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Article ; Online: Reviews of attitude research in implementation science require comprehensiveness, accuracy, and specificity.

Aarons, Gregory A

2022 Volume 17, Issue 1, Page(s) 28

MeSH term(s)	Data Collection ; Humans ; Implementation Science
Language	English
Publishing date	2022-05-10
Publishing country	England
Document type	Letter ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	2225822-X
ISSN	1748-5908 ; 1748-5908
ISSN (online)	1748-5908
ISSN	1748-5908
DOI	10.1186/s13012-022-01198-4
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Article ; Online: Efficient and effective measurement of provider competence in community-based substance use treatment settings: Performance of the Motivational Interviewing Coach Rating Scale (MI-CRS).

Naar, Sylvie / Chapman, Jason E / Aarons, Gregory A

Journal of substance use and addiction treatment

2023 Volume 150, Page(s) 209027

Abstract: Objective: Efficient and effective fidelity measurement is necessary to improve rigor and reduce burden of motivational interviewing (MI) implementation studies for both fidelity outcomes and quality improvement strategies. This article reports on such ... ...

Abstract	Objective: Efficient and effective fidelity measurement is necessary to improve rigor and reduce burden of motivational interviewing (MI) implementation studies for both fidelity outcomes and quality improvement strategies. This article reports on such a measure developed with rigorous methodology and tested in community-based substance abuse treatment settings. Methods: This scale development study analyzed data from a National Institute on Drug Abuse study testing the Leadership and Organizational Change for Implementation (LOCI) strategy. Utilizing item response theory (IRT) methods and Rasch modeling, we analyzed coded recordings (N = 1089) of intervention sessions of 238 providers from 60 substance use treatment clinics across nine agencies in an implementation trial focusing on MI. Results: These methods yielded a reliable and valid 12-item scale representing single construct dimensionality, strong item-session maps, good rating scale functionality, and item fit. Separation reliability and absolute agreement for adjacent categories was high. No items were significantly misfitting, though one was borderline. The LOCI community providers were less likely to be scored in the advanced competence range and items were more difficult compared to the original development sample. Conclusions: The 12-item Motivational Interviewing Coach Rating Scale (MI-CRS) showed excellent performance in a large sample of community-based substance use treatment providers using real recordings. The MI-CRS is the first efficient and effective fidelity measure appropriate for diverse ethnic groups, with interventions that are MI only or interventions that integrate MI with other treatments, and with adolescents and adults. Follow-up coaching by trained supervisors may be needed for community-based providers to achieve the highest level of MI competence.
MeSH term(s)	Adult ; Humans ; Adolescent ; Motivational Interviewing/methods ; Reproducibility of Results ; Substance-Related Disorders/diagnosis ; Leadership
Language	English
Publishing date	2023-03-29
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2949-8759
ISSN (online)	2949-8759
DOI	10.1016/j.josat.2023.209027
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Article ; Online: Acceptability and feasibility of policy implementation strategies for taxes earmarked for behavioral health services.

Purtle, Jonathan / Stadnick, Nicole A / Wynecoop, Megan / Walker, Sarah C / Bruns, Eric J / Aarons, Gregory A

Frontiers in health services

2024 Volume 4, Page(s) 1304049

Abstract: Background: This study's aims are to: (1) Compare the acceptability and feasibility of five types of implementation strategies that could be deployed to increase the reach of evidence-based practices (EBPs) with revenue from policies that earmark taxes ... ...

Abstract	Background: This study's aims are to: (1) Compare the acceptability and feasibility of five types of implementation strategies that could be deployed to increase the reach of evidence-based practices (EBPs) with revenue from policies that earmark taxes for behavioral health services, and (2) Illustrate how definitions of implementation strategies and measures of acceptability and feasibility can be used in policy-focused implementation science research. Methods: Web-based surveys of public agency and community organization professionals involved with earmarked tax policy implementation were completed in 2022-2023 ( Findings: For acceptability, capacity-building strategies had the highest rating ( Conclusions: Capacity-building and dissemination strategies may be well-received and readily deployed by policy implementers to support EBPs implementation with revenue from taxes earmarked for behavioral health services. Adapting definitions of implementation strategies for policy-focused topics, and applying established measures of acceptability and feasibility to these strategies, demonstrates utility as an approach to advance research on policy-focused implementation strategies.
Language	English
Publishing date	2024-04-04
Publishing country	Switzerland
Document type	Journal Article
ISSN	2813-0146
ISSN (online)	2813-0146
DOI	10.3389/frhs.2024.1304049
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Article ; Online: Applying after-action reviews to child and family teams to improve mental health service linkage within child welfare services: a study protocol.

Sklar, Marisa / Kenneally, Ryan / Aarons, Gregory A / Fettes, Danielle L

Implementation science communications

2023 Volume 4, Issue 1, Page(s) 121

Abstract: Background: Half of child-welfare-involved children and adolescents meet the criteria for at least one mental health diagnosis. This project proposes to improve successful mental health service linkage in child welfare services (CWS) by adapting and ... ...

Abstract	Background: Half of child-welfare-involved children and adolescents meet the criteria for at least one mental health diagnosis. This project proposes to improve successful mental health service linkage in child welfare services (CWS) by adapting and testing the after-action review (AAR) team effectiveness intervention to augment the child and family team (CFT) services' intervention. Despite being both required and a collaborative approach to service planning, CFT meetings are implemented with questionable fidelity and consistency, rarely including the voice of children and families as intended. Methods: Using a parallel group trial design, with non-equivalent comparison groups, and qualitative and quantitative methodology, this study will tailor and assess the impact of the AAR on enhancing CFT outcomes. The authors will conduct a qualitative needs assessment targeting the ongoing implementation of the CFT services intervention in a large, publicly funded, CWS system. A qualitative inquiry consisting of interviews and focus groups with key stakeholders will result in the preparation of an action plan to address identified gaps between the current and desired CFT services intervention outcomes. The AAR implementation strategy will be adapted and tailored to address the CFT services' intervention needs. To test the effectiveness of the AAR on improving outcomes associated with the CFT services intervention, we will utilize blocked randomization of four CWS caseworkers from two CWS system regions to either the intervention condition (CFT + AAR) or standard implementation (CFT as usual). The authors will collect data from the CWS caseworkers and additional CFT members via web-based surveys. Mechanisms of the AAR team effectiveness intervention for CFT implementation will be assessed. Discussion: By inclusion of child and family voice, the AAR-enhanced CFT should lead to increased fidelity to the CFT intervention and greater levels of parental satisfaction with the service and shared decision-making, thus resulting in enhanced follow-through with service plans and linkage to mental health treatment services for children. The knowledge gained by this randomized clinical trial has the potential to benefit service delivery and integration for CWS leaders, caseworkers, formal and informal CFT member support persons, parents/caregivers, and children with open cases. Improving intervention effectiveness, both at the system and family levels, is crucial for practice efficiencies and improved child and family outcomes. Trial registration: NCT05629013. Approval date: November 28, 2022 (version 1). Trial sponsor: University of California, San Diego. Responsible party: Danielle Fettes.
Language	English
Publishing date	2023-10-05
Publishing country	England
Document type	Journal Article
ISSN	2662-2211
ISSN (online)	2662-2211
DOI	10.1186/s43058-023-00479-3
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Article: Site-level evidence-based practice accreditation: A qualitative exploration using institutional theory.

Hall, Rebecca Lengnick / Willging, Cathleen Elizabeth / Aarons, Gregory A / Reeder, Kendal

Human service organizations, management, leadership & governance

2023 Volume 47, Issue 3, Page(s) 157–175

Abstract: Accreditation is gaining ground in human services as leaders find ways to demonstrate the quality and legitimacy of services. This study examined site-level accreditation for SafeCare®, an evidence-based practice designed to prevent and reduce child ... ...

Abstract	Accreditation is gaining ground in human services as leaders find ways to demonstrate the quality and legitimacy of services. This study examined site-level accreditation for SafeCare®, an evidence-based practice designed to prevent and reduce child maltreatment. We leveraged two waves of qualitative data to explore the perspectives of trainers, organizational and system leaders, and program developers who participated in an initial rollout of a site-level accreditation process for SafeCare. Institutional theory was used to frame accreditation's potential benefits, burden, and impact. Findings highlight specific considerations for the human service environment, including the inherent resource scarcity, interdependence among organizations, and the impact of cost and slow-moving bureaucratic processes.
Language	English
Publishing date	2023-04-12
Publishing country	United States
Document type	Journal Article
ISSN	2330-3131
ISSN	2330-3131
DOI	10.1080/23303131.2023.2194940
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Article ; Online: Common Elements Approaches to Implementation Research and Practice: Methods and Integration with Intervention Science.

Engell, Thomas / Stadnick, Nicole A / Aarons, Gregory A / Barnett, Miya L

Global implementation research and applications

2023 Volume 3, Issue 1, Page(s) 1–15

Abstract: We propose that : Supplementary information: The online version contains supplementary material available at 10.1007/s43477-023-00077-4. ...

Abstract	We propose that Supplementary information: The online version contains supplementary material available at 10.1007/s43477-023-00077-4.
Language	English
Publishing date	2023-03-22
Publishing country	Switzerland
Document type	Journal Article
ISSN	2662-9275
ISSN (online)	2662-9275
DOI	10.1007/s43477-023-00077-4
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Article ; Online: Tailoring dissemination strategies to increase evidence-informed policymaking for opioid use disorder treatment: study protocol.

Crable, Erika L / Grogan, Colleen M / Purtle, Jonathan / Roesch, Scott C / Aarons, Gregory A

Implementation science communications

2023 Volume 4, Issue 1, Page(s) 16

Abstract: Background: Policy is a powerful tool for systematically altering healthcare access and quality, but the research to policy gap impedes translating evidence-based practices into public policy and limits widespread improvements in service and population ... ...

Abstract	Background: Policy is a powerful tool for systematically altering healthcare access and quality, but the research to policy gap impedes translating evidence-based practices into public policy and limits widespread improvements in service and population health outcomes. The US opioid epidemic disproportionately impacts Medicaid members who rely on publicly funded benefits to access evidence-based treatment including medications for opioid use disorder (MOUD). A myriad of misaligned policies and evidence-use behaviors by policymakers across federal agencies, state Medicaid agencies, and managed care organizations limit coverage of and access to MOUD for Medicaid members. Dissemination strategies that improve policymakers' use of current evidence are critical to improving MOUD benefits and reducing health disparities. However, no research describes key determinants of Medicaid policymakers' evidence use behaviors or preferences, and few studies have examined data-driven approaches to developing dissemination strategies to enhance evidence-informed policymaking. This study aims to identify determinants and intermediaries that influence policymakers' evidence use behaviors, then develop and test data-driven tailored dissemination strategies that promote MOUD coverage in benefit arrays. Methods: Guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, we will conduct a national survey of state Medicaid agency and managed care organization policymakers to identify determinants and intermediaries that influence how they seek, receive, and use research in their decision-making processes. We will use latent class methods to empirically identify subgroups of agencies with distinct evidence use behaviors. A 10-step dissemination strategy development and specification process will be used to tailor strategies to significant predictors identified for each latent class. Tailored dissemination strategies will be deployed to each class of policymakers and assessed for their acceptability, appropriateness, and feasibility for delivering evidence about MOUD benefit design. Discussion: This study will illuminate key determinants and intermediaries that influence policymakers' evidence use behaviors when designing benefits for MOUD. This study will produce a critically needed set of data-driven, tailored policy dissemination strategies. Study results will inform a subsequent multi-site trial measuring the effectiveness of tailored dissemination strategies on MOUD benefit design and implementation. Lessons from dissemination strategy development will inform future research about policymakers' evidence use preferences and offer a replicable process for tailoring dissemination strategies.
Language	English
Publishing date	2023-02-16
Publishing country	England
Document type	Journal Article
ISSN	2662-2211
ISSN (online)	2662-2211
DOI	10.1186/s43058-023-00396-5
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Article ; Online: Correction: Tailoring dissemination strategies to increase evidence-informed policymaking for opioid use disorder treatment: study protocol.

Crable, Erika L / Grogan, Colleen M / Purtle, Jonathan / Roesch, Scott C / Aarons, Gregory A

Implementation science communications

2023 Volume 4, Issue 1, Page(s) 28

Language	English
Publishing date	2023-03-17
Publishing country	England
Document type	Published Erratum
ISSN	2662-2211
ISSN (online)	2662-2211
DOI	10.1186/s43058-023-00406-6
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Article ; Online: A Tale of Two Taxes: Implementation of Earmarked Taxes for Behavioral Health Services in California and Washington State.

Purtle, Jonathan / Stadnick, Nicole A / Wynecoop, Megan / Walker, Sarah C / Bruns, Eric J / Aarons, Gregory A

Psychiatric services (Washington, D.C.)

2023 Volume 75, Issue 5, Page(s) 410–418

Abstract: Objective: The authors sought to characterize perceptions of the impacts, attributes, and support for taxes earmarked for behavioral health services and to compare perceptions of the taxes among professionals in California and Washington, two states ... ...

Abstract	Objective: The authors sought to characterize perceptions of the impacts, attributes, and support for taxes earmarked for behavioral health services and to compare perceptions of the taxes among professionals in California and Washington, two states differing in earmarked tax designs. Methods: Surveys were completed by 155 public agency and community organization professionals involved in tax implementation in California (N=87) and Washington State (N=68) during 2022-2023 (29% response rate). Respondents indicated their perceptions of the taxes' impacts, attributes, and support. Responses were summed as aggregate scores and were also analyzed as individual items. Bivariate analyses were used to compare responses of professionals in California versus Washington State. Results: Earmarked taxes were generally regarded positively. Of the respondents, >80% strongly agreed that the taxes increased funding for services and were helpful, and only 10% strongly agreed that the taxes decreased behavioral health funding from other sources. Substantially more respondents in California than in Washington State strongly agreed that taxes' reporting requirements were complicated (45% vs. 5%, p<0.001) and that the taxes increased unjustified scrutiny of services or systems (33% vs. 2%, p<0.001). However, more respondents in California than in Washington State also strongly agreed that the taxes increased public awareness about behavioral health (56% vs. 15%, p<0.001) and decreased behavioral health stigma (47% vs. 14%, p<0.001). Conclusions: Perceptions of the strengths and weaknesses of taxes earmarked for behavioral health services may vary by design features of the tax. Such features include stigma-reduction initiatives and tax spending and reporting requirements.
MeSH term(s)	Washington ; Humans ; California ; Taxes/economics ; Mental Health Services/economics ; Surveys and Questionnaires
Language	English
Publishing date	2023-11-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1220173-x
ISSN	1557-9700 ; 1075-2730
ISSN (online)	1557-9700
ISSN	1075-2730
DOI	10.1176/appi.ps.20230257
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Article ; Online: Misalignment in Community Mental Health Leader and Therapist Ratings of Psychological Safety Climate Predicts Therapist Self-Efficacy with Evidence-Based Practices (EBPs).

Byeon, Y Vivian / Brookman-Frazee, Lauren / Aarons, Gregory A / Lau, Anna S

Administration and policy in mental health

2023 Volume 50, Issue 4, Page(s) 673–684

Abstract: Therapist self-efficacy in delivering evidence-based practices (EBPs) is associated with implementation outcomes, including adoption and sustainment in community mental health settings. Inner context organizational climate, including psychological safety, ...

Abstract	Therapist self-efficacy in delivering evidence-based practices (EBPs) is associated with implementation outcomes, including adoption and sustainment in community mental health settings. Inner context organizational climate, including psychological safety, can proximally shape therapist learning experiences within EBP implementation. Psychologically safe environments are conducive to learning behaviors including taking risks, admitting mistakes, and seeking feedback. Organization leaders are instrumental in facilitating psychological safety, but may have differing perspectives of organizational climate than front-line therapists. Discrepant leader and therapist views of psychological safety may have independent associations with therapist EBP learning and implementation outcomes over and above average therapist perceptions of climate. This study examined survey data from 337 therapists and 123 leaders from 49 programs contracted to deliver multiple EBPs within a study examining determinants of sustainment within a large system-driven implementation. Both leaders and therapists completed measures of psychological safety climate and therapists reported on their self-efficacy in delivering multiple EBPs in children's mental health services. Polynomial regression and response surface analysis models were conducted to examine the associations of therapist and leader reports of psychological safety and therapist EBP self-efficacy. Greater discrepancies between leader and therapist reports of psychological safety, in either direction, were associated with lower therapist EBP self-efficacy. Alignment in leader and therapist views of psychological safety climate may impact EBP implementation outcomes. Strategies for improving alignment in perceptions and priorities among organizational members can be included in organizational implementation interventions and may represent unexamined implementation mechanisms of action.
MeSH term(s)	Child ; Humans ; Mental Health ; Organizational Culture ; Self Efficacy ; Evidence-Based Practice ; Mental Health Services
Language	English
Publishing date	2023-05-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1025319-1
ISSN	1573-3289 ; 0894-587X
ISSN (online)	1573-3289
ISSN	0894-587X
DOI	10.1007/s10488-023-01269-8
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