Characterizing Shared and Unique Implementation Influences in Two Community Services Systems for Autism: Applying the EPIS Framework to Two Large-Scale Autism Intervention Community Effectiveness Trials

Brookman‐Frazee, Lauren; Chlebowski, Colby; Suhrheinrich, Jessica; Finn, Natalie K.; Dickson, Kelsey S.; Aarons, Gregory A.; Stahmer, Aubyn C.

doi:10.1007/s10488-019-00931-4

Cited by 43 publications

(33 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The EPIS framework was used to inform the development of key informant interviews and focus groups, and data coding and analytic procedures to capture the key outer and inner context and innovation factor influences across implementation phases of two large-scale community effectiveness trials [51]. Within the trials themselves, EPIS informed the selection of quantitative measures of inner context organizational and provider measures [52].…”

Section: Epis Applicationmentioning

confidence: 99%

Ten recommendations for using implementation frameworks in research and practice

Moullin

Dickson

Stadnick

et al. 2020

Implement Sci Commun

Self Cite

226

175

View full text Add to dashboard Cite

Background: Recent reviews of the use and application of implementation frameworks in implementation efforts highlight the limited use of frameworks, despite the value in doing so. As such, this article aims to provide recommendations to enhance the application of implementation frameworks, for implementation researchers, intermediaries, and practitioners. Discussion: Ideally, an implementation framework, or multiple frameworks should be used prior to and throughout an implementation effort. This includes both in implementation science research studies and in real-world implementation projects. To guide this application, outlined are ten recommendations for using implementation frameworks across the implementation process. The recommendations have been written in the rough chronological order of an implementation effort; however, we understand these may vary depending on the project or context: (1) select a suitable framework(s), (2) establish and maintain community stakeholder engagement and partnerships, (3) define issue and develop research or evaluation questions and hypotheses, (4) develop an implementation mechanistic process model or logic model, (5) select research and evaluation methods (6) determine implementation factors/determinants, (7) select and tailor, or develop, implementation strategy(s), (8) specify implementation outcomes and evaluate implementation, (9) use a framework(s) at micro level to conduct and tailor implementation, and (10) write the proposal and report. Ideally, a framework(s) would be applied to each of the recommendations. For this article, we begin by discussing each recommendation within the context of frameworks broadly, followed by specific examples using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Summary: The use of conceptual and theoretical frameworks provides a foundation from which generalizable implementation knowledge can be advanced. On the contrary, superficial use of frameworks hinders being able to use, learn from, and work sequentially to progress the field. Following the provided ten recommendations, we hope to assist researchers, intermediaries, and practitioners to improve the use of implementation science frameworks.

show abstract

Section: Epis Applicationmentioning

confidence: 99%

Ten recommendations for using implementation frameworks in research and practice

Moullin

Dickson

Stadnick

et al. 2020

Implement Sci Commun

Self Cite

226

175

View full text Add to dashboard Cite

show abstract

“…Second, CPRT training should include an extensive introduction to behavioral principles as the foundation for CPRT to emphasize the rationale of each CPRT component and their necessity for student learning. 74 This is particularly important when trainees are not familiar with ABA, 75 which applies to most, if not all, special education teachers in the Netherlands. Third, self-management strategies could be added to the current CPRT training to train teachers to discriminate between correct and incorrect implementation of 'difficult' CPRT components and record their own behavior in order to improve their fidelity of CPRT implementation.…”

Section: Discussionmentioning

confidence: 99%

Training Teachers to Implement Classroom Pivotal Response Teaching during Small-group Instruction: A Pilot Study

Verschuur¹,

Huskens

Didden

2020

Developmental Neurorehabilitation

View full text Add to dashboard Cite

Background: Providing effective education to students with autism spectrum disorder (ASD) poses a significant challenge to educators. Although several evidence-based practices (EBPs) have been developed, few have been systematically implemented in educational settings. Pivotal response treatment (PRT) is a naturalistic behavioral intervention that has been adapted for implementation in the school context. Methods: This pilot study used a concurrent multiple baseline design across seven teachers and students with ASD to examine the effectiveness of teacher training in classroom pivotal response teaching (CPRT) on teacher fidelity of implementation during small-group instruction and students' communication skills and maladaptive behaviors in schools for special education in the Netherlands. Results: Results indicated no replicated effect of CPRT training on teachers' fidelity of implementation or children's communications skills and maladaptive behavior, although teachers reported high satisfaction with the CPRT training. Discussion: Implications for clinical practice and directions for future research are discussed.

show abstract

“…Fidelity measures which will be assessed throughout EFFECT for ASD implementation. Additional objective metrics of implementation outcomes related to the research process (e.g., enrollment/withdrawal rate, data collection completion rate) will also be examined given prior data highlighting the influence of perceptions regarding research and data collection activities on implementation [ 67 ]. For the qualitative focus interviews, semi-structured interview guides with pre-selected questions will be used to gather participant perspectives pertaining to EFFECT for ASD feasibility, acceptability, appropriateness, and effectiveness.…”

Section: Methodsmentioning

confidence: 99%

“…As the outer context is relatively stable, the primary focus will be on the impact of relevant inner context factors, namely provider characteristics, across the first three implementation phases (i.e., exploration, preparation, and implementation). As one of the outer/inner context “bridging factors” specified in EPIS and applied in previous ASD-focused research in mental health services [ 67 ], a community-academic partnership will also be integrated to tailor EFFECT for ASD fit and impact in mental health services settings. The proposed study has three specific aims that correspond to the first three EPIS phases: Aim 1.…”

Section: Executive Functioning As a Target Of Ebismentioning

confidence: 99%

Adaption and pilot implementation of an autism executive functioning intervention in children’s mental health services: a mixed-methods study protocol

Dickson

Aarons

Anthony

et al. 2020

Pilot Feasibility Stud

Self Cite

View full text Add to dashboard Cite

Background Youth with autism spectrum disorder (ASD) represent a growing population with significant service needs. Prominent among these needs are high rates of co-occurring psychiatric conditions that contribute to increased functional impairments and often necessitate mental health services. Executive functioning deficits are associated with ASD as well as common co-occurring conditions (e.g., attention-deficit/hyperactivity disorder) and an evidence-based intervention has been developed and tested to address executive functioning within the school context. There is an urgent need to implement indicated evidence-based interventions for youth with ASD receiving care in community mental health settings. Interventions that optimally “fit” the mental health services context as well as the complex and co-occurring mental health needs of these youth have the potential to improve key clinical outcomes for this high priority population. Methods This mixed-methods developmental study will apply the Exploration, Preparation, Implementation, Sustainment implementation framework and a community-academic partnership approach to systematically adapt and test an evidence-based executive functioning intervention for youth with ASD for delivery in community mental health settings. Specific aims are to (1) conduct a need and context assessment to inform the systematic adaptation an executive functioning evidence-based intervention; (2) systematically adapt the clinical intervention and develop a corresponding implementation plan, together entitled “Executive Functioning for Enhancing Community-based Treatment for ASD,” (EFFECT for ASD ) ; and (3) conduct a feasibility pilot test of EFFECT for ASD in community mental health settings. Discussion Tailoring evidence-based interventions for delivery in community-based mental health services for youth with ASD has the potential to increase quality of care and improve child outcomes. Results from the current study will serve as the foundation for large-scale hybrid implementation and effectiveness trials and a generalizable approach for different service systems of care and clinical populations. Trial registration Clinicaltrials.gov, NCT04295512 .

show abstract

Characterizing Shared and Unique Implementation Influences in Two Community Services Systems for Autism: Applying the EPIS Framework to Two Large-Scale Autism Intervention Community Effectiveness Trials

Cited by 43 publications

References 57 publications

Ten recommendations for using implementation frameworks in research and practice

Ten recommendations for using implementation frameworks in research and practice

Training Teachers to Implement Classroom Pivotal Response Teaching during Small-group Instruction: A Pilot Study

Adaption and pilot implementation of an autism executive functioning intervention in children’s mental health services: a mixed-methods study protocol

Contact Info

Product

Resources

About