Mental health interventions for individuals with serious mental illness in the criminal legal system: a systematic review.

BACKGROUND: Globally, individuals with mental illness get in contact with the law at a greater rate than the general population. The goal of this review was to identify and describe: (1) effectiveness of mental health interventions for individuals with serious mental illness (SMI) who have criminal legal involvement; (2) additional outcomes targeted by these interventions; (3) settings/contexts where interventions were delivered; and (4) barriers and facilitating factors for implementing these interventions. METHODS: A systematic review was conducted to summarize the mental health treatment literature for individuals with serious mental illness with criminal legal involvement (i.e., bipolar disorder, schizophrenia, major depressive disorder). Searches were conducted using PsychINFO, Embase, ProQuest, PubMed, and Web of Science. Articles were eligible if they were intervention studies among criminal legal involved populations with a mental health primary outcome and provided description of the intervention. RESULTS: A total of 13 eligible studies were identified. Tested interventions were categorized as cognitive/behavioral, community-based, interpersonal (IPT), psychoeducational, or court-based. Studies that used IPT-based interventions reported clinically significant improvements in mental health symptoms and were also feasible and acceptable. Other interventions demonstrated positive trends favoring the mental health outcomes but did not show statistically and clinically significant changes. All studies reported treatment outcomes, with only 8 studies reporting both treatment and implementation outcomes. CONCLUSION: Our findings highlight a need for more mental health research in this population. Studies with randomized design, larger sample size and studies that utilize non-clinicians are needed.

Developing a typology of network alteration strategies for implementation: a scoping review and iterative synthesis.

BACKGROUND: Social networks transmit knowledge, influence, and resources. These relationships among patients, professionals, and organizations can shape how innovations are disseminated, adopted, implemented, and sustained. Network alteration interventions-interventions that change or rewire social networks-have the potential to be used as implementation strategies. Yet, the types, mechanisms, and effectiveness of these interventions for implementation are unclear. This scoping review and iterative synthesis identified and described network alteration strategies that could be tested for implementation. METHODS: We used forward and backward citation tracking of influential articles on network interventions, bibliometric searches, and hand searches of peer-reviewed social network journals. At least two team members screened article titles/abstracts to identify studies that met inclusion criteria: empirical studies of an intervention, the intervention was designed to alter some element of a social network, and changes in social network metrics were measured at two or more time points. During full-text reviews, information about the network interventions, actors, ties, and main findings was extracted. Reporting was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). To develop our typology, we synthesized these results using an iterative team-based and consensus-building process. RESULTS: Fifty-three articles met the inclusion criteria. The interventions described were conducted in healthcare systems or behavioral health systems (34%), communities (26.4%), and schools (22.6%). The majority included records describing interventions designed to alter social support, information-sharing, or friendship networks (65%) among individual actors (84.9%), or to increase ties. Eight strategies emerged. Three strategies targeted the general context: (1) change the environment, (2) create groups, and (3) change the composition. Four strategies targeted individual actors: change (4) motivations, (5) skills for networking, (6) knowledge of one's social network, and (7) prominence/roles. One strategy (8) targeted specific ties within the network (targeting a particular pair-wise relationship or changing the nature of an existing tie). CONCLUSION: The network alteration strategies in this typology provide further operational specificity for how implementation strategies target relationships. Advancing these strategies will require greater theoretical specification, the development of strategies that target professionals and organizations, and studies that examine the impact on implementation outcomes.

"There's no money in community dissemination": A mixed methods analysis of researcher dissemination-as-usual.

Background: The field of dissemination and implementation science has the potential to narrow the translational research-to-practice gap and improve the use of evidence-based practices (EBPs) within community-based settings. Yet, foundational research related to dissemination efforts, such as understanding researcher attitudes, practices, and the determinants to sharing research findings, is lacking within extant literature. Methods: A sequential explanatory (QUANqual) mixed methods design was used to examine 85 academic researchers' perspectives and self-reported dissemination methods used to share research outcomes with community stakeholders to better understand researcher's usual dissemination practices (referred to as dissemination-as-usual). Quantitative surveys collected researcher demographic data, attitudes toward dissemination efforts, and dissemination strategy use. Results: Multiple linear regression examined predictors of the quantity of dissemination strategies utilized by researchers, finding that years since earning their degree, time spent disseminating, and the number of reasons for engaging in dissemination efforts predicted greater numbers of dissemination strategies utilized by researchers. Individual, semi-structured interviews with a subset of researchers (n = 18) expanded upon quantitative findings, identifying barriers and facilitators to their dissemination efforts. Data strands were integrated using a joint display, and the Dissemination of Research model guided data interpretation. More established researchers experienced fewer barriers and more facilitators to support their use of a variety of dissemination strategies to share findings with community stakeholders. However, researchers reported needing specific training, institutional support, and/or dedicated time to plan and enact dissemination strategies. Conclusion: The necessary first step in research translation is the dissemination of research evidence, and understanding dissemination-as-usual can identify areas of need to advance translational science.

Belonging to Something Greater Than Self: Flint Women Giving Back to the Community.

BACKGROUND: Having meaning in life promotes happiness and well-being across the lifespan. METHODS: A community-based participatory qualitative study was conducted to understand meaning in life, having a voice and the different ways women give back to their community by serving others. Interviews were held with participants (n = 100) who were community residents, people serving women, or both. RESULTS: Participants defined meaning in life as having a sense of significance, a deep connection to their community, and a sense of acknowledgement for their overall contributions. They emphasized the importance of opportunities for women to contribute to something greater than themselves. Participants suggested organizations would be responsive to the needs of women when women have a stronger voice. CONCLUSIONS: Women served their community in many roles. However, despite some societal progress, women continue to be underpaid and their contributions undervalued. Rectifying these inequities might contribute to better addressing the needs of women.

Integrating Mixed Methods Social Network Analysis to Assess Community-Academic Partnerships.

BACKGROUND: Community-academic partnerships (CAPs) in public health are increasingly utilized to integrate community voice into decision-making processes of health-related interventions, programs, and practice. However, community partners' collaboration experiences remain understated in the literature. Thus, there is a need to further advance methodological approaches that examine the effectiveness of CAPs, while also highlighting community voice to, ultimately, improve public health outcomes. OBJECTIVES: (1) To demonstrate how a practical approach to mixed methods social network analysis (MMSNA) can highlight power dynamics in community health partnerships and use MMSNA data to build relationships across stake-holders for systems change effortsMethods: MMSNA was used to examine a CAP focused on public health equity in a Midwest region. The project applied a sequential mixed methods design (QUAN → QUAL) with a network survey and individual semi-structured interviews. Both data strands served the function of expansion, where quantitative data identified what relationships existed in the network, level of activity, and factors for motivations, providing breadth of collaboration. Qualitative data further elaborated on how partners perceived these experiences, providing depth and contextualizing quantitative results. CONCLUSIONS: Systems level approaches must be applied to capture broader contexts (e.g., community, interpersonal, and individual) surrounding community health partnerships. The use of MMSNA maximizes benefits from a systems methodology-social network analysis-with qualitative interviews that allow for the critical assessment of network structure and community centered perspectives. Community health partnerships are encouraged to utilize this approach in order to deliver more sustainable public health efforts centered on the community that is directly impacted.

Community-based implementation strategy use and satisfaction: A mixed-methods approach to using the ERIC compilation for organizations serving children on the autism spectrum.

Background: Despite efforts to use standardized taxonomy and research reporting, documenting implementation strategies utilized in community settings remains challenging. This case study demonstrates a practical approach to gather use of and satisfaction with implementation strategies utilized within community-based sites to understand community providers' perspectives of implementing an early intensive behavioral intervention (EIBI) for children on the autism spectrum across different settings. Methods: Using a sequential explanatory mixed-methods design, survey and interview data were collected from directors/supervisors and direct providers (n = 26) across three sites (one university and two community-based replication sites). The Implementation Strategies and Satisfaction Survey (ISSS) was administered to identify staff-reported implementation strategy use and satisfaction. Informed by quantitative results, follow-up semi-structured interviews were conducted with a subsample (n = 13) to further understand staff experiences with endorsed implementation strategies and elicit recommendations for future efforts. Results: Survey results were used to demonstrate frequencies of implementation strategies endorsed by site and role. Overall, staff felt satisfied with implementation strategies used within their agencies. Content analysis of qualitative data revealed three salient themes related to implementation strategy use-context, communication, and successes and challenges-providing in-depth detail on how strategies were utilized, and strategy effectiveness based on community providers' experiences. Recommendations were also elicited to improve strategy use within "broader" community settings. Conclusions: The project demonstrated a practical approach to identifying and evaluating implementation strategies used within sites delivering autism services. Reporting implementation strategies using the ISSS can provide insight into community providers' perspectives and satisfaction with agency implementation strategy use that can generate more relevant and responsive strategies to address barriers in community settings. Plain language abstract Examining community providers' preferences and experiences with implementation strategies used to facilitate evidence-based practice uptake can broaden our understanding of what, how, and why implementation strategies work in community-based settings ( Chaudoir et al., 2013; Leeman et al., 2017; Proctor et al., 2013). Such efforts have great potential to tailor implementation strategies to address barriers/facilitators typically found in community-based settings.This case study demonstrates a practical approach using mixed methodology to: (a) gather self-reported use of and satisfaction with implementation strategies to understand community providers' perspectives of implementation strategy success. Using a new survey, the Implementation Strategies and Satisfaction Survey (ISSS) conjoined with interviews, the study demonstrated a practical approach using standardized language to report strategies used in one university-based site and two community-based replication sites that deliver an early intensive behavioral intervention (EIBI) for children on the autism spectrum. This paper contributes to one of the five priorities to enhance public health impact-improve tracking and reporting of implementation strategies utilized when translating research into practice ( Dingfelder & Mandell, 2011; Powell et al., 2019; Stahmer et al., 2019). This approach emphasizes the importance of understanding context (e.g., community organizations providing services to children on the autism spectrum) to develop strategies that work better for EIBI implementation and scale-up. Understanding community provider's preferences and experiences with implementation strategies can support use of implementation strategies that better fit usual care contexts, with the ultimate goal of improving implementation practice in community-based settings.

Implementation-as-Usual in Community-Based Organizations Providing Specialized Services to Individuals with Autism Spectrum Disorder: A Mixed Methods Study.

Autism spectrum disorder (ASD) is a highly prevalent neurodevelopmental disorder. ASD community-based organizations (ASD-CBOs) underutilize or inconsistently utilize evidence-based practices (ASD-EBPs) despite numerous available EBPs to treat ASD. Nonetheless, ASD-CBOs implement changes to practices regularly. Understanding ASD-CBO's implementation-as-usual (IAU) processes may assist to develop strategies to facilitate ASD-EBP adoption, implementation and sustainment. A convergent mixed methods (quan + QUAL) design was utilized. Twenty ASD-CBO agency leaders (ALs) and 26 direct providers (DPs), from 21 ASD-CBOs, completed the Autism Model of Implementation Survey Battery, including demographic and agency IAU process questions. Surveys were analyzed through descriptive and content analyses. A subset of 10 ALs provided qualitative interview data that were analyzed using coding, consensus and comparison methods to allow for a more comprehensive understanding of the IAU process within their ASD-CBOs. Quantitative analyses and qualitative coding were merged utilizing a joint display and compared. Results suggest that the IAU process follows some phases identified in the Exploration, Preparation, Implementation, Sustainment (EPIS) framework but were conducted in an informal manner-lacking specificity, structure and consistency across and within ASD-CBOs. Moreover, data suggest adding a specific adoption decision phase to the framework. Nonetheless, most ALs felt previous implementation efforts were successful. IAU processes were explored to determine whether the implementation process may be an area for intervention to increase ASD-EBP utilization in ASD-CBOs. Developing a systematized implementation process may facilitate broader utilization of high quality ASD-EBPs within usual care settings, and ultimately improve the quality of life for individuals with ASD and their families.

Evidence-based intervention sustainability strategies: a systematic review.

BACKGROUND: Sustainability of evidence-based interventions (EBI) remains a challenge for public health community-based institutions. The conceptual definition of sustainment is not universally agreed upon by researchers and practitioners, and strategies utilized to facilitate sustainment of EBI are not consistently reported in published literature. Given these limitations in the field, a systematic review was conducted to summarize the existing evidence supporting discrete sustainment strategies for public health EBIs and facilitating and hindering factors of sustainment. METHODS: We searched PsychINFO, Embase, ProQuest, PubMed, and Google Scholar. The initial search was run in March 2017 and an update was done in March 2019. Study eligibility criteria included (a) public health evidence-based interventions, (b) conducted in the community or community-based settings, and (c) reported outcomes related to EBI sustainment. Details characterizing the study setting, design, target population, and type of EBI sustained were extracted. RESULTS: A total of 26 articles published from 2004 to 2019 were eligible for data extraction. Overall, the importance of sustainability was acknowledged across all of the studies. However, only seven studies presented a conceptual definition of sustainment explicitly within the text. Six of the included studies reported specific sustainment strategies that were used to facilitate the sustainment of EBI. Only three of the studies reported their activities related to sustainment by referencing a sustainment framework. Multiple facilitators (i.e., adaptation/alignment, funding) and barriers (i.e., limited funding, limited resources) were identified as influencing EBI sustainment. The majority (n = 20) of the studies were conducted in high-income countries. Studies from low-income countries were mostly naturalistic. All of the studies from low-income countries reported lack of funding as a hindrance to sustainment. IMPLICATION FOR DISSEMINATION AND IMPLEMENTATION RESEARCH: Literature focused on sustainment of public health EBIs should present an explicit definition of the concept. Better reporting of the framework utilized, steps followed, and adaptations made to sustain the intervention might contribute to standardizing and developing the concept. Moreover, encouraging longitudinal dissemination and implementation (D&I) research especially in low-income countries might help strengthen D&I research capacity in public health settings.