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PURPOSE. To capitalize on investments in evidence-based practices, technology is needed to scale up fidelity assessment and supervision. Stakeholder feedback may facilitate adoption of such tools. This evaluation gathered stakeholder feedback and preferences to explore whether it would be fundamentally feasible or possible to implement an automated fidelity-scoring supervision tool in community mental health settings. METHOD. A partially mixed, sequential research method design was used including focus group discussions with community mental health therapists (n=18) and clinical leadership (n=12) to explore typical supervision practices, followed by discussion of an automated fidelity feedback tool embedded in a cloud-based supervision platform. Interpretation of qualitative findings was enhanced through quantitative measures of participants’ use of technology and perceptions of acceptability, appropriateness, and feasibility of the tool. RESULTS. Initial perceptions of acceptability, appropriateness, and feasibility of automated fidelity tools were positive and increased after introduction of an automated tool. Standard supervision was described as collaboratively guided and focused on clinical content, self-care, and documentation. Participants highlighted the tool’s utility for supervision, training, and professional growth, but questioned its ability to evaluate rapport, cultural responsiveness, and non-verbal communication. Concerns were raised about privacy and the impact of low scores on therapist confidence. Desired features included intervention labeling and transparency about how scores related to session content. Opportunities for asynchronous, remote, and targeted supervision were particularly valued. CONCLUSIONS. Stakeholder feedback suggests that automated fidelity measurement could augment supervision practices. Future research should examine the relations among use of such supervision tools, clinician skill, and client outcomes.

Purpose. To capitalize on investments in evidence-based practice implementation, technology is needed to scale up fidelity assessment. Stakeholder feedback may facilitate adoption of such tools. This study examined mental health providers’ perceptions of an automated fidelity-rating tool for Cognitive Behavioral Therapy (CBT). Methods. We administered online surveys before and after focus groups that included therapists (n=18) and clinical leadership (n=12) from community mental health programs implementing CBT. Discussions centered on supervision practices followed by feedback about the fidelity tool. Transcripts were analyzed using a grounded theory approach.Results. Initial perceptions of acceptability, appropriateness, and feasibility of automated CBT fidelity tools were positive and increased after introduction of the tool, including significant increases in ratings of acceptability and appropriateness. Standard supervision was described as collaboratively guided, either scheduled or spontaneous, and focused on clinical content, self-care, and documentation. Participants highlighted the tool’s utility for supervision, training, and professional growth, but questioned its ability to rate skills related to rapport, cultural diversity, and non-verbal communication. Concerns were raised about client and therapist privacy, and the impact of low scores on therapist confidence. Desired features included labeling of interventions used and transparency about how fidelity scores related to specific point in the session. Opportunities for asynchronous, remote, and targeted supervision were of particular value. Conclusions. Automated fidelity assessment may present an opportunity for an acceptable, appropriate, and feasible approach to large-scale EBP implementation. Continued partnership with community stakeholders will be key for designing such tools in a manner that increases the likelihood of uptake.

Although there are approximately 20,000 shipwrecks in U.S. waters, we now know that most of them are unlikely to be substantial pollution threats. Using initial screening factors (age, location, construction material, propulsion type, type, and size), 573 wrecks were identified as potentially containing larger amounts of oil. Secondary screening factors that relied on archival research and original documents for details, such as structural integrity and potential cargo and bunker capacities, reduced the list to 87 wrecks known or suspected to pose a substantial pollution threat. The majority of these are associated with World War II casualties in the Battle of the Atlantic. As of 2013, the average age of each wreck is 83 years old, as many were built or retrofitted for service during WWII. A consequence analysis consisting of oil spill trajectory and fate modeling and an assessment of ecological and socio-economic resources at risk was conducted for the 87 wrecks. Based on vessel pollution potential factors and ecological/socio-economic impact scores, a final relative risk score was assigned to each. Further assessments to determine the vessel condition, amount of oil onboard, and feasibility of oil removal action were recommended for seventeen vessels with known locations. Other recommendations included surveys of opportunity to identify the actual or best-guess location of each wreck in applicable oil spill contingency plans (so that if a mystery spill occurs, the wreck(s) can be investigated as a possible source), monitoring the condition of known wrecks, surveys to locate wrecks with unknown locations, and outreach to local communities. Recent surveys leveraged assets engaged in other activities, yielding additional information on a number of the high and medium priority targets. Although, this process has validated the existence of vessels of concern in U.S. waters that need to be reflected in area spill contingency plans, NOAA can now state that the coastline of the U.S. is not littered with “ticking time bombs” as previously believed. This assessment puts reliable bounds on the potential oil pollution threats from wrecks and helps delineate a path for determining risk for wrecks with as yet unconfirmed locations. The USCG can plan accordingly for monitoring, in-water assessments, and pollution recoveries as appropriate, rather than waiting for the potential harm these wrecks could cause to coastal areas. These findings are reassuring in light of earlier global analyses with much higher estimates such as that of the IOSC 2005 white paper (Michel et al., 2005).

An evaluation was made of the amounts and types of oil potentially released from sunken vessels in U.S. waters, where oil would be transported, how rapidly it would reach sensitive resources, and magnitudes of impacts on surface water and shorelines. Oil spill modeling was performed as part of a screening analysis to identify those sunken vessels of highest risk for environmental and socioeconomic impacts, with the expectation that those identified will be subject to more detailed analysis. The modeling provides estimates of the locations of oiling, as well as areas of water surface, lengths of shoreline, and volumes of water exposed above potential effects thresholds (oil thickness or concentrations). We developed regression models of the resulting indices of oil impacts as a function of spill volume, allowing for predictions of water surface area, shoreline extent, and water volume affected for any potential (partial or entire) release volume from the sunken vessel. We ran RPS-ASA's SIMAP model in probabilistic mode, i.e., long-term wind and current records were sampled at random and model runs performed for each of 200 selected spill dates and times. The model results provide a statistical description of the probabilities and potential locations and magnitudes of oil-related impacts. This consequence analysis may be used to assign priorities for potential salvage of sunken vessels based on relative risk. The resultant analysis may be used by decision-makers to evaluate response needs, such as response equipment capacities, timing of deployment required to protect sensitive resources, and possible time windows and areas for dispersant use.