Harvesting the Scientific Investment in Prevention Science to Promote Children's Cognitive, Affective, and Behavioral Health Workshop Summary (2015) / Chapter Skim
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2 New Analytic Methods and Technologies for Dissemination, Implementation, and Quality Improvement
2 New Analytic Methods and Technologies for Dissemination, Implementation, and Quality Improvement
Pages 5-18
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From page 5... ...
is a knowledge management system with a direct service model that provides a way to develop and tailor an intervention based on research evidence so that the intervention is best suited to the youth receiving it. This system, which was developed by Bruce Chorpita of the University of California, Los Angeles, and Eric Daleiden from PracticeWise LLC, involves a feedback and local evidence component that involves real-time monitoring of progress during implementation and adapting practices appropriately because, as Chorpita noted, "Without b eing dynamic, we are not always going to succeed." Chorpita and Daleiden developed MAP to coordinate and leverage both generalized knowledge, which stems from theory and randomized trials, and local knowledge, which is specific to the locale or even the individual for whom the intervention is implemented.
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A randomized trial of a modular treatment approach based on the MAP system but developed specifically for youth with anxiety, depression, or conduct problems found significantly greater rates of improvement compared with providing either a standard EBI or usual care (see Figure 2-1) (Weisz et al., 2012)
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From page 7... ...
The need for such dynamic therapy was revealed by a study Chorpita conducted that found that 69 percent of cases had a client event, such as the death of a loved one or a school expulsion, that caused treatment to derail with no guidance on what should be done next (Chorpita et al., 2014)
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He has been working with the Washington State Children's Administration to implement for child welfare applications a suite of behavioral EBIs, including The Incredible Years®, which was originally designed for school systems, as well as more traditional child welfare prevention interventions such as SafeCare. Recognizing the importance of providing infrastructure support for implementers of EBIs, including implementation strategies, Bruns and his colleagues developed a Web-based guidance tool for social workers to pick the right EBI based on the characteristics of the child they are work ing with, as well as a readiness assessment, so they can choose providers able to implement the EBI, and enhancements to the existing suite of EBIs, such as cross-EBI motivational enhancement training.
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Factorial trials can test multiple components of an intervention, treatment, or prevention program, or an implementation strategy. Testing multiple components simultaneously enables understanding of how to optimize them and reveals which are core elements that must be part of the inter
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These multiple aims can drive different study designs. Optimal design and purposeful sampling is a mixed methods study design aimed at achieving a compromise across different methods, according to Duan (Palinkas et al., 2013)
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"This methodology development hopefully will stimulate more local investigations that use empirical approaches, and it will empower local organizations to use their own data to address their own questions, which might be a way to help generate buy in," Duan said. Hendricks Brown of Northwestern University agreed, noting, "Every community I have gone to claims they are unlike everybody 1 More information about the PREEMPT study can be found at http://www.ucdmc.ucdavis.
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, which involves using mobile phones, tablets, computers, and sensor data to promote behavior change in support of health, mental health, and wellness. He noted that BITs got off the ground about 10 to 15 years ago when Web-based interventions such as MoodGYM were first developed.
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. The basic principle of supportive accountability is that users are more likely to adhere to a behavioral intervention technology if they have clear use goals and they know they will be communicating with a coach about whether or not they met those use goals.
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. He then applied the supportive accountability model by developing computer interventions embedded in automated peer networks that display features for support and accountability, such as interventions that display information about when people were last logged in and what their activity was (Duffecy et al., 2013)
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Mohr is using this information to develop behavioral interventions that positively reinforce desired behavior and offer suggestions for improving other behavior as well as provide information for clinicians. But Mohr noted that it takes a long time to develop and test BITs -- a time frame not well suited for digital devices, which tend to evolve swiftly.
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and the sequential multiple assignment randomized trial (SMART) : New meth ods for more potent eHealth interventions.
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. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research.
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