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Process adaptations to community-engaged research for preventing victimization against trans women: Failure as a blueprint toward nonexploitative implementation science.

ABSTRACT: Effective violence prevention interventions are largely inaccessible to trans women and trans femmes, despite clear evidence that disproportionate exposure to experiences of victimization is a social determinant of health disparity. Community-engaged implementation science paradigms hold promise for guiding research psychologists in the delivery of evidence-based programming to address drivers of health disparities impacting trans women and trans femmes. Unfortunately, guidance on how to engage in a process of real-time self-reflection to note where implementation is failing in its goals to establish reciprocal and sustainable (i.e., nonexploitative) community partnerships are lacking. We describe our application of a modified failure modes and effects analysis to guide data-informed adaptations to our community-engaged implementation research project, tailoring and delivering an evidence-based intervention to prevent victimization of trans women and trans femmes. By mapping our failure modes, we offer a blueprint for other research psychologists invested in advancing nonexploitative research in partnership with community. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

SUBMITTER: Smith AM

PROVIDER: S-EPMC10071411 | biostudies-literature | 2023 Feb-Mar

REPOSITORIES: biostudies-literature

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Process adaptations to community-engaged research for preventing victimization against trans women: Failure as a blueprint toward nonexploitative implementation science.

Smith Ash M AM Hotchkiss Maiya M Gilbert Craig C Williams Daniel N DN Madhav Kylie K Bloomfield Kat K Pautz Carolyn R CR Berke Danielle S DS

The American psychologist 20230201 2

Effective violence prevention interventions are largely inaccessible to trans women and trans femmes, despite clear evidence that disproportionate exposure to experiences of victimization is a social determinant of health disparity. Community-engaged implementation science paradigms hold promise for guiding research psychologists in the delivery of evidence-based programming to address drivers of health disparities impacting trans women and trans femmes. Unfortunately, guidance on how to engage ...[more]

PMID: 37011169

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Project description:PurposeThis article reports on recommendations arising from an invitational workshop series held at the National Institutes of Health for the purposes of identifying critical genomics problems important to the health of the public that can be addressed through nursing science. The overall purpose of the Genomic Nursing State of the Science Initiative is to establish a nursing research blueprint based on gaps in the evidence and expert evaluation of the current state of the science and through public comment.Organizing constructsA Genomic Nursing State of the Science Advisory Panel was convened in 2012 to develop the nursing research blueprint. The Advisory Panel, which met via two webinars and two in-person meetings, considered existing evidence from evidence reviews, testimony from key stakeholder groups, presentations from experts in research synthesis, and public comment.FindingsThe genomic nursing science blueprint arising from the Genomic Nursing State of Science Advisory Panel focuses on biologic plausibility studies as well as interventions likely to improve a variety of outcomes (e.g., clinical, economic, environmental). It also includes all care settings and diverse populations. The focus is on (a) the client, defined as person, family, community, or population; (b) the context, targeting informatics support systems, capacity building, education, and environmental influences; and (c) cross-cutting themes. It was agreed that building capacity to measure the impact of nursing actions on costs, quality, and outcomes of patient care is a strategic and scientific priority if findings are to be synthesized and aggregated to inform practice and policy.ConclusionsThe genomic nursing science blueprint provides the framework for furthering genomic nursing science to improve health outcomes. This blueprint is an independent recommendation of the Advisory Panel with input from the public and is not a policy statement of the National Institutes of Health or the federal government.Clinical relevanceThis genomic nursing science blueprint targets research to build the evidence base to inform integration of genomics into nursing practice and regulation (such as nursing licensure requirements, institutional accreditation, and academic nursing school accreditation).

Project description:Introduction: Uptake of evidence-based interventions for adolescents and young adults living with HIV (AYA-LWH) in sub-Saharan Africa (SSA) is complex, and cultural differences necessitate local adaptations to enhance effective implementation. Few models exist to guide intervention tailoring, yet operationalizing strategies is critical to inform science and implementation outcomes, namely acceptability, appropriateness, feasibility, fidelity, and sustainability. This paper describes operationalizing the ADAPT-ITT framework applied to a manualized trauma-informed cognitive behavioral therapy (TI-CBT) intervention addressing mental and sexual health for AYA-LWH in SSA in preparation for a randomized controlled trial (RCT). Methods: Phase 1 of the RCT focused on operationalizing ADAPT-ITT steps 3-7 to tailor the intervention for use in eight sites across Botswana, Malawi, South Africa, and Zimbabwe. Well-defined processes were developed to supplement the general guidelines for each step to provide clear, consistent direction on how to prepare and conduct each step, including documenting, assessing, and determining adaptations, while maintaining intervention fidelity. The processes provided efficient standardized step-by-step progression designed for future replication. All sites participated in Phase 1 using the created tools and strategies to translate and present the TI-CBT to community stakeholders for feedback informing local adaptations. Results: The research team developed and operationalized materials guiding adaptation. A translation review process verified local adaptability, maintained core concepts, and revealed differing interpretations of words, idioms, and culturally acceptable activities. Strategically designed tools comprised of feedback and translation verification forms resulted in meticulous management of adaptations. Robust collaborations between investigators, research managers, site personnel, and topical experts maximized multidisciplinary expertise, resulting in ~10-15 personnel per site facilitating, collecting, assessing, and integrating local feedback. Processes and tools operationalized in steps 3-7 effectively addressed implementation outcomes during community engagements (n = 108), focus groups (n = 5-8 AYA-LWH and caregivers per group), and strategic training of youth leaders. Discussion: This paper offers a novel generalizable approach using well-defined processes to guide intervention adaptation building on the ADAPT-ITT framework. The processes strengthen the science of implementation and provide much-needed specificity in adaptation steps to optimize and sustain real-world impact and help researchers and community stakeholders maximize existing infrastructure, culture, and resources to inform implementation strategies.

Project description:IntroductionImplementation is influenced by factors beyond individual clinical settings. Nevertheless, implementation research often focuses on factors related to individual providers and practices, potentially due to limitations of available frameworks. Extant frameworks do not adequately capture the myriad organizational influences on implementation. Organization theories capture diverse organizational influences but remain underused in implementation science. To advance their use among implementation scientists, we distilled 70 constructs from nine organization theories identified in our previous work into theoretical domains in the Organization Theory for Implementation Science (OTIS) framework.MethodsThe process of distilling organization theory constructs into domains involved concept mapping and iterative consensus-building. First, we recruited organization and implementation scientists to participate in an online concept mapping exercise in which they sorted organization theory constructs into domains representing similar theoretical concepts. Multidimensional scaling and hierarchical cluster analyses were used to produce visual representations (clusters) of the relationships among constructs in concept maps. Second, to interpret concept maps, we engaged members of the Cancer Prevention and Control Research Network (CPCRN) OTIS workgroup in consensus-building discussions.ResultsTwenty-four experts participated in concept mapping. Based on resulting construct groupings' coherence, OTIS workgroup members selected the 10-cluster solution (from options of 7-13 clusters) and then reorganized clusters in consensus-building discussions to increase coherence. This process yielded six final OTIS domains: organizational characteristics (e.g., size; age); governance and operations (e.g., organizational and social subsystems); tasks and processes (e.g., technology cycles; excess capacity); knowledge and learning (e.g., tacit knowledge; sense making); characteristics of a population of organizations (e.g., isomorphism; selection pressure); and interorganizational relationships (e.g., dominance; interdependence).DiscussionOrganizational influences on implementation are poorly understood, in part due to the limitations of extant frameworks. To improve understanding of organizational influences on implementation, we distilled 70 constructs from nine organization theories into six domains. Applications of the OTIS framework will enhance understanding of organizational influences on implementation, promote theory-driven strategies for organizational change, improve understanding of mechanisms underlying relationships between OTIS constructs and implementation, and allow for framework refinement. Next steps include testing the OTIS framework in implementation research and adapting it for use among policymakers and practitioners.

Project description:BackgroundScreening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice that can identify adolescents who use alcohol and other drugs and support proper referral to treatment. Despite an American College of Surgeons mandate to deliver SBIRT in pediatric trauma care, trauma centers throughout the United States have faced numerous patient, provider, and organizational level barriers to SBIRT implementation. The Implementing Alcohol Misuse Screening, Brief Intervention, and Referral to Treatment Study (IAMSBIRT) aimed to implement SBIRT across 10 pediatric trauma centers using the Science-to-Service Laboratory (SSL), an empirically supported implementation strategy. This manuscript aimed to assess trauma center staff preferences and experience with the didactic training, performance feedback, and ongoing coaching elements of the SSL via a retrospective qualitative process evaluation.MethodsNurses, social workers, and site leaders that participated in IAMSBIRT were recruited to complete qualitative exit interviews guided by the Consolidated Framework for Implementation Research. Qualitative interviews were recorded, transcribed, and analyzed by two coders using a directed content analysis approach in NVivo software. Codes were then translated into frequently endorsed themes by the IAMSBIRT study research team.ResultsThirty-six exit interviews were conducted with site leaders, social workers, and nurses across the 10 IAMSBIRT pediatric trauma centers. Findings revealed key strengths as well as areas for improvement across the IAMSBIRT preparation phase and the three elements of the SSL: didactic training, performance feedback, and ongoing coaching. Trauma center staff generally reported that all three elements of the SSL were high quality and helpful for supporting SBIRT implementation. However, staff also noted that performance feedback and ongoing coaching were generally only available to center leadership or to individuals selected by leadership, making it challenging for non-leaders to troubleshoot SBIRT delivery.ConclusionsFindings from the qualitative process evaluation revealed discrepancies in the experience of the SSL strategy between those in leadership roles and those involved in direct care delivery. These results suggest the need for several modifications to the SSL strategy, including increasing engagement of direct care staff in all elements of the SSL throughout the implementation process.Trial registrationClinicaltrials.gov NCT03297060 . Registered 29 September 2017.

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Process adaptations to community-engaged research for preventing victimization against trans women: Failure as a blueprint toward nonexploitative implementation science.

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Process adaptations to community-engaged research for preventing victimization against trans women: Failure as a blueprint toward nonexploitative implementation science.

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