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Am Psychol. 2018 Jul 19. doi: 10.1037/amp0000309. [Epub ahead of print]

Evaluating the effectiveness and implementation of evidence-based treatment: A multisite hybrid design.

Author information

1
Center for Medical Psychology.
2
Department of Patient and Family Support Services.
3
Department of Psychology.
4
Gilda's Club Quad Cities.
5
East Alabama Medical Center.
6
Wellness House.
7
Department of Supportive Oncology.
8
Cancer Wellness Center.
9
Department of Counseling Psychology, Social Psychology and Counseling.
10
Providence St. John's Cancer Center.
11
Department of Pediatric Psychosocial Oncology.
12
Psych-Oncology Services.
13
Independent Practice.
14
Patient and Family Support Services.
15
Department of Adult Psychology and Behavioral Medicine.
16
Department of Psychological and Brain Sciences.

Abstract

The gap between treatment development and efficacy testing to scaled up implementations of evidence-based treatment (EBT) is an estimated 20 years, and hybrid research designs aim to reduce the gap. One was used for a multisite study in cancer control, testing coprimary aims: (a) determine the feasibility and utility of a flexible EBT implementation strategy and (b) determine the clinical effectiveness of an EBT as implemented by newly trained providers. Therapists from 15 diverse sites implemented the biobehavioral intervention (BBI) for cancer patients (N = 158) as part of standard care. For implementation, therapists determined treatment format, number of sessions, and so forth and reported session-by-session fidelity. Patients completed fidelity and outcome assessments. Results showed therapists BBI implementation was done with fidelity, for example, session "dose" (59%), core content coverage (60-70%), and others. Patient reported fidelity was favorable and comparable to the BBI efficacy trial. Effectiveness data show the primary outcome, patients' scores on the Profile of Mood States total mood disturbance, significantly improved (R² = 0.06, β = -0.24, p < .01) as did a secondary outcome, physical activity (R² = 0.02, β = 0.13, p < .05). This first use of a hybrid design in health psychology provided support for a novel strategy that allowed providers implementation flexibility. Still, the EBT was delivered with fidelity and in addition, therapists generated novel procedures to enhance setting-specific usage of BBI and its ultimate effectiveness with patients. This research is an example of translational research spanning theory and efficacy tests to dissemination and implementation. (PsycINFO Database Record.

PMID:
30024215
PMCID:
PMC6339615
[Available on 2020-01-19]
DOI:
10.1037/amp0000309

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