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Treatment fidelity, including adherence and competence, is assessed during the implementation of evidence-based treatments to ensure that care is delivered as intended. Although fidelity monitoring...

Objective: Problematic maternal alcohol use confers risk for child maltreatment, though the effect on specific aspects of parenting is unclear. This study examined concurrent and prospective links among maternal alcohol use history, care neglect, supervisory neglect, and harsh or inconsistent discipline. Method: Multimethod multisource data were utilized to assess deficient parenting in 311 economically disadvantaged mothers at high risk of child maltreatment. Structural equation modeling was used to test hypothesized relations. Results: Maternal history of alcohol use was associated with more inconsistent discipline and higher levels of subsequent supervisory neglect. Secondary analyses among two-parent families found that paternal substance misuse was associated with maternal care neglect and poor supervision. Conclusions: Among low socioeconomic status families, maternal alcohol use increases the risk of inconsistent discipline and inadequate supervision. Inconsistent discipline may also lead to punitive parenting practices. Given the potential effect of paternal substance use on maternal parenting, findings highlight the importance of screening all caregivers for substance use in child welfare and research contexts to clarify when and how to intervene most effectively.

There is a growing emphasis on utilizing evidence-based treatments in community settings; yet little is known about treatment practices in usual care. The first aim of this study sought to describe treatment-as-usual (TAU) for children at risk of physical abuse, and identify elements of one evidence-based treatment, Alternatives for Families: A Cognitive Behavior Therapy (AF-CBT), present in usual care. A second aim was to identify how contextual variables influenced treatment practices. Participants included 44 practitioners and 64 families that presented with concerns of risk of physical abuse. The Therapy Process Observational Coding System for Child Psychotherapy–Strategies Scale and AF-CBT Adherence Coding System were used to understand treatment practices in 278 therapy sessions. Similar to other studies on TAU, families received treatment for an extensive time ( M = 19 sessions), and practitioners delivered a wide array of therapeutic techniques and some elements of AF-CBT; however, they did not utilize many techniques in great depth. An analysis of contextual factors indicated that there was variation based upon agency, practitioner, and family characteristics in the delivery of treatment practices. These findings are an important step in understanding treatment practices and contextual influences on usual care for children at risk of physical abuse.

Background In recent decades, evidence-based practices (EBPs) have been broadly promoted in community behavioural health systems in the United States of America, yet reported EBP penetration rates remain low. Determining how to systematically sustain EBPs in complex, multi-level service systems has important implications for public health. This study examined factors impacting the sustainability of parent-child interaction therapy (PCIT) in large-scale initiatives in order to identify potential predictors of sustainment. Methods A mixed-methods approach to data collection was used. Qualitative interviews and quantitative surveys examining sustainability processes and outcomes were completed by participants from 12 large-scale initiatives. Results Sustainment strategies fell into nine categories, including infrastructure, training, marketing, integration and building partnerships. Strategies involving integration of PCIT into existing practices and quality monitoring predicted sustainment, while financing also emerged as a key factor. Conclusions The reported factors and strategies impacting sustainability varied across initiatives; however, integration into existing practices, monitoring quality and financing appear central to high levels of sustainability of PCIT in community-based systems. More detailed examination of the progression of specific activities related to these strategies may aide in identifying priorities to include in strategic planning of future large-scale initiatives. Trial registration ClinicalTrials.gov ID NCT02543359; Protocol number PRO12060529. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0230-8) contains supplementary material, which is available to authorized users.

The implementation of any evidence-based treatment (EBT) into community settings, especially at a broad scale, is a complex, dynamic process. Large-scale implementation requires consideration of factors at a variety of levels, including those related to the broader system, provider agencies, clinical and professional staff, as well as families. This chapter will explore the implementation of one EBT, parent–child interaction therapy (PCIT), across one state, the Commonwealth of Pennsylvania. The spread and implementation of the intervention will be discussed in light of the current literature related to dissemination and implementation. Specific examples and case discussions from the state will also be highlighted, including a review of specific facilitating factors and barriers, as well as strategies used to promote implementation with fidelity and ongoing sustainability of the model.

Children's emotion dysregulation, children's appraisals, maternal psychological functioning, and harsh discipline were investigated as potential mediators in the putative link between exposure to intimate partner violence and poor child outcomes. Participants included 132 children ages 6-8 and their mothers who had been enrolled in a longitudinal study of parenting and children's social development. The mothers were receiving some form of government-based economic assistance or other social services, and were currently involved in a romantic relationship. Results of structural equation modeling indicated children's emotion dysregulation mediated the links between exposure to intimate partner violence (IPV) and both internalizing and externalizing problems. Harsh discipline mediated the link between exposure to IPV and externalizing, but not internalizing, symptoms. Child appraisals and maternal psychological functioning mediated the link between exposure to IPV and internalizing, but not externalizing, symptoms.

A1 Introduction to the 8th Annual Conference on the Science of Dissemination and Implementation: Optimizing Personal and Population Health David Chambers1, Lisa Simpson2 1Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, 20850, USA; 2AcademyHealth, Washington, DC, 20036, USA For the second year in a row, we are pleased to be able to share the proceedings of the Annual Conference on the Science of Dissemination and Implementation in Health, a large meeting reflecting the expanding and evolving research field that seeks to optimize the use of evidence, interventions, and tools from health research within the myriad of settings where people receive health care, make health-related decisions, and increase knowledge of influences on the health of the population. We once again benefitted from a strong partnership, co-led by AcademyHealth and the National Institutes of Health (NIH), with co-sponsorship from the Agency for Healthcare Research and Quality (AHRQ), the Patient Centered Outcomes Research Institute (PCORI), the Robert Wood Johnson Foundation (RWJF), the US Department of Veterans Affairs (VA), and the WT Grant Foundation. In addition, we benefitted from the collaboration of staff from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). NIH and AcademyHealth again co-led the program planning committee, which focused on the development of the plenary sessions, and convened a scientific advisory panel to suggest speakers and advise on the overall conference development. The planning committee identified four key areas around which to focus the plenary panels and keynote address. Dr. America Bracho, M.D., M.P.H., Executive Director of Latino Health Access in Orange County, California, spoke about the opportunities for implementation science to inform efforts to improve community health and engage underserved populations. The three plenary panels each focused on a significant future direction for dissemination and implementation (D & I) research: the interface between D&I science and population health, emerging opportunities for global implementation science, and the challenges around implementation of precision medicine. The plenary sessions were complemented by facilitated lunchtime discussions on the same three topics, which offered participants an opportunity to identify key research questions for each and brainstorm next steps. Synopses of the lunchtime discussions are included in this supplement. Given the overwhelming success of the 2014 conference and the large number of abstracts received in 2014 (660), the program planning committee identified eight program tracks for abstract submitters to respond to, and through which the concurrent sessions of the conference would be organized. These tracks—Behavioral Health, Big Data and Technology for Dissemination and Implementation Research, Clinical Care Settings, Global Dissemination and Implementation, Promoting Health Equity and Eliminating Disparities, Health Policy Dissemination and Implementation, Prevention and Public Health, and Models, Measures and Methods— were designed to enable conference participants to follow a consistent theme across the multiple sessions of the conference and form the structure of this supplement. The call for abstracts, including individual paper presentations, individual posters and panel presentations, resulted in 515 submissions, spread across the eight thematic tracks. Over one hundred reviewers devoted their time to ensuring a comprehensive and expert review, and reviews were conducted within each track and coordinated by the track leads. For the final program, 64 oral presentations, 12 panels, and 263 posters were presented over the two-day meeting. Slides for the oral presentations and panels (with the agreement of the authors) were posted on the conference website (http://diconference.academyhealth.org/archives/2015archives) and all abstracts were included on the conference webapp (https://academyhealth.confex.com/academyhealth/2015di/meetingapp.cgi). This supplement has compiled the abstracts for presented papers, panel sessions, and lunchtime discussions from the 8th Annual Meeting on the Science of Dissemination and Implementation in Health: Optimizing Personal and Population Health. We are pleased to have the abstracts from the conference together in one volume once again, and look forward to the 9th Annual meeting, scheduled for December in Washington, D.C.

Background Evidence-based treatments (EBTs) are available for treating childhood behavioral health challenges. Despite EBTs’ potential to help children and families, they have primarily remained in university settings. Little empirical evidence exists regarding how specific, commonly used training and quality control models are effective in changing practice, achieving full implementation, and supporting positive client outcomes. Methods/design This study (NIMH RO1 MH095750; ClinicalTrials.gov Identifier: NCT02543359), which is currently in progress, will evaluate the effectiveness of three training models (Learning Collaborative (LC), Cascading Model (CM), and Distance Education (DE)) to implement a well-established EBT , Parent-Child Interaction Therapy, in real-world, community settings. The three models differ in their costs, skill training, quality control methods, and capacity to address broader implementation challenges. The project is guided by three specific aims: (1) to build knowledge about training outcomes, (2) to build knowledge about implementation outcomes, and (3) to test the differential impact of training clinicians using LC, CM, and DE models on key client outcomes. Fifty (50) licensed psychiatric clinics across Pennsylvania were randomized to one of the three training conditions: (1) LC, (2) CM, or (3) DE. The impact of training on practice skills (clinician level) and implementation/sustainment outcomes (clinic level) are being evaluated at four timepoints coinciding with the training schedule: baseline, 6 (mid), 12 (post), and 24 months (1 year follow-up). Immediately after training begins, parent–child dyads (client level) are recruited from the caseloads of participating clinicians. Client outcomes are being assessed at four timepoints (pre-treatment, 1, 6, and 12 months after the pre-treatment). Discussion This proposal builds on an ongoing initiative to implement an EBT statewide. A team of diverse stakeholders including state policy makers, payers, consumers, service providers, and academics from different, but complementary areas (e.g., public health, social work, psychiatry), has been assembled to guide the research plan by incorporating input from multidimensional perspective. Trial registration ClinicalTrials.gov: NCT02543359