ACCESS FOR ADOLESCENTS: MULTISYSTEMIC THERAPY IN THE JUVENILE JUSTICE SYSTEM

In this application for funding, DC YouthLink, a non-profit organization that connects adolescents in the juvenile justice system to community resources, proposes to implement an evidence-based mental health intervention into the juvenile justice system in Washington D.C. The Director of DC YouthLink will serve as the Principal Investigator for this pilot program; she, along with five trained staff members, will be responsible for implementing multisystemic therapy (MST), an intensive form of therapy designed specifically for at-risk youth and their families. We propose to intervene at three main stages of the juvenile justice system— intake, correctional placement/probation supervision, and reentry. The short-term goals of this program will be to increase screening rates for mental illness, access to an evidence-based intervention, and levels of family functioning. Previous studies suggest that the MST program’s combination of therapy, a supportive social network, and behavioral parent training leads to a long-term decrease in recidivism rates compared to the standard of care in the juvenile justice system. All project activities include an extensive plan for evaluation and dissemination. In conclusion, we believe that this program has the potential to provide much-needed mental health services to a particularly vulnerable population, which will benefit the youth and their families, as well as the Washington D.C. community as a whole

Actual causes of death in relation to media, policy, and funding attention: Examining public health priorities

Despite numerous public health advancements over the last century, we continue to under-invest in prevention and public health efforts. As a result, one of the most challenging aspects of public health is prioritizing the use of limited resources. Building on the foundation of previous researchers, the goal of this exploratory study was to provide current estimates for the actual causes of death, media attention, policy focus, and research funding in the United States. In addition, we sought to calculate and compare media attention, policy attention, and research funding trends to better assess the nation\u27s prioritization of health issues. Using a systematic approach, we searched available databases, including Media Cloud, Nexis Uni, Congress.gov, and the Department of Health and Human Services Tracking Accountability in Government Grants System from January 1, 2010-December 31, 2019 and compared how the actual causes of death in the United States align with health-related media attention, policy attention, and federal spending. Overall, our findings suggest that our priorities are not well-aligned with the actual causes of death. Certain actual causes appear to be consistently misaligned across media, legislative, and financial sectors (e.g., tobacco). This work highlights the importance of multiple strategies-media coverage, national legislation, and government spending-as indicators of public health attention and priorities. These results may inform discussions about how to best allocate U.S. public health resources to better align with the actual causes of death

Social determinants of health and cancer screening implementation and outcomes in the USA: A systematic review protocol

BACKGROUND: Improving the delivery, uptake, and implementation of cancer screening to meet evidence-based recommendations is needed to reduce persistent cancer health disparities in the USA. Current national public health targets emphasize the role of social determinants of health (SDOH) on cancer screening. However, there remains a need to explicate these linkages, toward the goal of identifying and implementing effective interventions that target and address SDOH to reduce inequities in cancer screening. METHODS: We will conduct a systematic review of English language peer-reviewed original research articles published between 2010 and 2021 that describe observational (qualitative and quantitative) and intervention studies conducted in the USA. In alignment with Healthy People 2030, we will include studies of breast, cervical, colorectal, and/or lung cancer screening. Guided by multiple SDOH frameworks, we will broadly define SDOH by five domain areas: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Following systematic literature searches in five databases (Ovid MEDLINE, Embase, CINAHL, Web of Science, Cochrane Library) and piloting of screening procedures, reviewers will independently screen titles/abstracts for potential relevance. Reviewer pairs will then screen full text articles for eligibility criteria. We will extract data items from included articles, including study characteristics, cancer screening intervention information, and coding of SDOH constructs. We will assess study quality using the Mixed Methods Appraisal Tool and synthesize our findings using narrative, descriptive statistics, tables, and figures. Our approach will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) recommendations. DISCUSSION: By completing this systematic review, we will summarize recent literature on SDOH and cancer screening, identify research gaps for inclusion of SDOH, and propose future opportunities for advancing equity in cancer screening by integrating SDOH as part of the implementation context to promote uptake, sustainability, and scale-up in the implementation of screening guidelines. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021276582

A perspective on implementation outcomes and strategies to promote the uptake of COVID-19 vaccines

Recent articles have highlighted the importance of incorporating implementation science concepts into pandemic-related research. However, limited research has been documented to date regarding implementation outcomes that may be unique to COVID-19 vaccinations and how to utilize implementation strategies to address vaccine program-related implementation challenges. To address these gaps, we formed a global COVID-19 implementation workgroup of implementation scientists who met weekly for over a year to review the available literature and learn about ongoing research during the pandemic. We developed a hierarchy to prioritize the applicability of lessons learned from the vaccination-related implementation literature. We identified applications of existing implementation outcomes as well as identified additional implementation outcomes. We also mapped implementation strategies to those outcomes. Our efforts provide rationale for the utility of using implementation outcomes in pandemic-related research. Furthermore, we identified three additional implementation outcomes: availability, health equity, and scale-up. Results include a list of COVID-19 relevant implementation strategies mapped to the implementation outcomes

A scoping review of frameworks in empirical studies and a review of dissemination frameworks

BACKGROUND: The field of dissemination and implementation (D&I) research has grown immensely in recent years. However, the field of dissemination research has not coalesced to the same degree as the field of implementation research. To advance the field of dissemination research, this review aimed to (1) identify the extent to which dissemination frameworks are used in dissemination empirical studies, (2) examine how scholars define dissemination, and (3) identify key constructs from dissemination frameworks. METHODS: To achieve aims 1 and 2, we conducted a scoping review of dissemination studies published in D&I science journals. The search strategy included manuscripts published from 1985 to 2020. Articles were included if they were empirical quantitative or mixed methods studies about the dissemination of information to a professional audience. Studies were excluded if they were systematic reviews, commentaries or conceptual papers, scale-up or scale-out studies, qualitative or case studies, or descriptions of programs. To achieve aim 1, we compiled the frameworks identified in the empirical studies. To achieve aim 2, we compiled the definitions from dissemination from frameworks identified in aim 1 and from dissemination frameworks identified in a 2021 review (Tabak RG, Am J Prev Med 43:337-350, 2012). To achieve aim 3, we compile the constructs and their definitions from the frameworks. FINDINGS: Out of 6017 studies, 89 studies were included for full-text extraction. Of these, 45 (51%) used a framework to guide the study. Across the 45 studies, 34 distinct frameworks were identified, out of which 13 (38%) defined dissemination. There is a lack of consensus on the definition of dissemination. Altogether, we identified 48 constructs, divided into 4 categories: process, determinants, strategies, and outcomes. Constructs in the frameworks are not well defined. IMPLICATION FOR D&I RESEARCH: This study provides a critical step in the dissemination research literature by offering suggestions on how to define dissemination research and by cataloging and defining dissemination constructs. Strengthening these definitions and distinctions between D&I research could enhance scientific reproducibility and advance the field of dissemination research

Quantitative measures of health policy implementation determinants and outcomes: A systematic review

BACKGROUND: Public policy has tremendous impacts on population health. While policy development has been extensively studied, policy implementation research is newer and relies largely on qualitative methods. Quantitative measures are needed to disentangle differential impacts of policy implementation determinants (i.e., barriers and facilitators) and outcomes to ensure intended benefits are realized. Implementation outcomes include acceptability, adoption, appropriateness, compliance/fidelity, feasibility, penetration, sustainability, and costs. This systematic review identified quantitative measures that are used to assess health policy implementation determinants and outcomes and evaluated the quality of these measures. METHODS: Three frameworks guided the review: Implementation Outcomes Framework (Proctor et al.), Consolidated Framework for Implementation Research (Damschroder et al.), and Policy Implementation Determinants Framework (Bullock et al.). Six databases were searched: Medline, CINAHL Plus, PsycInfo, PAIS, ERIC, and Worldwide Political. Searches were limited to English language, peer-reviewed journal articles published January 1995 to April 2019. Search terms addressed four levels: health, public policy, implementation, and measurement. Empirical studies of public policies addressing physical or behavioral health with quantitative self-report or archival measures of policy implementation with at least two items assessing implementation outcomes or determinants were included. Consensus scoring of the Psychometric and Pragmatic Evidence Rating Scale assessed the quality of measures. RESULTS: Database searches yielded 8417 non-duplicate studies, with 870 (10.3%) undergoing full-text screening, yielding 66 studies. From the included studies, 70 unique measures were identified to quantitatively assess implementation outcomes and/or determinants. Acceptability, feasibility, appropriateness, and compliance were the most commonly measured implementation outcomes. Common determinants in the identified measures were organizational culture, implementation climate, and readiness for implementation, each aspects of the internal setting. Pragmatic quality ranged from adequate to good, with most measures freely available, brief, and at high school reading level. Few psychometric properties were reported. CONCLUSIONS: Well-tested quantitative measures of implementation internal settings were under-utilized in policy studies. Further development and testing of external context measures are warranted. This review is intended to stimulate measure development and high-quality assessment of health policy implementation outcomes and determinants to help practitioners and researchers spread evidence-informed policies to improve population health. REGISTRATION: Not registered

Global Landscape Review of Serotype-Specific Invasive Pneumococcal Disease Surveillance among Countries Using PCV10/13: The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) Project.

Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome. Here we systematically characterize and summarize the global landscape of routine serotype-specific IPD surveillance in PCV10/13-using countries and describe the subset that are included in PSERENADE. Of 138 countries using PCV10/13 as of 2018, we identified 109 with IPD surveillance systems, 76 of which met PSERENADE data collection eligibility criteria. PSERENADE received data from most (n = 63, 82.9%), yielding 240,639 post-PCV10/13 introduction IPD cases. Pediatric and adult surveillance was represented from all geographic regions but was limited from lower income and high-burden countries. In PSERENADE, 18 sites evaluated PCV10, 42 PCV13, and 17 both; 17 sites used a 3 + 0 schedule, 38 used 2 + 1, 13 used 3 + 1, and 9 used mixed schedules. With such a sizeable and generally representative dataset, PSERENADE will be able to conduct robust analyses to estimate PCV impact and inform policy at national and global levels regarding adult immunization, schedule, and product choice, including for higher valency PCVs on the horizon

The Potential of Mental Health Policy Implementation: Methods and Applications

Mental illness affects roughly 20% of the world in some capacity and can be debilitating. Though a large emphasis has historically been placed on individual-level interventions (e.g., therapy or medication), mental health policies present an opportunity to intervene on a large scale, with the potential to enhance impact and equity. This dissertation contributes to the mental health policy research literature in three main ways—(1) exploring factors affecting policymakers’ overall support of mental health policies; (2) assessing the use and quality of quantitative and qualitative methods within this field; and (3) exploring implementation determinants and outcomes, as well as strategies used to bolster implementation. The findings provide insight into individual-, organizational-, and broader policy-level constructs affecting policy development and implementation. The findings also identify measurement gaps within mental health policy implementation research and areas for increased methodological rigor. This dissertation contributes to a more evidence-informed approach to implementing mental health policy, with long-term implications for improving mental health and health equity on a population level

Variation in Research Designs Used to Test the Effectiveness of Dissemination and Implementation Strategies: A Review

BackgroundThe need for optimal study designs in dissemination and implementation (D&I) research is increasingly recognized. Despite the wide range of study designs available for D&I research, we lack understanding of the types of designs and methodologies that are routinely used in the field. This review assesses the designs and methodologies in recently proposed D&I studies and provides resources to guide design decisions.MethodsWe reviewed 404 study protocols published in the journal Implementation Science from 2/2006 to 9/2017. Eligible studies tested the efficacy or effectiveness of D&I strategies (i.e., not effectiveness of the underlying clinical or public health intervention); had a comparison by group and/or time; and used ≥1 quantitative measure. Several design elements were extracted: design category (e.g., randomized); design type [e.g., cluster randomized controlled trial (RCT)]; data type (e.g., quantitative); D&I theoretical framework; levels of treatment assignment, intervention, and measurement; and country in which the research was conducted. Each protocol was double-coded, and discrepancies were resolved through discussion.ResultsOf the 404 protocols reviewed, 212 (52%) studies tested one or more implementation strategy across 208 manuscripts, therefore meeting inclusion criteria. Of the included studies, 77% utilized randomized designs, primarily cluster RCTs. The use of alternative designs (e.g., stepped wedge) increased over time. Fewer studies were quasi-experimental (17%) or observational (6%). Many study design categories (e.g., controlled pre–post, matched pair cluster design) were represented by only one or two studies. Most articles proposed quantitative and qualitative methods (61%), with the remaining 39% proposing only quantitative. Half of protocols (52%) reported using a theoretical framework to guide the study. The four most frequently reported frameworks were Consolidated Framework for Implementing Research and RE-AIM (n = 16 each), followed by Promoting Action on Research Implementation in Health Services and Theoretical Domains Framework (n = 12 each).ConclusionWhile several novel designs for D&I research have been proposed (e.g., stepped wedge, adaptive designs), the majority of the studies in our sample employed RCT designs. Alternative study designs are increasing in use but may be underutilized for a variety of reasons, including preference of funders or lack of awareness of these designs. Promisingly, the prevalent use of quantitative and qualitative methods together reflects methodological innovation in newer D&I research

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Background<p>The need for optimal study designs in dissemination and implementation (D&I) research is increasingly recognized. Despite the wide range of study designs available for D&I research, we lack understanding of the types of designs and methodologies that are routinely used in the field. This review assesses the designs and methodologies in recently proposed D&I studies and provides resources to guide design decisions.</p>Methods<p>We reviewed 404 study protocols published in the journal Implementation Science from 2/2006 to 9/2017. Eligible studies tested the efficacy or effectiveness of D&I strategies (i.e., not effectiveness of the underlying clinical or public health intervention); had a comparison by group and/or time; and used ≥1 quantitative measure. Several design elements were extracted: design category (e.g., randomized); design type [e.g., cluster randomized controlled trial (RCT)]; data type (e.g., quantitative); D&I theoretical framework; levels of treatment assignment, intervention, and measurement; and country in which the research was conducted. Each protocol was double-coded, and discrepancies were resolved through discussion.</p>Results<p>Of the 404 protocols reviewed, 212 (52%) studies tested one or more implementation strategy across 208 manuscripts, therefore meeting inclusion criteria. Of the included studies, 77% utilized randomized designs, primarily cluster RCTs. The use of alternative designs (e.g., stepped wedge) increased over time. Fewer studies were quasi-experimental (17%) or observational (6%). Many study design categories (e.g., controlled pre–post, matched pair cluster design) were represented by only one or two studies. Most articles proposed quantitative and qualitative methods (61%), with the remaining 39% proposing only quantitative. Half of protocols (52%) reported using a theoretical framework to guide the study. The four most frequently reported frameworks were Consolidated Framework for Implementing Research and RE-AIM (n = 16 each), followed by Promoting Action on Research Implementation in Health Services and Theoretical Domains Framework (n = 12 each).</p>Conclusion<p>While several novel designs for D&I research have been proposed (e.g., stepped wedge, adaptive designs), the majority of the studies in our sample employed RCT designs. Alternative study designs are increasing in use but may be underutilized for a variety of reasons, including preference of funders or lack of awareness of these designs. Promisingly, the prevalent use of quantitative and qualitative methods together reflects methodological innovation in newer D&I research.</p