Symposium 137 - Adaptations to evidence-based practices: Do stakeholders influence adaptations and do the adaptations impact implementation outcomes?

Sunday, November 19, 2023

10:30 AM – 12:00 PM PST

Location: Quinault, Level 5

CE: 1.5

Keywords: Community-Based, Evidence-Based Practice, Implementation
Level of Familiarity: All
Recommended Readings: Wiltsey Stirman, S., Baumann, A. A., & Miller, C. J. (2019). The FRAME: An expanded framework for reporting adaptations and modifications to evidence-based interventions. Implementation Science, 14(1), 58. https://doi.org/10.1186/s13012-019-0898-y, Wingood, G. M., & DiClemente, R. J. (2008). The ADAPT-ITT Model: A Novel Method of Adapting Evidence-Based HIV Interventions. JAIDS Journal of Acquired Immune Deficiency Syndromes, 47(Supplement 1), S40–S46. https://doi.org/10.1097/QAI.0b013e3181605df1, Harvey, A. G., Lammers, H. S., Dolsen, M. R., Mullin, A. C., Hilmoe, H. E., Tran, M., Portnova, V., Tuck, A. B., Mallidi, A., Fang, A., Byrnes, C., Kao, E., & Lee, C. (2021). Systematic review to examine the methods used to adapt evidence-based psychological treatments for adults diagnosed with a mental illness. Evidence Based Mental Health, 24(1), 33–40. https://doi.org/10.1136/ebmental-2020-300225, ,

Chair(s)

Marlen Diaz, B.A. (she/her/hers)

Clinical Science Graduate Student
University of California, Berkeley
Ceres, California

Discussant(s)

SW

Shannon Wiltsey Stirman, PhD

Associate Professor
National Center for PTSD and Stanford University
Menlo Park, California

Presenter(s)

Nicholas Perry, Ph.D. (he/him/his)

Research assistant professor
University of Denver
Denver, Colorado
Karen Bearss, Ph.D. (she/her/hers)

Associate Professor
Seattle Children's Autism Center, University of Washington
Seattle, Washington
ET

Emily Treichler, Ph.D. (she/her/hers)

Assistant Professor and Research Psychologist
VA San Diego MIRECC/University of California, San Diego
San Diego, California
Marlen Diaz, B.A. (she/her/hers)

Clinical Science Graduate Student
University of California, Berkeley
Ceres, California

Large scale implementation of evidence-based practices (EBPs) could have a tremendous positive impact for people who need treatment the most. Implementation science is the study of methods to promote the systematic adoption and integration of EBPs into routine practice. The goal of implementation science is to enhance the quality and effectivenessof health care services. While implementation science is flourishing and well-developed in many domains, adaptation science, which aims to increase treatment fit and sustainability without compromising fidelity and outcomes, is a relatively new field. In particular, while frameworks have been developed to guide adaptations at the researcher level, research on adaptations at the implementation phase and in diverse routine practice settings are understudied. Thus, identifying how various groups, like stakeholders and clinicians, contribute to adaptation to ensure treatment fit while minimizing burden and maintaining outcomes is of utmost importance. This symposium will provide innovative perspectives on how to implement and assess adaptations and their impacts. Presentations will span multiple EBPs designed to address a range presenting problems (e.g., SMI, autism, psychosis, sleep, and relationship education) for multiple populations (e.g., youth, adults, Latinos, and veterans).

First, Dr. Nicholas S. Perry will review data on community stakeholder input to identify adaptations that are needed to an evidence-based relationship education program (Within My Reach) for Latino sexual minority men. Second, Dr. Karen Bearss will describe a novel effort to implement the RUBI parent training program in primary care settings and present outcomes including modifications to standard RUBI training protocols, therapist engagement in and satisfaction with the RUBI training as well as provider use of RUBI strategies with families post training. Third, Dr. Emily Treichler will present findings on clinician contributions to the first three adaptation iterations of Collaborative Decision Skills Training for Veterans with psychosis. Fourth, Marlen Diaz will describe provider-initiated ad hoc adaptations to the Transdiagnostic Sleep and Circadian Intervention and their effect on implementation and clinical outcomes in a community mental health context. Last, Dr. Shannon Wiltsey-Stirman, a leading expert in the dissemination and implementation of evidence-based practices, will discuss cross-cutting themes, critique the findings presented, and provide ideas for future directions in the development of efficient adaptation processes and their impact on outcomes.

Learning Objectives:

At the end of the session, the learner will be able to:

Learn about novel and innovative methods for adapting evidence based practices at various stages in treatment development and implementation.
Learn how various stakeholders view and implement adaptations for various evidence based practices.
Learn how implementation of adaptations look across various diverse settings and populations.
Understand how adaptations impact implementation outcomes, such as therapist engagement, satisfaction, and perceived treatment fit.
Understand how adaptations can ensure treatment fit while minimizing burden and maintaining outcomes.