Less is more: Implementing the ‘Minimal Intervention Needed for Change (MINC)’ approach to increase contextual fit of speech-language interventions

2021 ◽  
Author(s):  
Maura Curran ◽  
Rouzana Komesidou ◽  
Tiffany P. Hogan
Keyword(s):  
Clinical Settings ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Minimal Intervention ◽  
Less Is More ◽  
Resource Limitations ◽  
Practice Method ◽  
Core Components ◽  
Contextual Fit ◽  
Clinically Significant

AbstractPurpose: Speech-Language Pathologists (SLPs) and researchers face difficulties in moving evidence-based practices from clinical research into widespread practice, in part due to a mismatch between the design of typical intervention research studies and the realities of clinical settings. SLPs must adapt interventions from the literature or established programs to fit the needs of specific clients and settings. Researchers must design studies that better reflect clinical practice. Method: Here, we provide an overview of the Minimal Intervention Needed for Change (MINC) approach; a systematic approach to developing and adapting interventions that focuses on achieving meaningful outcomes within specific contexts. We outline the principles of MINC, and illustrate this process through use of a case study.Results: MINC can support systematic development and adaptation of interventions in clinical and research settings, particularly settings with resource limitations. Conclusions: Researchers should work to align research intervention work with typical clinical settings. This involves both targeting outcomes that are functional and clinically significant and acknowledging resource limitations. SLPs should adapt evidence-based interventions systematically and carefully to meet the needs of clients and settings while retaining the core components of intervention that result in meaningful change for clients.

scholarly journals Treatment Fidelity: Its Importance and Reported Frequency in Aphasia Treatment Studies

2013 ◽  
Vol 22 (2) ◽  
Author(s):  
Jacqueline J. Hinckley ◽  
Natalie F. Douglas
Keyword(s):  
Review Process ◽  
Research Study ◽  
Peer Review Process ◽  
Treatment Fidelity ◽  
Clinical Settings ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Independent Variables ◽  
Treatment Research ◽  
Aphasia Treatment

Purpose Treatment fidelity is a measure of the reliability of the administration of an intervention in a treatment study. It is an important aspect of the validity of a research study, and it has implications for the ultimate implementation of evidence-supported interventions in typical clinical settings. Method Aphasia treatment studies published in the last 10 years in 3 journals were reviewed using coding techniques that were adapted from Gresham, Gansle, Noell, Cohen, and Rosenblum (1993). The following items were noted: identifying information, study design, description of both the dependent and independent variables, and whether a measure of treatment fidelity was explicitly included. Results Of the aphasia treatment studies published in the last 10 years, 14% explicitly reported treatment fidelity. Most studies reporting treatment fidelity used checking of videotaped sessions by independent raters. Of the reviewed studies, 45% provided sufficient treatment description to support replication. Conclusion Treatment fidelity is widely acknowledged as being critical to research validity and is a foundation for the implementation of evidence-based practices, but only a small percentage of aphasia treatment studies published in the last 10 years explicitly reported treatment fidelity. Recommendations for research practices include increased attention to matters of treatment fidelity in the peer review process and explicit incorporation of 3 levels of treatment fidelity in treatment research.

scholarly journals The Rush Caregiver Initiative: A Model for Caregiver Health and Wellness in Age-Friendly Health Systems

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 307-307
Author(s):  
Leslie Pelton ◽  
Ellen Carbonell ◽  
Robyn Golden
Keyword(s):  
Family Care ◽  
Well Being ◽  
Lessons Learned ◽  
System Level ◽  
Evidence Based ◽  
Health And Wellness ◽  
Evidence Based Practices ◽  
Caregiver Health ◽  
Clinically Significant

Abstract The Rush Caregiver Health and Well-Being Initiative (Caregiver Initiative) draws together evidence-based practices into a single framework to improve care for older adults and caregivers. The Caregiver Initiative has two components: system-level and caregiver level interventions. The complexities of system change take place within leadership, data management, and provider teams throughout the health care system, and solutions to resistance have been developed. Caregiver-level interventions start with an assessment using evidence-based tools, and offer an opportunity to participate in a Teach-Back Clinic, Family Care Planning sessions, and/or Goals of Medical Care meetings, all connected to the 4Ms of an Age-Friendly Health System. Contact and follow-up issues were addressed, and as of February 2021, 191 caregivers have enrolled. Outcomes to date show statistically and clinically significant reductions in depression, anxiety, and caregiver burden. This presentation will highlight lessons learned in the development of the model and caregiver outcomes to date.

Use of Implementation Science to Advance Nurse-Led Evidence-Based Practices in Clinical Settings

Nurse Leader ◽  
2021 ◽  
Author(s):  
Molly McNett ◽  
Sharon Tucker ◽  
Bindu Thomas ◽  
Penelope Gorsuch ◽  
Lynn Gallagher-Ford
Keyword(s):  
Implementation Science ◽  
Clinical Settings ◽  
Evidence Based ◽  
Evidence Based Practices

Selecting Evidence-Based Practices: What Works for Me

2019 ◽  
Vol 54 (5) ◽  
pp. 286-294 ◽  
Author(s):  
Melinda M. Leko ◽  
Carly Roberts ◽  
David Peyton ◽  
Daisy Pua
Keyword(s):  
Autism Spectrum ◽  
Evidence Based ◽  
Students With Learning Disabilities ◽  
Evidence Based Practices ◽  
What Works ◽  
Practical Guidelines ◽  
Contextual Fit ◽  
And Behavior ◽  
New Evidence

As the special education research community continues to identify new evidence-based practices (EBP), educators will need to make choices regarding which EBPs to implement. This article provides educators with practical guidelines for selecting EBPs that will improve outcomes for students with learning disabilities (LD), emotional and behavior disorders (EBD), and autism spectrum disorder (ASD). Among the factors for EBP consideration discussed are strength of evidence, cost, complexity and transferability, and contextual fit. By taking these factors (and others) into consideration, educators can make more informed decisions from the outset about which EBPs will work in their particular contexts, meet the specific needs of their students, and lead to long-term sustainability.

Social Validity of Evidence-Based Practices and Emerging Interventions in Autism

2016 ◽  
Vol 32 (3) ◽  
pp. 188-197 ◽  
Author(s):  
Kevin Callahan ◽  
Heather L. Hughes ◽  
Smita Mehta ◽  
Karen A. Toussaint ◽  
Susan M. Nichols ◽  
...  
Keyword(s):  
Consumer Satisfaction ◽  
Social Validity ◽  
Autism Spectrum ◽  
Future Research ◽  
Social Validation ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Emerging Treatments ◽  
Clinically Significant ◽  
Effective Use

Although social validation of the goals, methods, and outcomes of evidence-based practices (EBPs) in autism treatment is a significant factor in their selection and effective use, EBPs are typically identified on the basis of the technical soundness of research without consideration of social validity. The authors investigated EBPs and emerging treatments identified by the National Autism Center (NAC) and National Professional Development Center on Autism Spectrum Disorders (NPDC) to determine which interventions have evidence of social validity, and the types of social validation addressed. A review of 828 articles cited by the NAC and NPDC determined that only 221 articles (26.7%) demonstrated direct evidence of the measurement of social validation. Of seven social validity categories analyzed, only consumer satisfaction, clinically significant behavioral change, and socially important dependent variables were consistently reported. A list of EBPs with varying levels of social and empirical validation is presented, and implications for future research are discussed.

scholarly journals Increasing the impact of randomized controlled trials: an example of a hybrid effectiveness–implementation design in psychotherapy research

2018 ◽  
Vol 10 (3) ◽  
pp. 629-636 ◽  
Author(s):  
Adrienne L Johnson ◽  
Anthony H Ecker ◽  
Terri L Fletcher ◽  
Natalie Hundt ◽  
Michael R Kauth ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Depression Symptoms ◽  
Controlled Trials ◽  
Clinical Settings ◽  
Evidence Based ◽  
Health Administration ◽  
Evidence Based Practices ◽  
Randomized Controlled ◽  
Measurement Based Care ◽  
The Impact

Abstract Randomized controlled trials (RCTs) are the gold standard for clinical research. However, significant delays between completion of RCTs and adoption of evidence-based practices into clinical settings remain. Engagement of stakeholders and implementation-focused outcomes to augment traditional RCTs hold the potential to increase the impact of RCT outcomes for clinical practice and more rapidly lead to the adoption of evidence-based practices in clinical settings. The purpose of this study is to discuss hybrid effectiveness–implementation designs and use a project example to highlight important methodological considerations to enhance the impact of RCTs. A hybrid effectiveness–implementation study assessed the effectiveness and implementation potential of brief cognitive behavioral therapy (bCBT) for rural Veterans. A patient-randomized trial (bCBT vs. enhanced usual care) explored the impact on depression symptoms. Implementation elements included engagement of stakeholders and a multifaceted provider training and support program to increase bCBT use by providers in Veterans Health Administration (VA) community-based outpatient clinics. Implementation outcomes included the number of providers who adopted bCBT, provider fidelity, and delivery outcomes (e.g., use of measurement-based care, treatment engagement, and completion). Hybrid designs offer opportunities to improve the alignment between research and practice, potentially improving dissemination of evidence-based interventions and reducing known delays in the translation from research to practice. Expansion of traditional RCTs through collaborative stakeholder contributions and stakeholder/consumer-informed implementation approaches is critical to improve adoption postproject. Although hybrid designs offer significant benefits related to generalizability and adoption, these approaches involve complex procedures and processes and often come at the cost of reduced internal study controls.

Self-Regulation and the Writing Process: Enhancing the Performance of Students With Language and Learning Difficulties

2009 ◽  
Vol 16 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Gary A. Troia
Keyword(s):  
Writing Process ◽  
Self Regulation ◽  
Learning Difficulties ◽  
Evidence Based ◽  
Struggling Learners ◽  
Evidence Based Practices

Abstract This article first provides an overview of components of self-regulation in writing and specific examples of each component are given. The remainder of the article addresses common reasons why struggling learners experience trouble with revising, followed by evidence-based practices to help students revise their papers more effectively.

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