Adaptation happens: a qualitative case study of implementation of The Incredible Years evidence-based parent training programme in a residential substance abuse treatment programme
Adaptation happens: a qualitative case study of implementation of The Incredible Years evidence-based parent training programme in a residential substance abuse treatment programme
复制标题
DOI：
10.1108/17466661211286463
复制
发表时间：
2012-01-01
影响因子：
1.2
通讯作者：
Bradway, Richard
中科院分区：
文献类型：
--
作者：
Aarons, Gregory A.;Miller, Elizabeth A.;Bradway, Richard
目的-循证实践（EBP）越来越多地在现实世界中实施。虽然干预措施的有效性取决于是否忠实，但干预措施往往根据各级利益攸关方的需求进行调整，以适应服务环境。本研究的目的是探讨自然的实施令人难以置信的岁月（IY）养育计划在住宅物质滥用治疗计划为孕妇和养育women.Design/方法/方式-这项研究发生在一个住宅物质滥用治疗计划为孕妇和养育妇女及其子女。参与者包括120名女性客户。国际青年年的主要促进者是一名硕士水平的咨询心理学家。由一名受过训练的学士水平的人类学家亲自完成对国际年会议的观察。收集人种学领域的笔记，然后编码与先验的主题，并确定新兴的主题。家长组组长检查表被用来评估IY基本家长programme.Findings -定量分析的质量和完整性表明，不同类型的检查表活动的保真度。具体而言，坚持国际年方案是最高的开始主题活动，设置和家庭活动的审查，最低的角色扮演，小插曲，总结活动。定性分析表明，在国际年的实施中有一些调整。改编可分为两大类：方案交付的修改和方案内容的修改。在这些类别的修改包括组织驱动的适应，供应商驱动的适应，和消费者驱动的adaptation.Practical影响-以证据为基础的实践的变化一般采取两种形式-适应模型的意图和理论方法和变化，代表漂移的核心要素的EBP。实现科学的挑战是开发框架，在这些框架中，模型可以进行充分的调整，使它们能够适应服务上下文（或适应模型的服务上下文），同时避免漂移并保持保真度。参加适应的复杂性之前，并在实施过程中，有计划地帮助组织更好地利用EBP，以满足其独特的需求，同时保持fidelity. Origality/值-该文件表明，识别类型的干预适应和漂移允许考虑系统的方法，框架，以及在社区精神卫生和药物滥用治疗环境中实施EBP期间增加依从性的过程。
Purpose - Evidence-based practices (EBPs) are increasingly being implemented in real-world settings. While intervention effectiveness is dependent on fidelity, interventions are often adapted to service settings according to the needs of stakeholders at multiple levels. This study aims to examine the naturalistic implementation of The Incredible Years (IY) parenting programme in a residential substance abuse treatment programme for pregnant and parenting women.Design/methodology/approach - The study took place in a residential substance abuse treatment programme serving pregnant and parenting women and their children. Participants included 120 female clients. The primary IY facilitator was a master's level counselling psychologist. In person observations of IY sessions were completed by a trained bachelor's level anthropologist. Ethnographic field notes were collected and then coded in keeping with a priori themes and to identify emergent themes. The Parent Group Leader Checklist was used to evaluate quality and integrity of the IY basic parent programme.Findings - Quantitative analyses indicate that fidelity varied by type of checklist activity. Specifically, adherence to the IY programme was highest in beginning topic activities, setup, and home activity review, and lowest in role play, vignettes, and wrap-up activities. Qualitative analyses revealed a number of adaptations in implementation of IY. Adaptations fit into two broad categories: modification of programme delivery and modification of programme content. Within each of these categories modifications included organisation-driven adaptations, provider-driven adaptations, and consumer-driven adaptations.Practical implications - Changes to evidence-based practice generally take two forms - adaptations consistent with model intent and theoretical approach and changes that represent drift from core elements of the EBP. The challenge for implementation science is to develop frameworks in which models can be adapted enough to make them viable for the service context (or the service context adapted to fit the model), yet avoid drift and maintain fidelity. Attending to the complexities of adaptation prior to and during implementation in a planned way is likely to help organisations better utilise EBPs to meet their unique needs while maintaining fidelity.Originality/value - The paper shows that identification of types of intervention adaptations and drift allows for consideration of systematic approaches, frameworks, and processes to increase adherence during EBP implementation in community mental health and substance abuse treatment settings.