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Background: Aphasia services are currently faced by increasing evidence for therapy of greater intensity and comprehensiveness. Intensive Comprehensive Aphasia Programs (ICAPs) combine these elements in an evidence-based, time-limited group program. The incorporation of new service delivery models in routine clinical practice is, however, likely to pose challenges for both the service provider and administering clinicians. This program of research aims to identify these challenges from the perspective of aphasia clinicians from six countries and will seek to trial potential solutions. Continual advancements in global communication technologies suggest that solutions will be easily shared and accessed across multiple countries. Aims: To identify the perceived and experienced barriers and facilitators to the implementation of 1) intensive aphasia services, 2) comprehensive aphasia services, and 3) ICAPs, from aphasia clinicians across six countries. Methods and procedures: A qualitative enquiry approach included data from six focus groups (n = 34 participants) in Australia, New Zealand, Canada, United States of America (USA), United Kingdom (UK), and Ireland. A thematic analysis of focus group data was informed by the Theoretical Domains Framework (TDF). Outcomes and results: Five prominent theoretical domains from the TDF influenced the implementation of all three aphasia service types across participating countries: environmental context and resources, beliefs about consequences, social/professional role and identity, skills, and knowledge. Four overarching themes assisted the identification and explanation of the key barriers and facilitators: 1. Collaboration, joint initiatives and partnerships, 2. Advocacy, the promotion of aphasia services and evidence-based practice, 3. Innovation, the ability to problem solve challenges, and 4. Culture, the influence of underlying values. Conclusions: The results of this study will inform the development of a theoretically informed intervention to improve health services' adherence to aphasia best practice recommendations. [ABSTRACT FROM AUTHOR]

The Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP) is an online database of mental health and substance- abuse interventions that have undergone an independent review process to rate their quality of research and readiness for dissemination. Originally conceived as a U.S.-based national registry, NREPP has effectively become an international resource on evidence-based programs and practices, containing information on interventions from around the world and drawing an international audience. The objectives of this descriptive study were to determine how many interventions in the registry (1) have been implemented outside the United States, (2) have materials translated into one or more languages, (3) have received funding from a non-U.S. source, and (4) have been evaluated in studies conducted outside the United States. The growing interest in other countries for tools to assist in the identification and implementation of evidence-based programs suggests that NREPP will become increasingly relevant and useful to international mental health constituencies. [ABSTRACT FROM AUTHOR]