Application of the Non-adoption, Abandonment, Scale-up, Spread and, Sustainability (NASSS) Framework to evaluate the role of technology in the Pathways to Comorbidity Care (PCC) implementation project to improve management of comorbid substance use and mental disorders

Abstract (250 words)In substance use treatment settings, there is a high prevalence of comorbid mental health problems. Yet an integrated approach for managing comorbidity, implementation of evidence-based intervention in drug and alcohol settings remains problematic. Technology can help the adoption of evidence-based practice and successfully implement effective treatment health care pathways. This study sought to examine aspects of electronic resources utilisation (barriers and facilitators) by clinicians participating in the PCC training. MethodA self-report questionnaire and a semi-structured interview was designed to measure overall satisfaction with the PCC portal and e-resources available throughout the 9-month intervention for participating clinicians. An adapted version of the ‘Non-adoption, Abandonment, Scale-up, Spread and, Sustainability’ (NASSS) framework was used to facilitate discussion in regards to the study findings. ResultsA total of 20 clinicians from drug and alcohol services responded to all the measures. Facilitators of portal use included: i. clinician acceptance of the PCC portal; ii. guidance from the clinical supervisor or clinical champion that encouraged the use of e-resources. Some of the barriers included: i. complexity of the illness (condition), ii. clinicians’ preference (adopter system) for face-to-face resources and training modes (e.g. clinical supervision, clinical champion workshops), and iii. lack of face-to-face training on how to use the portal (technology and organisation).ConclusionBased on the NASSS framework, we were able to identify several barriers and facilitators including such as the complexity of the illness, lack of face-to-face training and clinician preference for training mediums. Recommendations include ongoing consultation of clinicians to assist in the development of tailored e-health resources and offering in-house training on how to operate and effectively utilise these resources.

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Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

Qualitative Health Research ◽

10.1177/1049732321993443 ◽

2021 ◽

pp. 104973232199344

Author(s):

Oladunni Oluwoye ◽

Elizabeth Fraser

Keyword(s):

Substance Use ◽

Behavior Change ◽

Theoretical Domains Framework ◽

First Episode Psychosis ◽

Barriers And Facilitators ◽

First Episode ◽

Evidence Based ◽

Behavior Change Techniques ◽

Episode Psychosis ◽

And Behavior

In this qualitative study, we explore providers’ experiences with addressing substance use among individuals with first-episode psychosis (FEP) enrolled in coordinated specialty care (CSC) programs. Three focus groups were conducted with 24 providers from CSC programs for FEP in Washington. Questions were focused on barriers and facilitators to addressing substance use using the Theoretical Domains Framework (TDF) as a guide. Thematic analysis was used to code all transcripts. Identified TDF domains were then mapped onto the COM-B (Capability, Opportunity, Motivation, Behavior) intervention functions and behavior change techniques. Seven theoretical domains were identified as the most relevant to addressing substance use: “Knowledge,” “Skills,” “Environmental Context and Resources,” “Social Influences,” “Social and Professional Role and Identity,” “Beliefs about Capabilities,” and “Reinforcement.” The use of the TDF provides a framework to explore barriers and facilitators for targeting substance use and suggestions for behavior change techniques when considering implementation of evidence-based strategies to enhance CSC models.

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Innovative Adaptation of Training and Technical Assistance

10.4018/978-1-7998-7623-6.ch011 ◽

2022 ◽

pp. 239-264

Author(s):

Holly N. Hagle ◽

Yifei Liu ◽

Deena M. Murphy ◽

Laurie Krom

Keyword(s):

Substance Use ◽

Behavioral Health ◽

Community Involvement ◽

Technical Assistance ◽

Mental Illnesses ◽

Evidence Based ◽

Telecommunication Services ◽

Face To Face ◽

Rapid Transition ◽

Behavioral Health Workforce

The behavioral health workforce is pivotal to provide evidence-based services (EBPs) for patients with mental illnesses or substance use disorders. The COVID-19 pandemic has exacerbated existing healthcare issues for these patients and highlighted the need for a well-trained workforce. The stay-at-home orders compelled a rapid transition to delivering behavioral health services from traditional face-to-face encounters to telehealth/telecommunication services. Training and technical assistance (TTA) networks supporting the behavioral health workforce's educational needs quickly moved to virtual delivery. This shift has resulted in innovations and adaptations categorized into four areas: adapting is crucial, convening stakeholders is essential, resources (human and technological) are needed, and community involvement is integral. Future TTA efforts should focus on sharing the successful virtual adaptations to EBPs.

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Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program

10.21203/rs.3.rs-16135/v2 ◽

2020 ◽

Author(s):

Jessica Haughton ◽

Michelle L. Takemoto ◽

Jennifer Schneider ◽

Steven P. Hooker ◽

Borsika Rabin ◽

...

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Scale Up ◽

Implementation Strategies ◽

Barriers And Facilitators ◽

Physical Activity Program ◽

Evidence Based ◽

Church Staff ◽

Faith Based ◽

Activity Program

Abstract Background: Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale up, and sustainment of evidence-based interventions. Faith in Action (Fe en Acción) is an evidence-based promotora-led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women.Methods: We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of Faith in Action and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results: Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers’ behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: 1) health behavior change training for pastors and staff; 2) tailored messaging; 3) developing community collaborations; and 4) gaining denominational support.Conclusions: While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

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Adapting a Revised Child Anxiety and Depression Scale for rural India: a pilot, amenable to scale up.

10.31234/osf.io/25pnr ◽

2016 ◽

Author(s):

Kasturi Haldar

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Child Anxiety ◽

Scale Up ◽

Depression Scale ◽

Population Level ◽

National Language ◽

Self Report ◽

Anxiety And Depression ◽

Field Workers

*Abstract. *Education is an important cornerstone of economic developmentin India. Mental health critically impacts education but its comprehensiveassessment at a population level, especially in children in rural areaspresents significant challenges. Mental health problems areunder-recognized in the community and the clinic. Assessment by clinicalpractitioners requires specialized expertise which (for both logistical andcost reasons) are not amenable to scale-up. Diversity in languages,cultures and variation in levels of literacy further compounds the problem.Consequently, despite universal recognition that mental health isimportant, tools to measure its overall prevalence at scale are limited.Here we report adaptation of a robust, internationally validated, mentalhealth assessment scale, the Revised Child Anxiety and Depression Scale(RCADS) into Hindi, the national language, spoken by the largest number ofIndians. First RCADS in Urdu1 was translated to Hindi (since spoken Urdu isclose to Hindi). In addition, iterative steps of field adaptation andtraining enabled conversion from self-report to a questionnaire-survey(qaRCADS-H) to facilitate inclusion of illiterate respondents and improvethe overall accuracy and acceptance of the tool. Pratham EducationalFoundation-ASER Center field workers administered qaRCADS-H as a homeinterview/survey in a largely agrarian village where in 2011 the Censusreported 35% illiteracy2. Over a period of three weeks, fourcollege-educated field workers with prior survey experience, targeted 115households with children of which 110 agreed, resulting in participation of130 children 10-17 years of age. Our findings are discussed in context ofscaling and sensitization needed to effectively assess mental healthprevalence in a vulnerable group in large regions of India.

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Cofactors of Substance Use among Male Street Prostitutes

Journal of Drug Issues ◽

10.1177/002204269202200412 ◽

1992 ◽

Vol 22 (4) ◽

pp. 977-994 ◽

Cited By ~ 10

Author(s):

Edward V. Morse ◽

Patricia M. Simon ◽

Stephanie A. Baus ◽

Paul M. Balson ◽

Howard J. Osofsky

Keyword(s):

Substance Use ◽

Structured Interview ◽

Self Report ◽

Self Medication ◽

Use Patterns ◽

Polysubstance Use ◽

Psychological Symptomatology ◽

Street Prostitutes ◽

Negative Feelings ◽

Male Prostitutes

Two hundred and eleven male street prostitutes were surveyed using a semi-structured interview schedule and standardized self-report instruments. Information about substance use, occupational and lifestyle characteristics, levels of psychological symptomatology and self-esteem was gathered to delineate prostitutes' substance use patterns and possible cofactors to substance use. Results indicate that daily polysubstance use among male prostitutes is normative for both IDU and non-IDUs. Additionally, data demonstrate a direct link between substance use and economic dependence on prostitution. Most importantly, prostitutes' substance use was found to increase significantly while engaging in acts of prostitution and was exacerbated by the presence of psychological distress and conflicts about sexual orientation. Findings suggest that social policy surrounding interventions aimed at male prostitutes' substance use should not be conceptualized solely in terms of recreational and or addictive factors, but also as the resultant outgrowth of the need for self-medication to cope with negative feelings and/or conflicts associated with practicing prostitution.

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Engaging stakeholders to identify implementation strategies for a faith-based physical activity program

10.21203/rs.2.23928/v1 ◽

2020 ◽

Author(s):

Jessica Haughton ◽

Michelle L. Takemoto ◽

Jennifer Schneider ◽

Steven P. Hooker ◽

Borsika Rabin ◽

...

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Scale Up ◽

Implementation Strategies ◽

Health Behavior Change ◽

Barriers And Facilitators ◽

Physical Activity Program ◽

Evidence Based ◽

Faith Based ◽

Activity Program

Abstract Background Stakeholder engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community stakeholders increases the likelihood of successful implementation, scale up, and sustainment of evidence-based interventions. Faith in Action ( Fe en Acción ) is an evidence-based promotora -led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women. Methods We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of a Faith in Action and to identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results Stakeholders described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of PA; influence on churchgoers’ behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: 1) health behavior change training for pastors and staff; 2) tailored messaging; 3) developing community collaborations; and 4) gaining denominational support. Conclusions While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

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Engaging stakeholders to identify implementation strategies for a faith-based physical activity program

10.21203/rs.3.rs-16135/v1 ◽

2020 ◽

Author(s):

Jessica Haughton ◽

Michelle L. Takemoto ◽

Jennifer Schneider ◽

Steven P. Hooker ◽

Borsika Rabin ◽

...

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Scale Up ◽

Implementation Strategies ◽

Health Behavior Change ◽

Barriers And Facilitators ◽

Physical Activity Program ◽

Evidence Based ◽

Faith Based ◽

Activity Program

Abstract Background: Stakeholder engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community stakeholders increases the likelihood of successful implementation, scale up, and sustainment of evidence-based interventions. Faith in Action ( Fe en Acción ) is an evidence-based promotora -led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women.Methods: We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of a Faith in Action and to identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach.Results: Stakeholders described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of PA; influence on churchgoers’ behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: 1) health behavior change training for pastors and staff; 2) tailored messaging; 3) developing community collaborations; and 4) gaining denominational support.Conclusions: While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

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Associations Between Emotion Dysregulation Dimensions and Parenting Behaviors in Trauma-Exposed African American Mothers

Child Maltreatment ◽

10.1177/1077559520988352 ◽

2021 ◽

pp. 107755952098835

Author(s):

Abigail Powers ◽

Kallio Hunnicutt ◽

Anais Stenson ◽

Tanja Jovanovic ◽

Nadine Kaslow ◽

...

Keyword(s):

Substance Use ◽

African American ◽

Emotion Dysregulation ◽

Psychological Symptoms ◽

Hospital Setting ◽

Parenting Behaviors ◽

Structured Interview ◽

Parenting Behavior ◽

Self Report ◽

African American Mothers

Parenting behavior is key to understanding transmission of intergenerational trauma-related risk. Emotion dysregulation (ED) and psychological symptoms are associated with negative parenting behaviors, although their unique roles remain unclear. The current study examined associations of ED dimensions, depression, PTSD, and substance use with parenting behaviors in African American mothers. Participants included 98 mother-child dyads recruited from an urban hospital setting. Trauma exposure, ED, depression, substance use, and parenting behaviors (overreactivity, laxness, demandingness, warmth, corporal punishment) were assessed using self-report measures. PTSD was assessed using a semi-structured interview. Correlational results showed significant positive associations between ED and dysfunctional parenting behavior ( p < .001), overreactivity ( p < .001), and laxness ( p < .01) and negative associations with warmth ( p < .01). These associations varied across the dimensions of ED examined. Regression analyses were run to examine the unique effects of ED (separate models for overall and specific dimensions) and psychological symptoms; overall ED and its dimensions accounted for significant variance in parental behaviors ( R 2 = .10–.24, p’s < .01), while additional model steps including psychological symptoms were not significant except for the association between depression and lower warmth. In efforts to reduce the intergenerational effects of trauma, parenting interventions that include a direct focus on certain dimensions of ED may be critical.

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“I Tried to Get Help About my Addiction but he Just gave me Tablets:” Male Aboriginal Drug and Alcohol Rehabilitation Clients’ Experiences and Preferences Speaking about Substance use in Primary Care

10.21203/rs.3.rs-929770/v1 ◽

2021 ◽

Author(s):

Sara Farnbach ◽

Jamie Fernando ◽

Joe Coyte ◽

Matthew Simms ◽

Maree Hackett

Keyword(s):

Substance Use ◽

Mental Health Problems ◽

Treatment Options ◽

Culturally Appropriate ◽

Structured Interviews ◽

Substance Use Problems ◽

Alcohol Rehabilitation ◽

Drug And Alcohol ◽

Culturally Appropriate Services ◽

Improve Access

Abstract Background Primary healthcare (PHC) services are crucial in supporting people with substance use problems. The aims of this study were to explore Aboriginal and Torres Strait Islander (hereafter Aboriginal) males in treatment for substance use problems experiences about speaking about their substance use with PHC staff, and their preferences for accessing PHC about their substance use.MethodsSemi-structured interviews with residential drug and alcohol rehabilitation treatment service clients. Thematic analysis was used to develop themes inductively and deductively. Two interviews were independently double coded by an Aboriginal researcher and the project was supported by an Aboriginal Advisory Group.ResultsTwenty male adults who self-identified as Aboriginal participated (mean age 27 years). Half reported visiting PHC and talking about their substance use before their residential service stay. Two major themes developed: (1) asking for help for substance use or mental health problems linked with substance use, (2) ways to improve access to PHC about substance use. Although some males were offered treatment, some were not, and others had concerns about the treatments offered. ConclusionThis research highlights opportunities to improve access and to better support Aboriginal males with substance use problems in PHC. Focus on culturally appropriate PHC and providing staff with training around substance use and treatment options may improve access. It is important to foster culturally appropriate services, develop PHC staff knowledge around substance use, focus on therapeutic relationships and have a range of treatment options available that can be tailored to individual circumstances.

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Exploring Clinical Supervision Model employed by Qualified Nursing Staff at Mbarara Regional Referral Hospital and its Contribution to Students’ Competencies

10.51168/sjhrafrica.v2i9.64 ◽

2021 ◽

Author(s):

◽

Mark Opio

Keyword(s):

Clinical Supervision ◽

Nurse Practitioners ◽

Nursing Staff ◽

Professional Growth ◽

Structured Interview ◽

Self Directed Learning ◽

Face To Face ◽

Qualitative Descriptive ◽

Directed Learning ◽

Supervision Model

Background. Clinical supervision is an instructional face-to-face interaction between the supervisor and the supervisee which enables the supervisee to perform his/her job better. There is a various model which is being used in the supervision of students which includes coaching, mentorship, preceptorships, and individualized model when used leads to the acquisition of knowledge, skills, improve performance and students competencies. The purpose of the study was to explore clinical supervision models employed by qualified nursing staff at MRRH and their contribution to students’ competencies Methodology. A qualitative descriptive design was employed in this study. The purposive sampling method was used to recruit 9 participants. Data collection was done by in-depth interview method using a semi-structured interview guide. Inductive content analysis was used to generate the themes and categories. Results. The study findings revealed three themes that emerged as the participants’ descriptions of the clinical supervision model. These themes included coaching, self-directed learning, and individualized learning. Conclusion and Recommendation. The supervisory model used by the qualified staff in this study was coaching; mentoring, self-directed learning that enhances professional growth and skills competencies as well as promoting the relationship between the supervisor and the supervisee. The use of supervisory models in clinical practice should be emphasized so that nurse practitioners use them to provide the best learning to approach that enables students to achieve competencies. Integration of supervisory models in the nurse curriculum so that they know the importance of when they qualify and utilize them during the supervision of students to maximized learning in a clinical setting.

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