The ACT SMART Toolkit: An Implementation Strategy for Community-Based Agencies Providing Services to Children with Autism Spectrum Disorder

Saturday 1:00 – 2:15 Breakout E3

Presentor: Amy Drahota

Amy Drahota, San Diego State University; Jonathan I. Martinez, San Diego State University; Brigitte Brikho, San Diego State University; Rosemary Meza, University of Washington; Aubyn C. Stahmer, University of California, Davis; Gregory A. Aarons, University of California, San Diego 


One in 68 U.S. children is diagnosed with Autism Spectrum Disorder (ASD), costing approximately $35 billion for services annually. Typically, ASD community providers (CPs) provide services to children with ASD using treatments with variable evidentiary support. Despite positive outcomes of EBP use, implementation practices have not been systematically studied in this setting. This study evaluated implementation practices used by community-based agencies providing ASD services to children. CPs (n=27) and agency leaders (ALs) (n=20) completed the Autism Model of Implementation Survey. ALs (n=10) participated in qualitative interviews. Data (Quan→QUAL) was converged for triangulation within and across methods. Results identified multiple challenges for implementing EBPs within ASD community agencies including: no existing systematic implementation strategies fitting this setting; lack of structure and consistency with implementation efforts; agency leader uncertainty; and organizational, provider, and treatment characteristics impacting implementation. Results indicate the need for the development of a comprehensive implementation strategy. The ACT SMART Toolkit is such a strategy to support agencies in successfully implementing new EBPs by assisting in identifying training/service delivery gaps, selecting effective treatments to meet needs, facilitating treatment adoption decisions, guiding the design of effective training and implementation strategies, and supporting efforts to sustain effective treatments.


The Collaborative Intervention Planning Framework: An approach to Engage Stakeholders in Preparing and Customizing Interventions for Implementation

Saturday 1:00 – 2:15 Breakout E3

Presentor: Leopoldo J. Cabassa

Leopoldo J. Cabassa, Columbia University School of Social Work; Dianna Dragatsi, New York State Psychiatric Institute; Richard Younge, Columbia University; Roberto Lewis-Fernández, New York State Psychiatric Institute


Implementing health-care interventions in public mental health clinics is a pressing need since people with serious mental illness (SMI) face persistent health disparities.  Few studies currently exist describing collaborative approaches that can be used to prepare healthcare interventions for routine practice in public mental health clinics.  The aim of this NIMH-funded study is to describe the application of the collaborative intervention planning framework, an approach that combines community-based participatory research principles and intervention mapping procedures

[3], to inform the adaptation of a health-care manager intervention to a new population (Hispanics) and provider group (social workers) to enhance its use in public mental health clinics.  The framework included four steps: fostering collaborations between stakeholders (e.g., social workers, physicians, peer advocates) understanding the needs of the local population through a mixed-methods needs assessment, literature reviews, and group discussions; reviewing intervention objectives to identify targets for adaptation; and developing the adapted intervention. This process enabled stakeholders to identify a series of cultural and provider level-adaptations without compromising core intervention elements.  This study illustrates one approach that can be used to engage stakeholders in the intervention adaptation process to enhance the transportability of interventions to address health disparities among people with SMI.


Community Capacity Building: Training Providers to Address the Psychological Health of Military Families through HomeFront Strong


Saturday 1:00 – 2:15 Breakout E3

Presentor: Laura Supkoff Nerenberg

Laura Supkoff Nerenberg; University of Michigan; Michelle Kees, University of Michigan; Adrian Blow, Michigan State University;


Since 9/11, the United States has relied significantly on the Reserve Component (RC) of the military, with deployments to high-risk war zones that have been frequent and lengthy. Though such deployments significantly impact military families, there are few services available to support the mental health and wellbeing of spouses, particularly in civilian communities where RC families are embedded. Our study seeks to address these unmet needs, by utilizing HomeFront Strong (HFS), an 8-week psychological health intervention for military spouses incorporating evidence based strategies from Cognitive Behavior Therapy, Dialectical Behavior Therapy, and Positive Psychology. Given promising Phase I findings coupled with a vital public health need for effective programs for this population, we are currently underway with an effectiveness-implementation hybrid design study that puts an emphasis on community capacity building and includes efforts to foster public-private partnerships for collaboration. Our design represents an effort to provide quality training that can be utilized by community practitioners in their current practices, while recruiting and training providers to implement HFS.  Strategies and challenges around utility, acceptability, and sustainability of HFS provide a useful model for understanding the process of dissemination of knowledge and programming tailored for a population with particular challenges and needs.