Exploration, Preparation, Implementation, Sustainment (EPIS) framework

Moullin, Joanna C.; Dickson, Kelsey S.; Stadnick, Nicole A.; Becan, Jennifer E.; Wiley, Tisha R. A.; Phillips, Joella; Hatch, Melissa; Aarons, Gergory A.

doi:10.4337/9781788975995.00009

Cited by 17 publications

(12 citation statements)

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“…Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics) is a cluster-randomized, type 3 hybrid trial focused on testing the effectiveness of the ATTC implementation strategy versus the enhanced-ATTC strategy. Both the ATTC and enhanced-ATTC strategies are guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) model [ 41 ], a comprehensive implementation framework that can be used as both a process model to delineate the phases of implementation and a determinant model to highlight key contextual factors influencing implementation. Consistent with the EPIS framework, both implementation strategies delineate activities across phases (as elaborated in the “ Implementation strategies ” section).…”

Section: Specific Aimsmentioning

confidence: 99%

“…Guided by the EPIS framework, which conceptualizes implementation as a “process,” [ 41 ] implementation activities in both conditions are divided into four phases. The Exploration phase was completed in recent formative work with OTP counselors and leaders, soliciting their preferences for CM implementation [ 21 , 55 ].…”

Section: Implementation Strategiesmentioning

confidence: 99%

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Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics): A cluster-randomized type 3 hybrid effectiveness-implementation trial

Becker

Murphy

Hartzler

et al. 2021

Addict Sci Clin Pract

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Background Opioid-related overdoses and harms have been declared a public health emergency in the United States, highlighting an urgent need to implement evidence-based treatments. Contingency management (CM) is one of the most effective behavioral interventions when delivered in combination with medication for opioid use disorder, but its implementation in opioid treatment programs is woefully limited. Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics) was funded by the National Institute on Drug Abuse to identify effective strategies for helping opioid treatment programs improve CM implementation as an adjunct to medication. Specific aims will test the impact of two different strategies on implementation outcomes (primary aim) and patient outcomes (secondary aims), as well as test putative mediators of implementation effectiveness (exploratory aim). Methods A 3-cohort, cluster-randomized, type 3 hybrid design is used with the opioid treatment programs as the unit of randomization. Thirty programs are randomized to one of two conditions. The control condition is the Addiction Technology Transfer Center (ATTC) Network implementation strategy, which consists of three core approaches: didactic training, performance feedback, and on-going consultation. The experimental condition is an enhanced ATTC strategy, with the same core ATTC elements plus two additional theory-driven elements. The two additional elements are Pay-for-Performance, which aims to increase implementing staff’s extrinsic motivations, and Implementation & Sustainment Facilitation, which targets staff’s intrinsic motivations. Data will be collected using a novel, CM Tracker tool to document CM session delivery, session audio recordings, provider surveys, and patient surveys. Implementation outcomes include CM Exposure (number of CM sessions delivered per patient), CM Skill (ratings of CM fidelity), and CM Sustainment (number of patients receiving CM after removal of support). Patient outcomes include self-reported opioid abstinence and opioid-related problems (both assessed at 3- and 6-months post-baseline). Discussion There is urgent public health need to improve the implementation of CM as an adjunct to medication for opioid use disorder. Consistent with its hybrid type 3 design, Project MIMIC is advancing implementation science by comparing impacts of these two multifaceted strategies on both implementation and patient outcomes, and by examining the extent to which the impacts of those strategies can be explained by putative mediators. Trial registration: This clinical trial has been registered with clinicaltrials.gov (NCT03931174). Registered April 30, 2019. https://clinicaltrials.gov/ct2/show/NCT03931174?term=project+mimic&draw=2&rank=1

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Section: Specific Aimsmentioning

confidence: 99%

Section: Implementation Strategiesmentioning

confidence: 99%

Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics): A cluster-randomized type 3 hybrid effectiveness-implementation trial

Becker

Murphy

Hartzler

et al. 2021

Addict Sci Clin Pract

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“…The relevance of multilevel behavioural influences is evident in many theories and determinant frameworks applied in the field (13), e.g., Organisational Readiness to Change (73), Consolidated Framework for Implementation Research (74) and Exploration, Preparation, Implementation, Sustainment (75). The relative emphasis on individual-vs. collective-level determinants differs among these theoretical approaches.…”

Section: Discussionmentioning

confidence: 99%

Conceptualising Four Categories of Behaviours: Implications for Implementation Strategies to Achieve Behaviour Change

Nilsen¹,

Potthoff²,

Birken³

2022

Front.Health Serv.

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Background: Effectiveness of implementation strategies is influenced by the extent to which they are based on appropriate theories concerning the behaviours that the strategies intend to impact. Effectiveness may be limited simply because the strategies are based on theories that are limited in scope or are derived from partially inaccurate assumptions about the behaviours in question. It may therefore be important to combine insights from various theories to cover the range of influences on the behaviours that will be changed.Aim: This article aims to explore concepts, theories and empirical findings from different disciplines to categorise four types of behaviours and discuss the implications for implementation strategies attempting to change these behaviours.Influences on behaviours: Multilevel influences on behaviours are dichotomized into individual-level and collective-level influences, and behaviours that are guided by conscious cognitive processes are distinguished from those that rely on non-conscious processing. Combining the two dimensions (levels and cognitive modes) creates a 2 x 2 conceptual map consisting of four categories of behaviours. Explicitly conceptualising the levels and cognitive modes is crucial because different implementation strategies are required depending on the characteristics of the behaviours involved in the practise that needs to be changed.Conclusion: The 2 x 2 conceptual map can be used to consider and reflect on the nature of the behaviours that need to be changed, thus providing guidance on the type of theory, model or framework that might be most relevant for understanding and facilitating behaviour change.

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“…We chronicle our approach using the EPIS framework. The EPIS framework documents 4 phases integral to successful implementation including Exploration, Preparation, Implementation, and Sustainment 25,26…”

Section: Methodsmentioning

confidence: 99%

Summarizing Implementation Support for School-Based COVID-19 Testing Programs in Southwest American Indian Communities

Archuleta,

Ingalls,

Allison-Burbank

et al. 2023

Journal of Public Health Management and Practice

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Context: American Indian communities have been disproportionately affected by the COVID-19 pandemic, with school closures exacerbating health and education disparities. Program: Project SafeSchools' COVID-19 school-based testing program utilized federal and state funding to provide weekly pooled testing with follow-up rapid antigen testing to students and staff from the White Mountain Apache Tribe and Navajo Nation. Implementation: The project provided partner schools with training and continual logistical and technical support to aid in school-based testing and adherence to state and local reporting requirements. Evaluation: Using the EPIS (Exploration, Preparation, Implementation, and Sustainment) framework, we identified facilitators and barriers to successful program function. While community support and buy-in were essential for successfully implementing school-based testing in these communities, communication, school staff turnover, and funding are among the most significant challenges. Discussion: Community partnerships in American Indian communities involving schools and local health authorities can successfully implement testing protocols by remaining flexible and working together to maintain strong lines of communication.

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Exploration, Preparation, Implementation, Sustainment (EPIS) framework

Cited by 17 publications

References 0 publications

Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics): A cluster-randomized type 3 hybrid effectiveness-implementation trial

Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics): A cluster-randomized type 3 hybrid effectiveness-implementation trial

Conceptualising Four Categories of Behaviours: Implications for Implementation Strategies to Achieve Behaviour Change

Summarizing Implementation Support for School-Based COVID-19 Testing Programs in Southwest American Indian Communities

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