Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Implementation Science
Published in: Implementation Science 1/2017

Open Access 01-12-2017 | Study protocol

Improving and sustaining delivery of CPT for PTSD in mental health systems: a cluster randomized trial

Authors: Shannon Wiltsey Stirman, Erin P. Finley, Norman Shields, Joan Cook, Rachel Haine-Schlagel, James F. Burgess Jr, Linda Dimeff, Kelly Koerner, Michael Suvak, Cassidy A. Gutner, David Gagnon, Tasoula Masina, Matthew Beristianos, Kera Mallard, Vanessa Ramirez, Candice Monson

Published in: Implementation Science | Issue 1/2017

Login to get access

Abstract

Background

Large-scale implementation of evidence-based psychotherapies (EBPs) such as cognitive processing therapy (CPT) for posttraumatic stress disorder can have a tremendous impact on mental and physical health, healthcare utilization, and quality of life. While many mental health systems (MHS) have invested heavily in programs to implement EBPs, few eligible patients receive EBPs in routine care settings, and clinicians do not appear to deliver the full treatment protocol to many of their patients. Emerging evidence suggests that when CPT and other EBPs are delivered at low levels of fidelity, clinical outcomes are negatively impacted. Thus, identifying strategies to improve and sustain the delivery of CPT and other EBPs is critical. Existing literature has suggested two competing strategies to promote sustainability. One emphasizes fidelity to the treatment protocol through ongoing consultation and fidelity monitoring. The other focuses on improving the fit and effectiveness of these treatments through appropriate adaptations to the treatment or the clinical setting through a process of data-driven, continuous quality improvement. Neither has been evaluated in terms of impact on sustained implementation.

Methods

To compare these approaches on the key sustainability outcomes and provide initial guidance on sustainability strategies, we propose a cluster randomized trial with mental health clinics (n = 32) in three diverse MHSs that have implemented CPT. Cohorts of clinicians and clinical managers will participate in 1 year of a fidelity oriented learning collaborative or 1 year of a continuous quality improvement-oriented learning collaborative. Patient-level PTSD symptom change, CPT fidelity and adaptation, penetration, and clinics’ capacity to deliver EBP will be examined. Survey and interview data will also be collected to investigate multilevel influences on the success of the two learning collaborative strategies. This research will be conducted by a team of investigators with expertise in CPT implementation, mixed method research strategies, quality improvement, and implementation science, with input from stakeholders in each participating MHS.

Discussion

It will have broad implications for supporting ongoing delivery of EBPs in mental health and healthcare systems and settings. The resulting products have the potential to significantly improve efforts to ensure ongoing high quality implementation and consumer access to EBPs.

Trial registration

NCT02449421. Registered 02/09/2015
Literature
1.
McHugh RK, Barlow DH. The dissemination and implementation of evidence-based psychological treatments: a review of current efforts. Am Psychol. 2010;65:73–84.CrossRefPubMed
2.
Karlin BE, Cross G. From the laboratory to the therapy room: national dissemination and implementation of evidence-based psychotherapies in the US Department of Veterans Affairs Health Care System. Am Psychol. 2014;69(1):19–33.CrossRefPubMed
3.
Karlin BE, Brown GK, Trockel M, Cunning D, Zeiss AM, Taylor CB. National dissemination of cognitive behavioral therapy for depression in the Department of Veterans Affairs Health Care System: therapist and patient level outcomes. J Consult Clin Psychol. 2012;80(5):707.CrossRefPubMed
4.
Chard KM, Ricksecker EG, Healy ET, Karlin BE, Resick PA. Dissemination and experience with cognitive processing therapy. J Rehabil Res Dev. 2012;49(5):667–78.CrossRefPubMed
5.
Eftekhari A, Ruzek JI, Crowley JJ, Rosen CS, Greenbaum MA, Karlin BE. Effectiveness of national implementation of prolonged exposure therapy in Veterans Affairs care. JAMA Psychiatry. 2013;70(9):949–55.CrossRefPubMed
6.
Shiner B, D’Avolio LW, Nguyen TM, Zayed MH, Young-Xu Y, Desai RA, Schnurr PP, Fiore LD, Watts BV. Measuring use of evidence based psychotherapy for posttraumatic stress disorder. Adm Policy Ment Health Ment Health Serv Res. 2013;40(4):311–8.CrossRef
7.
Lu MW, Plagge JM, Marsiglio MC, Dobscha SK. Clinician documentation on receipt of trauma-focused evidence-based psychotherapies in a VA PTSD clinic. J Behav Health Serv Res. 2016;43(1):71–87.CrossRefPubMed
8.
Osei-Bonsu PE, Bolton RE, Stirman SW, Eisen SV, Herz L, Pellowe ME. Mental health providers’ decision-making around the implementation of evidence-based treatment for PTSD. J Behav Health Serv Res. 2016;7:1–1.CrossRef
9.
Cook JM, Dinnen S, Simiola V, Thompson R, Schnurr PP. VA residential provider perceptions of dissuading factors to the use of two evidence-based PTSD treatments. Prof Psychol: Res Pract. 2014;45(2):136–42.CrossRef
10.
Cook JM, Dinnen S, Simiola V, Thompson R, Schnurr PP. VA residential provider perceptions of dissuading factors to use of two evidence-based PTSD treatments. Clin Psychol. In press.
11.
Osei-Bonsu PE, Bokhour BG, Glickman ME, Rodrigues S, Mueller NM, Dell NS, Zhao S, Eisen SV, Elwy AR. The role of coping in depression treatment utilization for VA primary care patients. Patient Educ Couns. 2014;94(3):396–402.CrossRefPubMed
12.
Dusenbury L, Brannigan R, Falco M, Lake A. A review of research on fidelity of implementation: implications for drug abuse prevention in school settings. Health Educ Res. 2003;18(2):237–56.CrossRefPubMed
13.
Wilk JE, West JC, Duffy FF, Herrell RK, Rae DS, Hoge CW. Use of evidence-based treatment for posttraumatic stress disorder in Army behavioral healthcare. Psychiatry. 2013;76(4):336–48.CrossRefPubMed
14.
Waller G, Stringer H, Meyer C. What cognitive behavioral techniques do therapists report using when delivering cognitive behavioral therapy for the eating disorders? J Consult Clin Psychol. 2012;80(1):171.CrossRefPubMed
15.
Stirman SW, Calloway A, Toder K, Miller CJ, DeVito AK, Meisel SN, Xhezo R, Evans AC, Beck AT, Crits-Christoph P. Community mental health provider modifications to cognitive therapy: implications for sustainability. Psychiatr Serv. 2013;64(10):1056–9.CrossRef
16.
Aarons GA, Miller EA, Green AE, Perrott JA, Bradway R. Adaptation happens: a qualitative case study of implementation of the incredible years evidence-based parent training program in a residential substance abuse treatment program. J Children’s Serv. 2012;7(4):233–45.CrossRef
17.
Castro FG, Barrera Jr M, Martinez Jr CR. The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci. 2004;5(1):41–5.CrossRefPubMed
18.
Griner D, Smith TB. Culturally adapted mental health intervention: a meta-analytic review. Psychother Theory Res Pract Train. 2006;43(4):531–48.CrossRef
19.
Bass JK, Annan J, McIvor Murray S, Kaysen D, Griffiths S, Cetinoglu T, Wachter K, Murray LK, Bolton PA. Controlled trial of psychotherapy for Congolese survivors of sexual violence. N Engl J Med. 2013;368(23):2182–91.CrossRefPubMed
20.
Schulz PM, Resick PA, Huber LC, Griffin MG. The effectiveness of cognitive processing therapy for PTSD with refugees in a community setting. Cogn Behav Pract. 2006;13(4):322.CrossRef
21.
Galovski TE, Blain LM, Mott JM, Elwood L, Houle T. Manualized therapy for PTSD: flexing the structure of cognitive processing therapy. J Consult Clin Psychol. 2012;80(6):968–81.CrossRefPubMedPubMedCentral
22.
Weisz JR, Chorpita BF, Palinkas LA, Schoenwald SK, Miranda J, Bearman SK, Daleiden EL, Ugueto AM, Ho A, Martin J, et al. Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: a randomized effectiveness trial. Arch Gen Psychiatry. 2012;69(3):274–82.CrossRefPubMed
23.
Von Ranson KM, Wallace LM, Stevenson A. Psychotherapies provided for eating disorders by community clinicians: infrequent use of evidence-based treatment. Psychother Res. 2013;23(3):333–43.CrossRef
24.
Schulte D, Künzel R, Pepping G, Schulte-Bahrenberg T. Tailor-made versus standardized therapy of phobic patients. Advanc Behav Res Ther. 1992;14(2):67.CrossRef
25.
Kennedy MG, Mizuno Y, Hoffman R, Baume C, Strand J. The effect of tailoring a model HIV prevention program for local adolescent target audiences. AIDS Educ Prev. 2000;12(3):225–38.PubMed
26.
Cook JM, Dinnen S, Thompson R, Simiola V, Schnurr PP. Changes in implementation of two evidence-based psychotherapies for PTSD in VA residential treatment programs: a national investigation. J Trauma Stress. 2014:n/a-n/a.
27.
Glisson C, Schoenwald SK, Kelleher K, Landsverk J, Hoagwood KE, Mayberg S, Green P. Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Adm Policy Ment Health Ment Health Serv Res. 2008;35(1–2):124.CrossRef
28.
Ehlers A, Grey N, Wild J, Stott R, Liness S, Deale A, Handley R, Albert I, Cullen D, Hackmann A. Implementation of cognitive therapy for PTSD in routine clinical care: effectiveness and moderators of outcome in a consecutive sample. Behav Res Ther. 2013;51(11):742–52.CrossRefPubMedPubMedCentral
29.
Schoenwald SK, Garland AF, Chapman JE, Frazier SL, Sheidow AJ, Southam-Gerow MA. Toward the effective and efficient measurement of implementation fidelity. Adm Policy Ment Health. 2011;38(1):32–43.CrossRefPubMedPubMedCentral
30.
Surís A, Link‐Malcolm J, Chard K, Ahn C, North C. A randomized clinical trial of cognitive processing therapy for Veterans with PTSD related to military sexual trauma. J Trauma Stress. 2013;26(1):28–37.CrossRefPubMed
31.
Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89:1322–7.CrossRefPubMedPubMedCentral
32.
Tanielian T, Jaycox L. Invisible wounds of war : psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica: RAND Corporation; 2008.
33.
34.
Aarons G, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health Ment Health Serv Res. 2011;38(1):4–23.CrossRef
35.
Brown PM, Cameron LD, Ramondt S. Sustainability of behavioral interventions: beyond cost-effectiveness analysis. Int J Behav Med. 2015;22(3):425–33.CrossRefPubMed
36.
Kessler RC. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry. 2000;61 suppl 5:4–12.PubMed
37.
Lunney CA, Schnurr PP. Domains of quality of life and symptoms in male Veterans treated for posttraumatic stress disorder. J Trauma Stress. 2007;20(6):955–64.CrossRefPubMed
38.
Ahrens J, Rexford L. Cognitive processing therapy for incarcerated adolescents with PTSD. J Aggress Maltreat Trauma. 2002;6(1):201–16.CrossRef
39.
Chard KM. An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. J Consult Clin Psychol. 2005;73(5):965.CrossRefPubMed
40.
Resick PA, Nishith P, Weaver TL, Astin MC, Feuer CA. A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J Consult Clin Psychol. 2002;70(4):867.CrossRefPubMedPubMedCentral
41.
Kaysen D, Lindgren K, Zangana GAS, Murray L, Bass J, Bolton P. Adaptation of cognitive processing therapy for treatment of torture victims: experience in Kurdistan, Iraq. Psychological Trauma: Theory, Research, Practice, and Policy. 2011;5(2):184.
42.
Kaysen D, Schumm J, Pedersen ER, Seim RW, Bedard-Gilligan M, Chard K. Cognitive processing therapy for veterans with comorbid PTSD and alcohol use disorders. Addict Behav. 2014;39(2):420–7.CrossRefPubMed
43.
Beidas R, Kendall PC. Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clin Psychol Sci Pract. 2010;17(1):1.CrossRef
44.
Herschell AD, Kolko DJ, Baumann BL, Davis AC. The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations. Clin Psychol Rev. 2010;30(4):448–66.CrossRefPubMedPubMedCentral
45.
Rakovshik SG, McManus F. Establishing evidence-based training in cognitive behavioral therapy: a review of current empirical findings and theoretical guidance. Clin Psychol Rev. 2010;30(5):496–516.CrossRefPubMed
46.
Stirman SW, Kimberly JR, Calloway A, Cook N, Castro F, Charns MP. The sustainability of new programs and interventions: a review of the empirical literature and recommendations for future research. Implement Sci. 2012;7:17.CrossRef
47.
Bein E, Anderson T, Strupp HH, Henry WP, Schacht TE, Binder J, Butler S. The effects of training in time-limited dynamic psychotherapy: changes in therapeutic outcome. Psychother Res. 2000;10(2):119–32.CrossRefPubMed
48.
Fauth J, Mathisen A, Smith S. Reflections on a time-limited dynamic psychotherapy training project: new directions for brief psychotherapy training. In: North American Society of Psychotherapy Research 2006 Annual Conference 2006; Columbus, OH. 2006.
49.
Webb CA, Derubeis RJ, Barber JP. Therapist adherence/competence and treatment outcome: a meta-analytic review. J Consult Clin Psychol. 2010;78(2):200–11.CrossRefPubMedPubMedCentral
50.
Farmer CC, Mitchell KS, Parker-Guilbert K, Galovski TE. Fidelity to the cognitive processing therapy protocol: evaluation of critical elements. Behav Ther. 2016.
51.
Schoenwald SK, Sheidow AJ, Chapman JE. Clinical supervision in treatment transport: effects on adherence and outcomes. J Consult Clin Psychol. 2009;77(3):410–21.CrossRefPubMedPubMedCentral
52.
Watts BV, Shiner B, Zubkoff L, Carpenter-Song E, Ronconi JM, Coldwell CM. Implementation of evidence-based psychotherapies for posttraumatic stress disorder in VA specialty clinics. Psychiatr Serv. 2014;65(5):648–53.CrossRefPubMed
53.
Aarons GA, Sommerfeld DH, Hecht DB, Silovsky JF, Chaffin MJ. The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect. J Consult Clin Psychol. 2009;77(2):270.CrossRefPubMedPubMedCentral
54.
Harned MS, Dimeff LA, Woodcock EA, Contreras I. Predicting adoption of exposure therapy in a randomized controlled dissemination trial. J Anxiety Disord. 2013;27(8):754–62.CrossRefPubMed
55.
Bond GR, Drake RE, McHugo GJ, Peterson AE, Jones AM, Williams J. Long-term sustainability of evidence-based practices in community mental health agencies. Adm Policy Ment Health Ment Health Serv Res. 2014;41(2):228–36.CrossRef
56.
Creed TA, Stirman SW, Evans AC, Beck AT. A model for implementation of cognitive therapy in community mental health: The Beck Initiative. Behav Therapist. 2014;37(3):56-64.
57.
Finley EP, Garcia HA, Ketchum NS, McGeary DD, McGeary CA, Stirman SW, Peterson AL. Utilization of evidence-based psychotherapies in Veterans Affairs posttraumatic stress disorder outpatient clinics. Psychological services. 2015;12(1):73.CrossRefPubMed
58.
Stirman SW, Gutierrez-Colina A, Toder K, Castro F, Esposito G, Barg F, Beck AT, Crits-Christoph P. Clinicians’ perspectives on cognitive therapy in community mental health settings: implications for training and implementation. Adm Policy Ment Health Ment Health Serv Res. 2013;40(4):274–85.CrossRef
59.
Stirman SW, Shields N, Deloriea J, Landy MSH, Belus JM, Maslej MM, Monson CM. A randomized controlled dismantling trial of post-workshop consultation strategies to increase effectiveness and fidelity to an evidence-based psychotherapy for posttraumatic stress disorder. Implement Sci. 2013;8(82):1–8.
60.
Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainability amid ongoing change. Implement Sci. 2013;8(1):117.CrossRefPubMedPubMedCentral
61.
Haine-Schlagel R, Brookman-Frazee L, Janis B, Gordon J. Evaluating a learning collaborative to implement evidence-informed engagement strategies in community-based services for young children. Child Youth Care Forum. 2013;42(5):457–73.CrossRef
62.
Chovil N. One small step at a time: implementing continuous quality improvement in child and youth mental health services. Child & Youth Services. 2010;31(1–2):21–34.CrossRef
63.
Aarons GA, Green A, Palinkas LA, Self-Brown S, Whitaker DJ, Lutzker JR, Silovsky JF, Hecht DB, Chaffin MJ. Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implementation Sci. 2012;7(1):32.CrossRef
64.
LeBrasseur R, Whissell R, Ojha A. Organisational learning, transformational leadership and implementation of continuous quality improvement in Canadian hospitals. Aust J Manag. 2002;27(2):141–62.CrossRef
65.
Nadeem E, Olin SS, Hill LC, Hoagwood KE, Horwitz SM. A literature review of learning collaboratives in mental health care: used but untested. Psychiatr Serv. 2014;65(9):1088–99.CrossRefPubMedPubMedCentral
66.
Raghavan R: The role of economic evaluation in dissemination and implementation research. In: Brownson RC, Colditz G, Proctor E, editors. Dissemination and implementation research in health: translating science into practice. edn. Oxford University Press; 2012: 94–113.
67.
Raghavan R, Bright C, Shadoin A. Toward a policy ecology of implementation of evidence-based practices in public mental health settings. Implement Sci. 2008;3(1):26.CrossRefPubMedPubMedCentral
68.
Curran G, Bauer MS, Mittman BS, Pyne JM, Stetler CB. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012.
69.
Proctor E, Silmere H, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health Ment Health Serv Res. 2011;38(2):65-76.
70.
Spillane J, Pareja A, Dorner L, Barnes C, May H, Huff J, Camburn E. Mixing methods in randomized controlled trials (RCTs): validation, contextualization, triangulation, and control. Educ Assess, Eval Account. 2010;22(1):5–28.CrossRef
71.
72.
Brown CH, Ten Have TR, Jo B, Dagne G, Wyman PA, Muthén B, Gibbons RD. Adaptive designs for randomized trials in public health. Annu Rev Public Health. 2009;30:1.CrossRefPubMedPubMedCentral
73.
Kanter JW, Tsai M, Holman G, Koerner K. Preliminary data from a randomized pilot study of web-based functional analytic psychotherapy therapist training. Psychotherapy. 2013;50(2):248.CrossRefPubMed
74.
Puspitasari A, Kanter JW, Murphy J, Crowe A, Koerner K. Developing an online, modular, active learning training program for behavioral activation. Psychotherapy. 2013;50(2):256.CrossRefPubMed
75.
Nadeem E, Olin SS, Hill LC, Hoagwood KE, Horwitz SM. Understanding the components of quality improvement collaboratives: a systematic literature review. Milbank Q. 2013;91(2):354–94.CrossRefPubMedPubMedCentral
76.
Stirman SW, Shields N, Deloriea J, Landy MS, Belus JM, Maslej MM, Lane J, Monson CM. A randomized comparison of three post-workshop consultation strategies. In: Association for Behavioral and Cognitive Therapies: 2014; Philadelphia, PA. 2014.
77.
Institute for Healthcare Improvement. The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003.
78.
Gustafson DH, Quanbeck AR, Robinson JM, Ford JH, Pulvermacher A, French MT, McConnell KJ, Batalden PB, Hoffman KA, McCarty D. Which elements of improvement collaboratives are most effective? A cluster‐randomized trial. Addiction. 2013;108(6):1145–57.CrossRefPubMedPubMedCentral
79.
Stirman SW, Calloway A, Rasmusson AM, McDonald A, Monson CM, Resick PA. The relationship between treatment fidelity and clinical outcomes in the implementation of CPT in VA settings. In: Association for Behavioral and Cognitive Therapies: 2011; Toronto, Canada. 2011.
80.
Garvin DA, Edmondson AE, Gino F. Is yours a learning organization? Harvard Business Review. 2008;86(3):109.
81.
82.
Lambert MJ, Finch AE. The outcome questionnaire. 1999.
83.
Lambert MJ. Administration and scoring manual for the OQ-45.2 (Outcome Questionnaire). OQ Measures, LLC; 2004.
84.
85.
Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD. Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann. 1979;2(3):197–207.CrossRefPubMed
86.
Mauskopf JA, Sullivan SD, Annemans L, Caro J, Mullins CD, Nuijten M, Orlewska E, Watkins J, Trueman P. Principles of good practice for budget impact analysis: report of the ISPOR task force on good research practices—budget impact analysis. Value Health. 2007;10(5):336–47.CrossRefPubMed
87.
Vallis TM, Shaw BF, Dobson K. The cognitive therapy scale: psychometric properties. J Consult Clin Psychol. 1986;54:381–5.CrossRefPubMed
88.
Stirman SW, Miller CJ, Toder K, Calloway A. Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implementation Sci. 2013;8(65).
89.
Ehrhart MG, Aarons GA, Farahnak LR. Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS). Implementation Science. 2014;9(1):157.CrossRefPubMedPubMedCentral
90.
Beidas R, Marcus S, Aarons GA, Hoagwood KE, Schoenwald SK, Evans AC, Hurford MO, Hadley T, Barg FK, Walsh LM, et al. Predictors of community therapists’ use of therapy techniques in a large public mental health system. JAMA Pediatr. 2015;169(4):374–82.CrossRefPubMedPubMedCentral
91.
Glisson C, Landsverk J, Schoenwald S, Kelleher K, Hoagwood K, Mayberg S, Green P. Assessing the organizational social context (OSC) of mental health services: implications for research and practice. Adm Policy Ment Health Ment Health Serv Res. 2008;35(1):98–113.CrossRef
92.
Aarons G, Ehrhart M, Farahnak L. The implementation leadership scale (ILS): development of a brief measure of unit level implementation leadership. Implement Sci. 2014;9(1):45.CrossRefPubMedPubMedCentral
93.
Cook JM, Thompson R, Schnurr PP. Perceived Characteristics of Intervention Scale: Development and Psychometric Properties. Assessment. 2015;22(6):704–14.CrossRefPubMed
94.
Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4(1):50.CrossRefPubMedPubMedCentral
95.
Blackwelder W. Current issues in clinical equivalence trials. J Dent Res. 2004;83 suppl 1:C113–5.CrossRefPubMed
96.
Schafer JL, Graham JW. Missing data: our view of the state of the art. Psychol Methods. 2002;7(2):147–77.CrossRefPubMed
97.
Foa EB, Yusko DA, McLean CP, et al. Concurrent naltrexone and prolonged exposure therapy for patients with comorbid alcohol dependence and PTSD: a randomized clinical trial. J Am Med Assoc. 2013;310(5):488–95.CrossRef
98.
Zalta AK, Gillihan SJ, Fisher AJ, Mintz J, McLean CP, Yehuda R, Foa EB. Change in negative cognitions associated with PTSD predicts symptom reduction in prolonged exposure. J Consult Clin Psychol. 2014;82(1):171.CrossRefPubMed
99.
Granger CW. Investigating causal relations by econometric models and cross-spectral methods. Econometrica: J Econometric Soc. 1969;37(3):424-38.
100.
Baldwin SA, Imel ZE, Braithwaite SR, Atkins DC. Analyzing multiple outcomes in clinical research using multivariate multilevel models. J Consult Clin Psychol. 2014;82(5):920.CrossRefPubMedPubMedCentral
101.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Erlbaum; 1988.
102.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed
103.
Raudenbush SW. Statistical analysis and optimal design for cluster randomized trials. Psychol Methods. 1997;2(2):173.CrossRef
104.
Snijders TA. Power and sample size in multilevel linear models. Encyclopedia of Statistics in Behavioral Science. 2005;3:1570–73.
105.
Nadeem E, Gleacher A, Pimentel S, Hill LC, McHugh M, Hoagwood KE. The role of consultation calls for clinic supervisors in supporting large-scale dissemination of evidence-based treatments for children. Administration and Policy in Mental Health and Mental Health Services Research. 2013;40(6):530-40.
106.
Dennhag I, Gibbons MBC, Barber JP, Gallop R, Crits-Christoph P. How many treatment sessions and patients are needed to create a stable score of adherence and competence in the treatment of cocaine dependence? Psychother Res. 2012;22(4):475–88.CrossRefPubMedPubMedCentral
107.
Garattini L, van de Vooren K. Budget impact analysis in economic evaluation: a proposal for a clearer definition. Eur J Health Econ. 2011;12(6):499–502.CrossRefPubMed
108.
Palinkas L, Aarons G, Horwitz S, Chamberlain P, Hurlburt M, Landsverk J. Mixed method designs in implementation Research. Adm Policy Ment Health Ment Health Serv Res. 2010;38(1):44–53.CrossRef
Metadata
Title
Improving and sustaining delivery of CPT for PTSD in mental health systems: a cluster randomized trial
Authors
Shannon Wiltsey Stirman
Erin P. Finley
Norman Shields
Joan Cook
Rachel Haine-Schlagel
James F. Burgess Jr
Linda Dimeff
Kelly Koerner
Michael Suvak
Cassidy A. Gutner
David Gagnon
Tasoula Masina
Matthew Beristianos
Kera Mallard
Vanessa Ramirez
Candice Monson
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2017
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-017-0544-5

Other articles of this Issue 1/2017

Implementation Science 1/2017 Go to the issue

Debate

Building capacity for dissemination and implementation research: one university’s experience

Study protocol

A methodological protocol for selecting and quantifying low-value prescribing practices in routinely collected data: an Australian case study

Research

The Evidence-based Practice Attitude Scale-36 (EBPAS-36): a brief and pragmatic measure of attitudes to evidence-based practice validated in US and Norwegian samples

Research

Studying de-implementation in health: an analysis of funded research grants

Study protocol

Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol

Debate

Beyond “implementation strategies”: classifying the full range of strategies used in implementation science and practice