Predicting implementation of an empirically supported treatment for cancer patients using the theory of planned behavior

Enhancing Evidence-Based Practice in Rural Social Work: Applying the Theory of Planned Behavior to Identify Key Determinants

PURPOSE

This study explores the application and extent of utilization of Evidence-Based Practice (EBP) among rural social workers, identifying key factors such as attitudes, social pressures, and perceived barriers that influence its use.

METHODS

Utilizing the Theory of Planned Behavior as a framework, this research involved a comprehensive survey targeting rural social workers. The survey assessed their attitudes toward EBP, the social pressures, and the barriers in implementing EBP. Data from 91 participants were analyzed using multiple regression to determine how these factors impact EBP utilization.

RESULTS

The analysis indicated that while attitudes toward EBP did not significantly affect its use, perceived ease of use, social pressures, and practical barriers were significant predictors. Interestingly, the data showed that external factors like organizational support and resource availability played a larger role than personal attitudes in the adoption of EBP. The regression model successfully explained 39% of the variance in EBP usage among rural social workers.

DISCUSSION

The findings underscore the importance of external over internal factors in the adoption of EBP within rural settings. The study suggests that improving access to EBP resources and enhancing organizational support could facilitate more effective use of EBP among rural social workers.

CONCLUSION

Effective implementation of EBP in rural areas necessitates addressing both perceived and actual barriers. Developing strategies to enhance resource availability and organizational support is recommended to boost EBP adoption, ultimately aiming to improve service outcomes and client well-being.

Oncology mental health providers' adaptation of an evidence-based intervention: A mixed-methods study

BACKGROUND

Adaptations are intentional modifications maximizing the fit of an evidence-based intervention (EBI) in new context. Little is known about EBI adaptation within psychosocial oncology. Guided by the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME), this mixed-methods study describes oncology mental health providers' planned adaptations to a psychosocial oncology EBI and examines the relationship between planned adaptations and longitudinal EBI usage.

METHODS

Providers (N = 128) were social workers (47%) and psychologists (40%) practicing in community settings (44%) or academic medical centers (41%). They attended a 3-day training on a multicomponent psychosocial oncology EBI, the Biobehavioral Intervention (BBI). During training, providers prepared an "adaptation plan" describing necessary adaptations to BBI and rationales for change. Qualitative data from adaptation plans were analyzed using directed content analysis. Linear mixed models examined the relationship between adaptation characteristics (number, similarity to the manualized BBI) and EBI usage across 12 months post-training.

RESULTS

Three sets of qualitative themes reflecting FRAME elements emerged: (1) content modifications (e.g., shortening/condensing, selecting elements, adding/removing elements); (2) contextual changes (e.g., alternative group formats); and (3) reasons for adaptations (e.g., organization/setting, provider, and recipient factors). Neither number of adaptations nor adaptation similarity were associated with BBI usage across 12 months post-training.

CONCLUSIONS

To our knowledge, this study is the first to characterize oncology mental health providers' planned adaptations to a psychosocial oncology EBI. Planned adaptations did not increase usage, but importantly they did not decrease usage. The adaptation process enabled providers to make thoughtful adaptation choices, with implementation successful irrespective of setting constraints.

Knowledge and attitudes of Implementation Support Practitioners-Findings from a systematic integrative review

BACKGROUND

It requires thoughtful planning and work to successfully apply and sustain research-supported interventions like healthcare treatments, social support, or preventive programs in practice. Implementation support practitioners (ISPs) such as facilitators, technical assistance providers, knowledge brokers, coaches or consultants may be involved to actively support the implementation process. This article presents knowledge and attitudes ISPs bring to their work.

METHODS

Building on a previously developed program logic, a systematic integrative review was conducted. Literature was sourced by searching nine electronic data bases, organizational websites, and by launching a call for publications among selected experts and social media. Article screening was performed independently by two researchers, and data from included studies were extracted by members of the research team and quality-assured by the lead researcher. The quality of included RCTs was assessed based on a framework by Hodder and colleagues. Thematic Analysis was used to capture information on knowledge and attitudes of ISPs across the included studies. Euler diagrams and heatmaps were used to present the results.

RESULTS

Results are based on 79 included studies. ISPs reportedly displayed knowledge about the clinical practice they work with, implementation / improvement practice, the local context, supporting change processes, and facilitating evidence-based practice in general. In particular, knowledge about the intervention to be implemented and its target population, specific improvement / implementation methods and approaches, organizational structures and sensitivities, training, and characteristics of (good) research was described in the literature. Seven themes describing ISPs' attitudes were identified: 1) professional, 2) motivated / motivating / encouraging / empowering, 3) empathetic / respectful / sensitive, 4) collaborative / inclusive, 5) authentic, 6) creative / flexible / innovative / adaptive, and 7) frank / direct / honest. Pertaining to a professional attitude, being responsive and focused were the most prevalent indicators across included publications.

CONCLUSION

The wide range and complexity of knowledge and attitudes found in the literature calls for a comprehensive and systematic approach to collaboratively develop a professional role for ISPs across disciplines. Embedding the ISP role in different health and social welfare settings will enhance implementation capacities considerably.

Replicating dissemination and identifying mechanisms of implementation of an empirically supported treatment

OBJECTIVE

Implementation research is needed in cancer control. Replication of the dissemination of empirically supported treatments (ESTs) is important as is the identification of mechanisms by which dissemination leads to implementation. Addressing these gaps, Study 1 (Cohorts 3-6, N = 104) tests for replication of a successful dissemination to community providers (Brothers et al., 2015; Cohorts 1-2; N = 62) and Study 2 (Cohorts 1-6) tests providers' changes on dissemination outcomes as mechanisms of EST usage.

METHOD

The Biobehavioral Intervention (BBI), a psychological EST in cancer control, was disseminated to oncology mental health providers using manual provision, didactics, roleplays, and other strategies. Study 1 tested for pre/post changes in dissemination outcomes (BBI knowledge/skills and attitudes toward and self-efficacy to deliver ESTs/BBI) between cohorts (1-2 vs. 3-6) with repeated measures ANOVAs. In Study 2, the implementation outcome was providers' (N = 166) BBI usage with patients (percent treated). Structural equation models tested dissemination outcome changes as predictors of usage at 2- and 4-months.

RESULTS

Study 1 replicated high dissemination outcomes and significant gains in BBI knowledge (p < .001) in Cohorts 3-6. Unlike Cohorts 1-2, significant gains were observed in self-efficacy (ps < .001) but not attitudes toward ESTs (p = .523) in Cohorts 3-6. In Study 2, gains in providers' self-efficacy (ps < .05) and EST attitudes (p = .008) predicted greater 2-month (58.4% ± 35.5%) and 4-month (66.2% ± 35.0%) usage of the BBI with patients, respectively.

CONCLUSIONS

This is the only replication of a dissemination for a psychological EST in cancer control. Results reliably show disseminations enhancing providers' self-efficacy to use and positive attitudes toward ESTs as mechanisms for EST implementation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Achieving oncology mental health providers' usage of an empirically supported treatment: Lessons learned

OBJECTIVE

There is a need for oncology mental health providers to receive training to use empirically supported psychological treatments (ESTs) with their patients. The purpose of this editorial is to describe "lessons learned" from disseminating-conducting EST trainings-and supporting providers' capacity and confidence to use the EST.

METHOD

Processes and outcomes from conducting six, 3-days (18 h) EST training institutes from 2012-2016 are discussed. Institutes trained 166 full time oncology mental health providers from more than 100 different settings. The dissemination was intentionally designed to achieve EST implementation, i.e., therapists' sustained usage of the EST for at least 12 months post training.

RESULTS

Previously published discussion and findings show the effort was successful in achieving positive EST dissemination outcomes and sustained EST implementation by providers. Thus, "lessons learned" include discussions of (1) orientation to design education/training to achieve EST usage using theory based aims and outcomes of training efficacy; (2) multimodal, educational strategies used to achieve therapists' positive attitudes toward and self-efficacy to implement the EST; (3) guidance to therapists for adapting the EST to their practice settings while maintaining fidelity; (4) assistance to therapists to identify and problem solve implementation challenges; and (5) using patient reported outcome measures to determine clinical change.

CONCLUSION

Our discussion of the plan, methods, and goals of EST training contributes to the science of dissemination/implementation by providing support for (1) theory-informed EST dissemination, and (2) mechanisms of EST implementation. For researchers, our experience may guide future EST dissemination/implementation efforts in psycho-oncology. For therapists, lessons learned provide criteria for evaluating future continuing education options.

Understanding consumer participation in managing ICT waste: Findings from two-staged Structural Equation Modeling-Artificial Neural Network approach

For environmental management, the role of consumers is extremely important in the settings of reverse logistics. Though it is a manufacturer's extended responsibility to handle the waste however by becoming the supplier of the end of life products, consumers' participation needed to be encouraged and hence require proper attention. For the said purpose, the present study is conducted whereby crucial determinants of consumer reversing behavior were identified and analyzed by the help of a unique two-staged methodology of partial least square-structural equation modeling and artificial neural network. The data comprised of 746 collected by the survey from ICT users whereby the findings reported to have significant relationships of return intention and reversing behavior with their determinants. Moreover, the aforementioned unique methodology helps in generating more robust results as findings from ANN reported to have moral norm as most important variable which according to PLS-SEM was second most significant construct, whereas attitude was found to be second most important as per ANN which according to PLS-SEM is the most significant construct. Nevertheless, the study offers insights which contributes in the literature of environmental management, reverse logistics, and consumer behavior. Lastly, based on the findings, the managerial implications and recommendations are accordingly discussed.