Using the Exploration-Preparation-Implementation-Sustainment (EPIS) Framework to prepare for the implementation of evidence-based practices into adolescent HIV settings

Carcone, April Idalski; Coyle, Karin; Butame, Seyram A.; Harper, Gary W.; Aarons, Gregory A.; Naar, Sylvie

doi:10.1007/s10461-022-03735-0

Cited by 9 publications

(9 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…( Idalski Carcone et al, 2019 , 2022 ) previously described the EPIS study (ATN 153), and ( Naar et al 2022 ) described the methods for the hybrid randomized trial of TMI in which it was embedded (ATN 146). In brief, using a stepped-wedge design, clinics were randomized to the implementation phase in five steps ( N = 10 clinics, 2 per step).…”

Section: Methodsmentioning

confidence: 99%

“…EPIS qualitative interview and coding. The interview was adapted from the EPIS developers ( Aarons et al, 2012 ) and has been previously described ( Idalski Carcone et al, 2019 , 2022 ). Trained interviewers conducted telephone interviews using a semi-structured interview guide to elicit anticipated barriers and facilitators of TMI implementation with a focus on inner organizational factors (which included bridging and innovation factors in the original EPIS framework).…”

Section: Methodsmentioning

confidence: 99%

“…Within the ATN, ATN protocol (146) ( Naar et al, 2019 , 2022 ) was a Type III hybrid effectiveness-implementation trial testing the effects of TMI implementation strategies on provider competence to deliver MI to address substance use and other risk behaviors while utilizing EPIS (ATN 153; Idalski Carcone, 2019 , 2022 ) to understand implementation context. Pre-implementation interviews were previously coded using inner and outer context factor codes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Understanding implementation completion of tailored motivational interviewing in multidisciplinary adolescent HIV clinics

Naar

Fernández

Todd

et al. 2023

Implementation Research and Practice

Self Cite

View full text Add to dashboard Cite

Background Understanding the barriers and facilitators of implementation completion is critical to determining why some implementation efforts fail and some succeed. Such studies provide the foundation for developing further strategies to support implementation completion when scaling up evidence-based practices (EBPs) such as Motivational Interviewing. Method This mixed-methods study utilized the Exploration, Preparation, Implementation, and Sustainment framework in an iterative analytic design to compare adolescent HIV clinics that demonstrated either high or low implementation completion in the context of a hybrid Type III trial of tailored motivational interviewing. Ten clinics were assigned to one of three completion categories (high, medium, and low) based on percentage of staff who adhered to three components of implementation strategies. Comparative analysis of staff qualitative interviews compared and contrasted the three high-completion clinics with the three low-completion clinics. Results Results suggested several factors that distinguished high-completion clinics compared to low-completion clinics including optimism, problem-solving barriers, leadership, and staff stress and turnover. Conclusions Implementation strategies targeting these factors can be added to EBP implementation packages to improve implementation success. Plain Language Summary While studies have begun to address adherence to intervention techniques, this is one of the first studies to address organizational adherence to implementation strategies. Youth HIV providers from different disciplines completed interviews about critical factors in both the inner and outer context that can support or hinder an organization's adherence to implementation strategies. Compared to less adherent clinics, more adherent clinics reported more optimism, problem-solving, and leadership strengths and less staff stress and turnover. Implementation strategies addressing these factors could be added to implementation packages to improve implementation success.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Understanding implementation completion of tailored motivational interviewing in multidisciplinary adolescent HIV clinics

Naar

Fernández

Todd

et al. 2023

Implementation Research and Practice

Self Cite

View full text Add to dashboard Cite

show abstract

“…Motivational interviewing (MI) may be more familiar to stakeholders given it is a client-centered approach that can be incorporated into clinical settings in a variety of ways [26]. It also is perceived to be a good fit with adolescent patient populations given its emphasis on autonomy and self-efficacy [27]. YMHP, on the other hand, is a multisession program designed for a particular population (young men who have sex with young men).…”

Section: Moderate Extent [2]mentioning

confidence: 99%

“…At the exploration phase, data on perceptions of fit could inform decisions regarding EBP adoption. Indeed, in the qualitative interviews stemming from the larger EPIS study (ATN 153), providers underscored the importance of taking the time to share the evidence base when introducing a new EBP and developing clinically relevant examples that align with the specific settings and characteristic patients, such as patient testimonials or brief videos demonstrating EBP integration, to increase EBP acceptability and perceptions of fit [27].…”

Section: Moderate Extent [2]mentioning

confidence: 99%

Adapting the self-assessment of contextual fit scale for implementation of evidence-based practices in adolescent HIV settings

Coyle

Carcone

Butame

et al. 2022

Implement Sci Commun

View full text Add to dashboard Cite

Background Contextual fit is an important variable in the implementation of evidence-based programs (EBPs). The objectives of the current study were to examine the psychometric properties of the adapted Self-Assessment of Contextual Fit (SACF) measure for HIV clinical care settings (calling it SACF-HIV) and explore how perceptions of contextual fit varied across two different interventions (an intervention to scale up tailored motivational interviewing and an individually focused HIV prevention intervention) and 12 clinical sites. Methods We collected SACF-HIV data as part of a larger cross-project implementation science study (ATN 153). The study sample includes 128 clinicians, community health workers, interventionists, adherence counselors, and other members of the prevention and care team who engage in the implementation of EBPs at 12 HIV prevention and clinical care sites in the USA. We assessed the internal consistency of the SACF-HIV using Cronbach’s alpha and examined the sub-dimensionality of the scale with an exploratory factor analysis. To explore concurrent validity, we examined Pearson’s correlation coefficients between the adapted scale and fit-related sub-scale scores from the Evidence-Based Practice Attitudes Scale-50 (EBPAS-50). Variation in perceptions of fit by intervention was examined using descriptive statistics. Results Internal consistency of the adapted scale was strong (α=0.895). Factor analyses revealed two sub-scales—one capturing general insights regarding contextual fit, such as perceptions of skill, experience, and alignment with client needs (loadings ranging from .5 to .84), and a second centering perceptions regarding implementation support, such as resources and administrative support (loadings ranging from .89 to .97). Concurrent validity was supported by statistically significant correlations in the expected direction with EBPAS-50 fit-related sub-scales (r=.33–.35, p ≤ 0.05). SACF-HIV mean fit scores varied by intervention and the difference was statistically significant (2.78 vs. 2.53, p < 0.05). Conclusions There are relatively few tools assessing perceptions of contextual fit in HIV clinical settings. These results suggest the 12-item adapted SACF is a reliable, valid global assessment of perceptions of contextual fit and implementation support. The SACF-HIV can be used by practitioners and researchers interested in understanding an implementation context when planning to prepare and support EBP implementation. Trial registration TMI ClinicalTrials.gov NCT03681912; YMPH ClinicalTrials.gov NCT03488914

show abstract

Building an HIV Learning Health Care Community for Youth in Florida: Opportunities and Challenges

Balán,

Cheshure,

Green

et al. 2023

AIDS Behav

View full text Add to dashboard Cite

Using the Exploration-Preparation-Implementation-Sustainment (EPIS) Framework to prepare for the implementation of evidence-based practices into adolescent HIV settings

Cited by 9 publications

References 55 publications

Understanding implementation completion of tailored motivational interviewing in multidisciplinary adolescent HIV clinics

Understanding implementation completion of tailored motivational interviewing in multidisciplinary adolescent HIV clinics

Adapting the self-assessment of contextual fit scale for implementation of evidence-based practices in adolescent HIV settings

Building an HIV Learning Health Care Community for Youth in Florida: Opportunities and Challenges

Contact Info

Product

Resources

About