Dissemination of an evidence-based treatment for cancer patients: training is the necessary first step

Carpenter, Kristen M.; Shelby, Rebecca A.; Thornton, Lisa M.; Frierson, Georita Marie; Patterson, Kyle L.; Andersen, Barbara L.

doi:10.1007/s13142-014-0273-0

Cited by 20 publications

(50 citation statements)

References 42 publications

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“…Our results reinforce prevailing models in emphasizing context and organizational leadership as determinants of implementation success [12][13][14][15]. While previous work has noted the importance of these factors in implementing mental health treatments [27][28][29], and distress screening [19][20][21][22] for cancer patients, this study is the first to our knowledge to consider context in the implementation of a cancerspecific EBT. Moreover, we are unaware of any documentation of solutions to potential implementation barriers.…”

Section: Discussionsupporting

confidence: 84%

“…Trainees were informed that the treatment could be delivered individually, however, and that this was a good strategy to practice content delivery. Data on the efficacy of the training are described elsewhere [27]. In brief, multimodal education utilized didactics, structured role-plays, and group discussions, addressing both the delivery of the intervention and its implementation at trainees' home institutions.…”

Section: Introductionmentioning

confidence: 99%

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Implementing evidence‐based psychological treatments for cancer patients

et al. 2015

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Objective New regulations and guidelines require implementation of screening and evidence based psychological treatment (EBT) for cancer patients, but little research exists to assist psychosocial care providers with implementation. This study aimed to develop a conceptual framework for community providers to consider as they embark on implementation of EBTs. Methods Full-time psychosocial care providers received training in delivery of a cancer-specific EBT and then received implementation support. Qualitative data were collected in two phases. In Phase I, after training, trainees (N=63) participated in six monthly group conference calls with 6-8 trainees and EBT trainers. Qualitative data from the calls were analyzed using a grounded theory paradigm. In Phase II, the resultant framework was piloted with additional trainees (N=73) during EBT training to prompt early planning for implementation at their home institutions. Results In Phase I, themes of “person” (i.e., attitudes, vocalizations, and behaviors of others) and “environment” factors (i.e., material, monetary, and time resources of organizations) affecting implementation emerged. It appeared that both factors influenced how easily barriers could be addressed, though positive person factors also appeared to positively influence environment factors. In Phase II, trainees found the framework acceptable and considered it when generating solutions for implementation challenges. Conclusions The framework suggests tailoring implementation efforts to consider person and environment factors. As person support is developed, any resource limitations of the environment may be more easily addressed.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Implementing evidence‐based psychological treatments for cancer patients

et al. 2015

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“…They assessed trainees pre-workshop to post-workshop on CBT knowledge and self-efficacy and found both to improve. Brothers et al [76] offer 3-day training institutes for providers to learn a biobehavioral intervention (BBI) [77]. Multimodal training using adult learning principles [44] includes lecture-style presentations (40%; didactics), roleplay and group discussions (20-35%; experiential), and small group and individual practices (25%; practice), with the aim of competency-based training.…”

Section: Discussionmentioning

confidence: 99%

Evidence‐based psychosocial treatment in the community: considerations for dissemination and implementation

Andersen

Dorfman

2015

Psycho-Oncology

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Background In psycho-oncology care, steps toward dissemination and implementation of evidence-based treatments (EBTs) have not been made. For this to change, factors associated with real-world dissemination and implementation must be identified. In the community, providers, their organizations, and patients are key stakeholders. Method A focused review of literatures in continuing education, dissemination, and implementation of mental health services is provided. Results Early-career providers are most ready to implement as they have greater openness and more positive attitudes toward EBTs. Current continuing education practices to teach EBTs have limited effectiveness. Instruction using interactive strategies tailored to therapists’ clinical needs and the provision of post-education consultation is needed. There is tension between EBT delivery with fidelity and the necessity for adaptation. EBT service provision is the key outcome of implementation, and documenting such is important to patients, providers, and organizations. Conclusion A multilevel conceptual framework, Setting, Therapist, Education, imPlementation, and Sustainability, is offered and provides directions for dissemination and sustainable implementation. Guidelines from the Commission on Cancer of the American College of Surgeons and the American Society of Clinical Oncology underscore the timeliness of the proposed framework to move EBTs from the research settings where they were developed to the practice settings where they are needed.

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“…Therapists-Providers (N = 108) from four BBI Institutes [28] were studied. The sample was predominantly female (n = 95; 88%) and middle aged (M = 42.93 years; SD = 10.55).…”

Section: Participantsmentioning

confidence: 99%

“…We first considered setting (see S in STEPS) and therapist (see T in STEPS) factors when designing the dissemination effort. An earlier report [28] provided data on the effectiveness of BBI dissemination via training institutes for oncology mental health providers. Using multimodal education strategies (see E in STEPS), the institutes were effective in producing knowledge gains and clinical facility with the BBI, enhanced self-efficacy and positive attitudes towards EBTs, and positive intentions to implement BBI.…”

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Implementation of an evidence-based biobehavioral treatment for cancer patients

Ryba

Andersen

2017

Behav. Med. Pract. Policy Res.

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One aim of dissemination and implementation (DI) research is to study the translation of evidence-based treatments (EBTs) from the research environments of their development and testing to broader communities where they are needed. There are few behavioral medicine DI studies and none in cancer survivorship. A determinant model (Setting, Therapist, Education, imPlementation, and Sustainability (STEPS)) was used to conceptualize DI of mental health treatment and frame a longitudinal study of implementation of a behavioral medicine EBT-a biobehavioral intervention (BBI) for cancer patients. Using effective dissemination strategies, therapists were trained in the BBI and followed to determine if implementation occurred. Participants (N = 108) were psychologists, social workers, and other oncology mental health providers from diverse settings to whom the BBI had been disseminated. BBI trainers then provided 6 months of support for implementation (e.g., monthly conference calls). Therapists reported number of patients treated, with or without the BBI, at 2, 4, and 6 months; use of support strategies was tracked. Generalized linear mixed models show that the proportion of patients treated with BBI ranged from 58 to 68%, with a 2% increase across follow-ups. Therapist and setting characteristics did not predict usage. Implementation of a behavioral medicine EBT provides a "real-world" demonstration of a BBI moved from the research setting to diverse communities. As the first study in cancer, it is an encouraging example of training and supporting mental health providers to deliver evidence-based psychological treatment and finding their success in doing so.

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Dissemination of an evidence-based treatment for cancer patients: training is the necessary first step

Cited by 20 publications

References 42 publications

Implementing evidence‐based psychological treatments for cancer patients

Implementing evidence‐based psychological treatments for cancer patients

Evidence‐based psychosocial treatment in the community: considerations for dissemination and implementation

Implementation of an evidence-based biobehavioral treatment for cancer patients

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