Pebbles, Rocks, and Boulders: The Implementation of a School-Based Social Engagement Intervention for Children with Autism
Friday 2:30 – 3:45 Breakout C1
Presentor: Jill Locke
Jill Locke, Ph.D., University of Pennsylvania; Courtney Benjamin Wolk, Ph.D., University of Pennsylvania; Colleen Harker, MA, University of Washington; Anne Olsen, BS, New York University; Travis Shingledecker, University of Pennsylvania; Frances Barg, Ph.D., University of Pennsylvania ; David Mandell, ScD, University of Pennsylvania, Rinad Beidas, Ph.D., University of Pennsylvania
Few evidence-based practices for children with autism have been successfully adopted, implemented, and sustained in public school settings. This study used qualitative methods to examine staff perspectives on the implementation of a social engagement intervention for children with autism in public schools. Semi-structured interviews were conducted with administrators (n = 15), teachers (n = 10), and school personnel (n = 14) who participated in a randomized controlled trial of a school-based social engagement intervention for children with autism. Participants answered questions about: 1) school factors related to general intervention implementation; 2) experiences implementing or overseeing the social engagement intervention; and 3) barriers to and facilitators of intervention implementation and sustainment. Themes were identified and coded using a grounded theory approach. Six nodes (implementation process, staff, leadership, support, barriers, facilitators) were identified. Schools used a top-down approach where multiple staff (pebbles, rocks, and boulders as a principal described them) played a role in implementation. A number of barriers (i.e., lack of time, resources, staff, and training) and facilitators (i.e., support, space, communication, and feedback) emerged. These data suggest that there are important factors that should be considered prior to adopting and implementing interventions for children with autism in public school settings.
PST.Net: A Stakeholder Analysis Examining the Feasibility and Acceptability of Teletherapy in Community Based Aging Services
Friday 2:30 – 3:45 Breakout C1
Presentor: Marissa C. Hansen, Ph.D.
Marissa Hansen, Ph.D., MSW, California State University, Long Beach, School of Social Work; Maria P. Aranda, Ph.D., MPH, LCSW, University of Southern California, School of Social Work; Isabel Torres-Vigil, DrPH, University of Houston, Graduate College of Social Work
Introduction: Effective psychosocial depression treatments exist for older adults, yet individual, provider, and organizational barriers impact service use. Video-based teletherapy services is a cost-savings approach to ease access to services. In this study, contextual factors framed by theories of diffusion of innovation were examined to understand the feasibility and acceptability of using Problem Solving Teletherapy (PST) in urban community based older adult services. Methods: Conducted semi-structured interviews and focus groups with a purposive sample of stakeholders from a social service agency serving older adults that included management staff(n=4), clinicians(n=5), and older adult clients(n=14). Results: Using methods informed from grounded theory, analysis revealed PST was not viable but better suited as an adapted supportive counseling and case management model. This approach would increase ability for case-management follow-up, address client need for socialization, and maximize provider-client interactions. Organizational process related to technology training would enhance staff-client interactions and outcomes in this model. Resources are needed to ensure access to suitable infrastructure and technology for agency and clients. Implications: Findings present practice implications for teletherapy as it relates to providing services to homebound urban dwelling older adults, as well as increasing capacity for social service providers in managing ongoing client mental health needs.
Collaborative Intervention Design: A Process That May Help Keep the Bonfire Stoked
Friday 2:30 – 3:45 Breakout C1
Presentor: Bryan Hartzler
Bryan Hartzler, Alcohol & Drug Abuse Institute, University of Washington
To promote sustainable use of contingency management (CM) in community settings, one may pool a purveyor’s conceptual expertise and contextual insights from treatment personnel to collaboratively design interventions. In the context of a hybrid effectiveness-implementation trial at an opiate treatment program (for which a range of successful implementation and clinical effectiveness outcomes were reported at a prior SIRC), an elicitation interview was conducted at trial conclusion to cull qualitative impressions of a collaboratively-designed CM intervention among its managerial staff. Based on attributes in Rogers’ (2003) Diffusion of Innovations framework, a phenomenological narrative analysis examined managerial staff opinions of the intervention’s relative advantages, compatibility, complexity, trialability, and observability. Based on 90 days of implementation experience at their opiate treatment program, managerial staff regarded the CM intervention to be: 1) cost-effective and clinically-useful, 2) compatible with existing service structure and resources, 3) procedurally uncomplicated to implement, 4) trialable among the program’s direct-care staff, and 5) offering palpable benefits for staff-patient interactions. Taken together with the opiate treatment program’s sustained and independent implementation of this CM intervention thereafter, this work offers a qualitative account of collaborative intervention design as a useful process to foster effective dissemination of empirically-supported therapeutic practices.