Combining intervention diffusion with change in clinical practice and public policy is an ambitious agenda. The impressive effort in Hawaii can be instructive, highlighting questions for a science of treatment dissemination. Among these questions, some of the most important are the following: (a) Who should be targeted for change? (e.g., “downstream” clinicians in practice, “upstream” clinicians in training, consumers, “brokers,” policy makers, or payers?); (b) What should be disseminated? (e.g., full evidence-based protocols, specific treatment elements or “kernels”?); and (c) Which procedures maximize change? (e.g., what combination and duration of teaching, supervision, consultation, and other support?). Ultimately, change efforts need to assess what aspects of practice were actually altered, what measurable impact the changes had on clinical outcomes, and what changes in practices and outcomes can be sustained over time.
The advancement of implementation science is dependent on identifying assessment strategies that can address implementation and clinical outcome variables in ways that are valid, relevant to stakeholders, and scalable. This paper presents a measurement agenda for implementation science that integrates the previously disparate assessment traditions of idiographic and nomothetic approaches. Although idiographic and nomothetic approaches are both used in implementation science, a review of the literature on this topic suggests that their selection can be indiscriminate, driven by convenience, and not explicitly tied to research study design. As a result, they are not typically combined deliberately or effectively. Thoughtful integration may simultaneously enhance both the rigor and relevance of assessments across multiple levels within health service systems. Background on nomothetic and idiographic assessment is provided as well as their potential to support research in implementation science. Drawing from an existing framework, seven structures (of various sequencing and weighting options) and five functions (Convergence, Complementarity, Expansion, Development, Sampling) for integrating conceptually distinct research methods are articulated as they apply to the deliberate, design-driven integration of nomothetic and idiographic assessment approaches. Specific examples and practical guidance are provided to inform research consistent with this framework. Selection and integration of idiographic and nomothetic assessments for implementation science research designs can be improved. The current paper argues for the deliberate application of a clear framework to improve the rigor and relevance of contemporary assessment strategies. KeywordsImplementation science, Assessment, Measurement, Nomothetic, Idiographic, Research design Intentional research design in implementation science: implications for the use of nomothetic and idiographic assessment Research design and measurement in implementation science Implementation science is focused on improving health services through the evaluation of methods that promote the use of research findings (e.g., evidencebased practices) in routine service delivery settings [1]. Studies in this area are situated at the end of the National Institutes of Health translational research pipeline (i.e., at T3 or T4); which describes how innovations move from basic scientific discovery, to intervention, and to large scale, sustained delivery in routine community practice [2]. Implementation research is also inherently multilevel, focusing on individuals, groups, organizations, and systems to change professional behavior and enact service quality improvements [3]. Frequently, the objectives of implementation science include the identification of multilevel variables that impact the uptake of evidence-based practices as well as specific strategies for improving adoption, implementation, and sustainment [4,5].
The objective of this paper is to address ethical and training considerations with behavioral health (BH) services practicing within rural, integrated primary care (IPC) sites through the conceptual framework of an ethical acculturation model. Method: Relevant articles are presented along with a description of how the acculturation model can be implemented to address ethical dilemmas. Results: Recommendations are provided regarding practice considerations when using the acculturation model and the utility of the model for both established BH practitioners and trainees. Conclusions: Psychologists integrated into rural IPC teams may be able to enhance their ethical practice and improve outcomes for patients and families through the use of the acculturation model. Psychologists serving as supervisors can utilize the acculturation model to provide valuable experiences to trainees in addressing ethical dilemmas when competing ethical principles are present. Implications for Impact StatementBy addressing ethical dilemmas through an acculturation model, psychologists may prevent themselves from drifting away from American Psychological Association ethical principles within the context of a multidisciplinary team while simultaneously providing valuable learning opportunities for trainees. This focus is particularly important in rural settings where access to specialty care and other resources are limited, and a psychologist may be the only licensed behavioral health provider on a multidisciplinary team.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.