Workshop on Implementation Science and Digital Therapeutics for Behavioral Health.

Digital therapeutics can overcome many of the barriers to translation of evidence-based treatment for substance use, mental health, and other behavioral health conditions. Delivered via nearly ubiquitous platforms such as the web, smartphone applications, text messaging, and videoconferencing, digital therapeutics can transcend the time and geographic boundaries of traditional clinical settings so that individuals can access care when and where they need it. There is strong empirical support for digital therapeutic approaches for behavioral health, yet implementation science with regard to scaling use of digital therapeutics for behavioral health is still in its early stages. In this paper, we summarize the proceedings of a day-long workshop, "Implementation Science and Digital Therapeutics," sponsored and hosted by the Center for Technology and Behavioral Health at Dartmouth College. The Center for Technology and Behavioral Health is an interdisciplinary P30 Center of Excellence funded by the National Institute on Drug Abuse, with the mission of promoting state-of-the-technology and state-of-the-science for the development, evaluation, and sustainable implementation of digital therapeutic approaches for substance use and related conditions. Workshop presentations were grounded in current models of implementation science. Directions and opportunities for collaborative implementation science research to promote broad adoption of digital therapeutics for behavioral health are offered.

Digital Presence of a Research Center as a Research Dissemination Platform: Reach and Resources.

BACKGROUND: Web-based platforms can be powerful tools for research dissemination. By leveraging the advantages of mass media and interpersonal channels of communication, Web-based dissemination platforms may improve awareness about, and subsequent adoption of, evidence-based practices (EBPs). Digital dissemination strategies can augment traditional dissemination models, improving stakeholder access to digestible and actionable information and promoting translation of EBPs. OBJECTIVE: This study aimed to describe the reach and content of the Web presence of a National Institute on Drug Abuse Center of Excellence and how it is used to disseminate research related to digital behavioral health approaches. METHODS: The Center for Technology and Behavioral Health (CTBH) has a website and regularly updated Facebook and Twitter accounts. The website features include summaries of digital behavioral health approaches and related empirical literature, a blog feed focused on the state of the science and technology concerning digital health care approaches, and a newsletter about Center activities. We extracted website usage metrics from Google Analytics and follower counts from social media accounts for the period from March 1, 2013, to July 17, 2018. RESULTS: Since the implementation of analytic tracking, 70,331 users have initiated 96,995 sessions on the CTBH website. The website includes summaries of 86 digital therapeutic programs, encompassing 447 empirical articles. There are 1160 posts in the CTBH blog feed, including 180 summaries of scholarly articles. The Twitter and Facebook accounts have 577 and 1500 followers, respectively. The newsletter has reached a growing subscriber network and has a high open rate relative to industry standards. CONCLUSIONS: The CTBH Web presence serves as a model for how to leverage accessible and easily updatable digital platforms as research dissemination channels. Digital dissemination tools can augment traditional dissemination strategies to promote awareness about evidence-based digital therapeutic approaches for behavioral health and health care more broadly.

"Everybody's Really Close-Knit": Disconnections Between Helping Victims of Intimate Partner Violence and More General Helping in Rural Communities.

Social support is key to well-being for victims of intimate partner violence (IPV), and bystanders have an important role to play in preventing IPV by taking action when there is risk for violence. The current study used qualitative interviews to explore young adults' perspectives on helping in situations of IPV, and more general helping, in the rural communities in which they resided. Participants were 74 individuals between the ages of 18 and 24 years from 16 rural counties across the eastern United States. Participants generally described their communities as close-knit and helpful, especially around daily hassles (e.g., broken down car) and unusual circumstances (e.g., house fire). Although participants generated ways in which community members help IPV victims, these mostly focused on providing support or taking action in the aftermath of IPV as opposed to more preventive actions. Lack of financial resources were uniquely cited as a barrier to more general helping, whereas concerns about privacy and lack of deservingness of help were barriers to both general helping and helping in IPV situations, although these were more pronounced in IPV situations than general helping situations. Taken together, these results suggest that although people generally see their communities as helpful and close-knit, these perceptions and scripts did not necessarily translate to helping in situations of IPV. Bystander intervention programs are needed that provide more specific helping scripts for IPV.

Rural Young Adults' Lay Theories of Intimate Partner Violence: A Qualitative Examination.

This study qualitatively examined rural emerging adults' ways of thinking (i.e., lay theories) about the causes of intimate partner violence (IPV) and ideas on how to prevent IPV most effectively. Participants were 74 individuals (majority Caucasian, heterosexual, low income) between the ages of 18 and 24 who resided in one of 16 rural communities. Participants' perceptions of the causes of IPV included (a) individual-level pathology, stress, and lack of education; (b) intergenerational transmission of violence and early-life factors; (c) relationship stressors and challenges; and (d) community factors. Furthermore, participants felt that IPV could most effectively be prevented through (a) education and awareness; (b) victim-focused efforts (e.g., teaching self-esteem); and (c) job creation. Overall, participants identified a number of established risk factors for IPV perpetration across the social ecological model, although a number were never or rarely mentioned (e.g., peer group norms, positive bystander action, and collective efficacy). Future research should examine if and how perceptions of the causes of IPV impact IPV prevention engagement and impact. Further, prevention initiatives that take into account understandings of lay theories about IPV may be more impactful in reducing IPV than prevention initiatives that do not.