Applying the Policy Ecology Framework to Philadelphia’s Behavioral Health Transformation Efforts

Raghavan et al. (Implement Sci 3(26):1-9, 2008) proposed that effective implementation of evidence-based practices requires implementation strategies deployed at multiple levels of the "policy ecology," including the organizational, regulatory or purchaser agency, political, and social levels. However, much of implementation research and practice targets providers without accounting for contextual factors that may influence provider behavior. This paper examines Philadelphia's efforts to work toward an evidence-based and recovery-oriented behavioral health system, and uses the policy ecology framework to illustrate how multifaceted, multilevel implementation strategies can facilitate the widespread implementation of evidence-based practices. Ongoing challenges and implications for research and practice are discussed

Proceedings of the 3rd Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2015: advancing efficient methodologies through community partnerships and team science

It is well documented that the majority of adults, children and families in need of evidence-based behavioral health interventionsi do not receive them [1, 2] and that few robust empirically supported methods for implementing evidence-based practices (EBPs) exist. The Society for Implementation Research Collaboration (SIRC) represents a burgeoning effort to advance the innovation and rigor of implementation research and is uniquely focused on bringing together researchers and stakeholders committed to evaluating the implementation of complex evidence-based behavioral health interventions. Through its diverse activities and membership, SIRC aims to foster the promise of implementation research to better serve the behavioral health needs of the population by identifying rigorous, relevant, and efficient strategies that successfully transfer scientific evidence to clinical knowledge for use in real world settings [3]. SIRC began as a National Institute of Mental Health (NIMH)-funded conference series in 2010 (previously titled the “Seattle Implementation Research Conference”; $150,000 USD for 3 conferences in 2011, 2013, and 2015) with the recognition that there were multiple researchers and stakeholdersi working in parallel on innovative implementation science projects in behavioral health, but that formal channels for communicating and collaborating with one another were relatively unavailable. There was a significant need for a forum within which implementation researchers and stakeholders could learn from one another, refine approaches to science and practice, and develop an implementation research agenda using common measures, methods, and research principles to improve both the frequency and quality with which behavioral health treatment implementation is evaluated. SIRC’s membership growth is a testament to this identified need with more than 1000 members from 2011 to the present.ii SIRC’s primary objectives are to: (1) foster communication and collaboration across diverse groups, including implementation researchers, intermediariesi, as well as community stakeholders (SIRC uses the term “EBP champions” for these groups) – and to do so across multiple career levels (e.g., students, early career faculty, established investigators); and (2) enhance and disseminate rigorous measures and methodologies for implementing EBPs and evaluating EBP implementation efforts. These objectives are well aligned with Glasgow and colleagues’ [4] five core tenets deemed critical for advancing implementation science: collaboration, efficiency and speed, rigor and relevance, improved capacity, and cumulative knowledge. SIRC advances these objectives and tenets through in-person conferences, which bring together multidisciplinary implementation researchers and those implementing evidence-based behavioral health interventions in the community to share their work and create professional connections and collaborations

The relationship between exposure to violence and depression: An ecological model of protective factors among African American adolescents

Depression among youth is recognized as a significant public health concern. Increased research has focused on identifying risk and protective factors for depression among youth. However, limited attention has been directed at examining community-level risk factors for depression, such exposure to violence, or has focused on ethnic minority groups, such as African American adolescents. This study examined the relationship between 3 types of exposure to violence (community, family, and school) and depressive symptoms among 212 (133 females; 79 females) African American high school students. An ecological model of depression based on Bronfenbrenner's (1979) ecological system's theory is presented that includes multiple protective factors at three levels (individual-level, micro-level, meso-level). Although the proposed model was not supported, exposure to violence as a risk factor and several compensatory factors for depressive symptoms were identified. Exposure to community violence and exposure to school violence were associated with increased depressive symptoms. Increased feelings of self-acceptance, racial identity, family support, peer support, and neighborhood cohesion were associated with fewer depressive symptoms. Results highlight the importance of examining both individual and community-level risk and protective factors. Implications of the findings for the development of culturally relevant preventive interventions that target youth who are exposed to violence are discussed. KEY WORDS: community violence exposure; depression, African Americans; adolescents; protective factor