Statewide System and Organizational Strategy for Evidence-Based Practice Implementation and Sustainment in Substance Use Disorder Treatment
Principal Investigator(s): Gregory Aarons, Ph.D. UC San Diego
Co-Investigators(s): Mark Ehrhart, Ph.D. University of Central Florida, Marisa Sklar, Ph.D. UC San Diego
This project will test an implementation strategy that seeks to align system, organization, and clinic leadership and strategies to implement and sustain an evidence-based practice (EBP) for substance use disorders. The Leadership and Organizational Change for Implementation - System Level (LOCI-SL) seeks to improve implementation leadership, climate, provider attitudes and behaviors, and EBP fidelity for enhanced client engagement in services and outcomes. LOCI-SL will be tested in integrated mental health and substance use disorder treatment clinics across the state of Oregon while engaging the Oregon Health Authority, the Alcohol and Drug Policy Commission, and managed care organizations.
Funding Information: NIH/NIDA, R01, DA049891
Study time period: 2020 - 2025
Applying Team Charters to Improve Distance Training Outcomes for Autism Interventions in Public Mental Health Services and Schools
Principal Investigator(s): Lauren Brookman-Frazee, Ph.D. UC San Diego, Aubyn Stahmer, Ph.D. UC Davis
The purpose of this R34 is to develop and test a team charter-enhanced implementation strategy for distance training to increase the reach and effectiveness of two evidence-based intervention practices (EBPs) for autism across two public service systems. Our research groups have adapted, tested, and implemented autism EBPs across two service systems: AIM HI (“An Individualized Mental Health Intervention for Autism”) in publicly funded mental health services and CPRT (“Classroom Pivotal Response Teaching”) in public school classrooms. The implementation strategy appears to be less effective when EBP training is provided from a distance, resulting in fewer providers completing training. Thus, geographic distance is a barrier for children and families needing care, and for high-quality provider training. Although there are many advantages to distance training, and this will be increasingly required with the sustained impact of COVID-19, preliminary data from our current trials reveal several challenges with providing high-quality EBP training and ongoing consultation/coaching remotely. Distance training requires effective and efficient coordination between individuals with different roles and backgrounds. Thus, we propose to co-create and pilot test a team charter-enhanced implementation strategy using “team charters” to increase the reach of Autism EBPs through distance training.
Funding Information: NIMH, P50, MH126231
Study time period: 2022 - 2027
Enhancing team effectiveness for a collaborative school-based intervention for ADHD
Principal Investigator(s): Lauren Brookman-Frazee, Ph.D. UC San Diego, Linda Pfiffner, Ph.D. UC San Francisco, Miguel Villodas, Ph.D. San Diego State University
The IN STEP R01 research project aims to integrate team-based implementation strategies to enhance implementation of the Collaborative Life Skills Program (CLS), an established school-based intervention for children with ADHD in grades 2-5. We will tailor three empirically-supported team development interventions, Team Charters, Team Communication Training (Student Handoff Protocols), and Team Performance Monitoring, and integrate them with the CLS protocol to create a team-enhanced CLS implementation protocol (CLS-T). We will conduct a Hybrid Type III cluster randomized trial in 24 schools in two large urban school districts, to evaluate whether CLS-T implementation results in improved implementation outcomes and child outcomes in comparison to standard CLS implementation.
Funding Information: NIMH, R01, MH126231-02
Study time period: 2022 - 2027
Adapting an ASD Executive Functioning Intervention for Implementation in Children’s Mental Health Services
Principal Investigator(s): Kelsey Dickson, Ph.D. San Diego State University
Co-Investigator(s): Lauren Brookman-Frazee, Ph.D. UC San Diego, Gregory Aarons, Ph.D. UC San Diego, Lauren Kenworthy, Children's National, Laura Anthony, Ph.D. University of Colorado, Scott Roesch, Ph.D. San Diego State University
The aims of the current project are to use an implementation science framework to: 1) conduct a needs and context assessment to inform the systematic adaptation of an ASD EF intervention (Unstuck and on Target [UOT]) for implementation in child mental health services; 2) systematically adapt UOT and develop a corresponding plan; and 3) conduct a feasibility pilot test of the adapted intervention and corresponding implementation plan in community mental health settings.
Funding Information: NIMH, K23, K23MH115100
Study time period: 2018 - 2023
Expanding Care Coordination and Developing Organizational Implementation Supports to Improve Disparity Reduction Efforts
Principal Investigator(s): Kelsey Dickson, Ph.D. San Diego State University
Co- Prinicpal Investigator(s): Elva Arredondo, Ph.D. San Diego State University
Apply implementation science methods to expand a care coordinator model to include an evidence-based mental health intervention and corresponding implementation strategies to address care disparities for underserved minority individuals served by a Federally Qualified Health Center.
Funding Information: NIMHD, U54 Awarded to SDSU, U54 MD012397
Study time period: 2021 - 2023
Redesigning an Autism Evidence-Based Practice Implementation Toolkit for Middle and High Schools
Principal Investigator(s): Kelsey Dickson, Ph.D. San Diego State University, Jill Locke, Ph.D. University of Washington
Co-Investigator(s): Amy Drahota, Ph.D. Michigan State University, Scott Roesch, Ph.D. San Diego State University
The ACT SMART implementation toolkit was developed and shown effective in targeting autism EBP adoption and decision-making in community settings. ACT SMART has immense potential to improve autism EBP decision-making, adoption, and implementation in schools; however, systematic and iterative redesign is necessary to optimize its fit to the unique context of public schools. Thus this project aims to: Aim 1. Engage stakeholders to identify targets for ACT SMART redesign to optimize its fit for middle and high school providers that work with autistic adolescents. Aim 2. Conduct prototyping and usability field testing of the refined ACT SMART and iteratively refine to ensure usability, feasibility, acceptability, and appropriateness for use in schools.
Funding Information: NIMH, R21, R21MH13079
Study time period: 2022 - 2024
Personalizing Parent Training Interventions for Culturally Diverse Families
Principal Investigator(s): Kristen McCabe, Ph.D. University of San Diego, May Yeh, Ph.D. San Diego State University
Co-Investigator(s): Argero Zerr, Ph.D. California State University Channel Islands
Behavioral Parent Training (BPT) interventions have been shown to be effective treatments for young children with behavior problems. However, not all families benefit, and ethnic minority families in particular are less likely to enroll, engage, and improve in BPT, in part because some aspects of these treatments may not fit with culturally influenced beliefs and attitudes about child mental health and its treatment. One way of improving engagement and outcomes in BPT for culturally diverse families may be to personalize the delivery of treatments by enhancing or modifying aspects of their delivery to increase the cultural fit of the treatment to the family when research suggests this might be helpful. In this project, we developed a personalization approach (PersIn) that utilizes cultural assessment results to tailor a BPT called Parent-Child Interaction Therapy (PCIT) to individual families in order maximize cultural responsiveness to a specific family while still being deliverable to a culturally diverse population. We then pilot tested this intervention, called MY PCIT, with 32 families from a range of racial/ethnic groups (African American, Asian American, Latinx, and Non-Hispanic White) that were seeking treatment for their child’s clinically significant behavior problems.
Funding Information: NIMH, R34, R34MH109561
Study time period: 2016 - 2021
Policy Implementation Research on Earmarked Taxes for Mental Health Services
Principal Investigator(s): Jonathan Purtle, DrPH New York University, Nicole Stadnick, Ph.D., MPH UC San Diego
The goal of this study is to generate knowledge about how to enhance the ability of earmarked taxes for mental health to increase the reach of evidence-based practices that improve population mental health.
Funding Information: NIMH, R21, MH125261
Study time period: 2020 - 2023
Expanding the PUENTE Network to Meet Emerging Needs
Principal Investigators: Sarah Rieth, Ph.D. San Diego State University, Lauren Brookman-Frazee, Ph.D. UC San Diego, Brenda Bello-Vazquez, San Diego Regional Center
Close examination of administrative claims data for services to individuals with developmental disabilities idenitifed spending disparities for Latinx families compared to non-Latinx families. In consultation with stakeholders, a short-term parent-to-parent psychoeducation and empowerment intervention was established and delivered to families of adolescents. Program evaluation data indicated a need for ongoing support and connection in order to further support family engagementi n the service system. This projects provides ongoing group support for families who graduate from the PUENT psychoeducation program; and (2) provides access to individual components the PUENTE curriculum through multiple community facing avenues (e.g., promotoras presenting PUENTE content within existing community groups/events and holding SDRC office hours). Specifically, a PUENTE network will be co-designed with multiple stakeholders and then pilot tested to assess feasibility, reach, and acceptability.
Funding Information: California Department of Developmental Services, Service Access and Equity, 22-SDRC-01
Study time period: 2023 - 2024
Adapting and Implementing an Integrated Care Model for Youth with Autism Spectrum Disorder and Psychiatric Comorbidity
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego
The study used implementation science theory and methods and a research-community partnership approach to: 1) identify targets to improve mental health screening and linkage to mental health services in primary care for children with autism, 2) adapt integrated care procedures into “Access To Tailored Autism INtegrated Care,” ATTAIN, to facilitate identification of mental health problems and linkage to evidence-based care for youth with autism, and 3) conduct an open trial feasibility pilot test of ATTAIN in pediatric primary care.
Funding Information: NIMH, K23
Study time period: 2017 - 2022
CO-CREATE-Ex: Community-engaged Optimization of COVID-19 Rapid Evaluation And TEsting Experiences
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego, Louise Laurent, Ph.D. UC San Diego, Borsika Rabin, Ph.D. UC San Diego
Other Collaborator(s): Global Action Research Center, San Ysidro Health
In our Phase I RADx-UP project, UC San Diego partnered with San Ysidro Health, a federally qualified health center, and the Global Action Research Center, a social change organization, to co-create and demonstrate the impact of a PCR-based COVID-19 testing program in San Ysidro, one of the most impacted areas from COVID-19 in San Diego County. To date, we have tested >10,000 community members (92% Latino) and received requests to scale-out the testing program to additional primary care clinic sites. In this Phase III proposal, we will extend work with our Phase I community and clinical partners to refine, specify, implement, and evaluate an implementation strategy bundle that optimizes COVID-19 testing, expanding beyond current PCR testing to FDA-authorized COVID-19 rapid antigen testing.
Funding Information: NIMHD, U01, MD018308-01
Study time period: 2022 - 2024
Developing and Testing a Team Communication Training Implementation Strategy for Depression Screening in a Pediatric Health Care System
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego
Co-Investigator(s): Gregory Aarons, Ph.D. UC San Diego, Jonathan Helm, Ph.D. San Diego State University
The objective is to refine and test a team communication training implementation strategy to improve implementation of an existing pediatric depression screening protocol in a large pediatric healthcare system. The implementation strategy will target team mechanisms at the organizational-level (intra-organizational alignment and implementation climate) and provider-level (communication, coordination, psychological safety, and shared cognition).
Funding Information: NIMH, P50, MH126231
Study time period: 2022 - 2027
Refining and Implementing Technology-Enhanced Family Navigation to Promote Early Access and Engagement with Mental Health Services for Youth with Autism
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego
Other Collaborator(s): Kaiser Permanente
This proposal aims to test the effectiveness and implementation of technology-enhanced family navigation to promote early access to, and engagement in evidence-based mental health care for children with autism plus mental health comorbidity.
Funding Information: NIMH, R34, MH120190
Study time period: 2020 - 2024
San Diego Center for AIDS Research Implementation Science Hub
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego, Borsika Rabin, Ph.D. UC San Diego
The SD CFAR IS hub will provide consultation and technical assistance to Ending the HIV Epidemic (EHE) projects and will be a value-added to both the EHE initiative and the broader field of IS research and practice.
Funding Information: NIH/NIAID, P30 supplement
Study time period: 2020 - 2024
Scaling and Sustaining COVID-19 Vaccination through Meaningful Community Engagement and Care Coordination for Underserved Communities
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego, Borsika Rabin, Ph.D. UC San Diego
Other Collaborator(s): Global Action Research Center, San Ysidro Health
The goal of this study is to co-refine, test, and scale a multicomponent health program to address the multi-level barriers to vaccine uptake and engagement in primary and secondary preventative healthcare in immigrant, refugee, Latino, and Black, Indigenous People of Color (BIPOC) communities in San Diego.
Funding Information: NIMHD, R01, MD017222
Study time period: 2022 - 2027
Share, Trust, Organize, Partner: The COVID-19 California Alliance (STOP COVID-19 CA)
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego, Borsika Rabin, Ph.D. UC San Diego
Other Collaborator(s): The Global Action Research Center
This is a California community engagement collaborative aimed at co-creating and evaluating community-driven strategies to increase participation of underserved communities in COVID-19 therapeutic trials.
Funding Information: NIMHD/NHLBI, OTA
Study period: 2020 - 2024
Team Effectiveness Factors in the Implementation of Autism Evidence-Based Practices
Principal Investigator(s): Allison Jobin, Ph.D. California State Univeristy San Marcos, Lauren Brookman-Frazee, Ph.D. UC San Diego, Aubyn Stahmer, Ph.D. UC DavisCo-Investigator(s): Elizabeth Rangel, M.A. UC San Diego, Patricia Schetter, M.Ed. Placer County Office of Education, Katherine Williams, Ph.D., Rady Children's Hospital-San Diego
The purpose of this R03 is to identify specific team-based inputs and processes of evidence-based practice (EBP) leadership teams associated with effective implementation of autism EBPs in community settings. Despite the importance of leadership teams in children’s mental health and education services, there is minimal research on effective teams for autism EBP implementation. Team effectiveness research (TER) specifies team-level factors as key levers impacting outcomes. Little research has attempted to understand these factors and how they are involved within EBP leadership teams, which has potential to improve their impact and scalability. Applying a community-partnered approach, this project capitalizes on existing data from statewide implementation trials to improve understanding of the role of teams in EBP implementation outcomes and has the potential to inform development of team-based implementation strategies to further promote effective autism EBP implementation efforts. We will apply secondary coding and analysis of team characteristics and in-group process data from a team-based EBP implementation strategy across two service systems to: (1) Identify team inputs associated with implementation outcomes, and (2) Identify team processes associated with implementation outcomes. Together, findings related to potent team-based factors (i.e. team inputs, key processes) will support a larger-scale project to develop and test an EBP implementation team toolkit for school and youth mental health services in collaboration with community partners.
Funding Information: NIMH, P50, MH126231
Study time period: 2023 - 2024