CIPN clinician decision support algorithm on clinicians’ frequency of CIPN assessment documentation and adherence to evidence-based management. Methods One hundred sixty-two patients receiving neurotoxic chemotherapy (e.g., taxanes, platinums, or bortezomib) answered patient-reported outcome measures on CIPN severity and interference prior to three clinic visits at breast, gastrointestinal, or multiple myeloma outpatient clinics (n = 81 usual care phase [UCP], n = 81 algorithm phase [AP]). During the AP, study staff delivered a copy of the CIPN assessment and management algorithm to clinicians (N = 53) prior to each clinic visit. Changes in clinicians’ CIPN assessment documentation (i.e., index of numbness, tingling, and/or CIPN pain documentation) and adherence to evidence-based management at the third clinic visit were compared between the AP and UCP using Pearson’s chi-squared test. Results Clinicians’ frequency of adherence to evidence-based CIPN management was higher in the AP (29/52 [56%]) than the UCP (20/46 [43%]), but the change was not statistically significant (p = 0.31). There were no improvements in clinicians’ CIPN assessment frequency during the AP (assessment index = 0.5440) in comparison to during the UCP (assessment index = 0.6468). Conclusions Implementation of a clinician-decision support algorithm did not significantly improve clinicians’ CIPN assessment documentation or adherence to evidence-based management. Further research is needed to develop theory-based implementation interventions to bolster the frequency of CIPN assessment and use of evidence-based management strategies in practice. Trial registration ClinicalTrials.Gov, NCT03514680. Registered 21 April 2018.

Psychosocial Interventions Situated Within the Natural Environment with Young People Who Have Experienced Trauma: A Scoping Review

2020 ◽  
Author(s):  
Jennifer Boddy ◽  
Maddy Slattery ◽  
Jianqiang Liang ◽  
Hilary Gallagher ◽  
Amanda Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Scoping Review ◽  
Natural Environment ◽  
Psychosocial Interventions ◽  
Database Search ◽  
Inclusion Criteria ◽  
Clinical Change ◽  
Social Work Interventions ◽  
The Impact

Abstract The natural environment is increasingly used in therapeutic psychosocial interventions for young people who have experienced trauma. However, as the research in this area has yet to be synthesised, very little is known about the types and outcomes of interventions. This prevents the optimisation of social work interventions in outdoor settings. Consequently, a scoping review of peer-reviewed research published from 2008 to 2018 was undertaken to examine how nature is being used in psychosocial interventions with young people aged ten to twenty-four years who have experienced trauma and the impact of these interventions on young people’s mental health. The database search identified 5,425 records; however, only ten papers met the inclusion criteria. These papers suggested that positive changes across a range of mental health outcomes for young people were achieved in psychosocial interventions which were situated in, or made use of the natural environment, although it is unclear whether the environment influenced the outcomes. The scoping review also highlighted the need for conducting further research that examines how environmental factors contribute to clinical change for young people who have experienced trauma.

Functional Mobility, Aging, and People With Mental Illness: Issues and Challenges

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 411-411
Author(s):  
Michelle Zechner ◽  
Ellen Anderson ◽  
Kenneth Gill
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Physical Functioning ◽  
Independent Living ◽  
Community Sample ◽  
Functional Decline ◽  
Premature Death ◽  
Functional Mobility ◽  
Health Conditions ◽  
The Impact

Abstract People with serious mental illness (SMI) are more likely to experience chronic health conditions at younger ages, which increases the risk of premature death. Co-morbid health conditions and risk for premature death are well-studied in the population, however less is understood about the impact of aging and SMI on functional ability. Research suggests that the population walk less and may have lower fitness levels than other populations (Gill et al., 2016). Specific data exploring functional age of people with SMI is sparse. The authors compared published standardized geriatric functional fitness values for people over 65 to baseline values of a community sample of people living with SMI who participated in a community health promotion intervention. The average age of the sample was 50 (SD=11). Three physical functioning measures were used in the comparison to measure physical functioning; the Sit to Stand Test, 6 Minute Walk, and Single Legged Stance. Results indicated significant differences in mean physical functioning values between the sample and standardized geriatric values. The sample performed at levels 20-30 years older than their chronological age. This finding suggests that mental health and aging services may need to adjust interventions, services and methods to improve physical functioning in middle-aged and older adults living with SMI. Premature functional decline impacts community living skills, independent living, housing choice, vocational options, and may impede personal goal attainment. Recommendations for interventions will be offered, as will suggestions for policies targeting services that cross aging and mental health silos.

scholarly journals Levels and Prevalence of Mental Health Functioning in Canadian University Student-Athletes

2018 ◽  
Vol 48 (2) ◽  
pp. 149-168 ◽  
Author(s):  
Krista J. Van Slingerland ◽  
Natalie Durand-Bush ◽  
Scott Rathwell
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Alcohol Use ◽  
Student Athletes ◽  
Online Survey ◽  
Well Being ◽  
Living Situation ◽  
Mental Health Functioning ◽  
Health Functioning ◽  
The Impact

We examined the level and prevalence of mental health functioning (MHF) in intercollegiate student-athletes from 30 Canadian universities, and the impact of time of year, gender, alcohol use, living situation, year of study, and type of sport on MHF. An online survey completed in November 2015 (N = 388) and March 2016 (n = 110) revealed that overall, MHF levels were moderate to high, and more student-athletes were flourishing than languishing. MHF levels did not significantly differ across time based on gender, alcohol use, living situation, year of study, and type of sport. Eighteen percent reported a previous mental illness diagnosis and yet maintained moderate MHF across time. These findings support Keyes’ (2002) dual-continua model, suggesting that the presence of mental illness does not automatically imply low levels of well-being and languishing. Nonetheless, those without a previous diagnosis were 3.18 times more likely to be flourishing at Time 1 (November 2015).  

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