Four Ways to Conceptualize and Study Policy in Implementation Science Research

Jonathan Purtle, DrPH, MSc
New York University

ABSTRACT:
This presentation will offer a typology of four ways to conceptualize policy in implementation science research: 1) Policy as something to adopt, 2) Policy as something to implement, 3) Policy as context to understand, and 4) Policy as strategy to use. Examples will be provided of studies that have conceptualized policy in these different ways in the area of behavioral health.

Recent trends in suicide and nonfatal suicidal behavior in the US and implications for public health prevention

Deborah Stone, ScD, MSW, MPH
Centers for Disease Control and Prevention

ABSTRACT:
Suicide is a continuing public health concern with rates having increased 33% between 1999 and 2019, with a slight dip in 2019 and another drop in 2020, according to provisional estimates. Further complicating this vexing issue are the added stressors associated with the ongoing and shifting COVID-19 pandemic, as well as ongoing concerns about data quality and potential misclassification of suicides. This presentation will showcase recent trends in suicide in the United States, including data on emergency department visits for suspected suicide attempts and other related outcomes (e.g., mental health conditions, suicide ideation) during the COVID-19 pandemic as compared to earlier time points. Implications for suicide prevention going forward and a discussion of CDC’s comprehensive approach to suicide prevention, including a focus on populations disproportionately impacted, will round out the session.

To request Dr. Stone’s powerpoint slides, please email psmg@northwestern.edu

Wingman-Connect Program: A Network-Health Suicide and Depression Prevention Program for Air Force Trainees

Peter Wyman, Ph.D.
University of Rochester School of Medicine

Anthony R. Pisani, Ph.D.
University of Rochester School of Medicine

Bryan Yates, BA
University of Rochester School of Medicine

C. Hendricks Brown, Ph.D.
Northwestern University

ABSTRACT:
Suicide has been a leading manner of death for military members in recent years. In this talk, we will describe a Dept of Defense-funded initiative to develop and test a universal prevention program for Airmen in training. The Wingman-Connect Program applies a network health approach to enhance protective group processes in natural organizational units including cohesion and diffusion of healthy norms among members. We report results from a cluster- randomized clinical trial testing impact on airmen through a 6-month follow-up period.

Rapid Cycle Systems Modeling and Decision Sampling to Inform Development and Implementation of System-Wide Innovations to Promote Pediatric Mental and Behavioral Health

Thomas I. Mackie, PhD, MPH
Rutgers School of Public Health

R. Christopher Sheldrick, PhD
Boston University School of Public Health

ABSTRACT:
Calls have been made for greater application of simulation modeling and decision sciences to expedite research evidence use into mental health policy. Funded by W.T. Grant Foundation, Drs. Mackie and Sheldrick will report on a study, entitled Research Evidence Adoption for Child Health (REACH), in which they propose the use of Rapid Cycle Systems Modeling (RCSM), as an implementation strategy that aims to assist local decision-makers in needs assessment and prioritization, knowledge exchange, and consensus building when developing system-wide innovations. RCSM requires that one (1) identify gaps in the information available and questions requiring resolve to inform stakeholders’ decisions, (2) build a simulation model and identify relevant estimates to parameterize the model (e.g., evidence reviews), and (3) conduct group facilitation sessions to asses model utility and need for further adaptation.

To demonstrate utility, we provide an illustrative case study from REACH in which we specifically sought to identify how decision-makers developed protocols to identify and treat the trauma of children entering foster care. In conducting the first step of RCSM, we identified information gaps by employing a “decision sampling” framework in qualitative interviews.  In this approach, we anchored key informants’ responses on a recent index decision to minimize recall and response bias and potential desirability of evidence use. Respondents (n=31) described a continuum of 14 decision points relevant to five domains when developing a system-wide approach to identify and address trauma, including: 1. reach of the screening protocol, 2. content of the screening tool, 3. threshold for referral, 4. resources for screening startup and sustainment, and 5. system capacity to respond to identified needs. In the second stage of RCSM, we built a Monte Carlos simulation model that responded to the gaps in available information identified across this decision continuum and used additional data collected in the interviews, coupled with evidence reviews, to inform the model structure and parameterization. Finally, we facilitated group interviews (n=4) learning that the model developed was assessed by relevant stakeholders to hold utility and face validity. We will present an overview of this work and the model to illustrate potential utility of RCSM and decision sampling in other research domains.

Applying lessons learned from global mental health to the opioid crisis

Jessica Magidson, Phd
Department of Psychology
University of Maryland

ABSTRACT:
The current opioid crisis in the United States has been considered an “epidemic of poor access to care”. Similar to the shortage of trained providers to prescribe medications to treat opioid use disorder (OUD), there is a severe shortage of trained providers to meet the behavioral health needs of patients with OUD. This talk will draw from global mental health models of “task sharing” to discuss how lessons learned from scaling up evidence-based interventions with lay health workers in low and middle-income countries can inform efforts to increase access to behavioral health care for patients with OUD in the US. Research will be presented using peer recovery coach models to integrate substance use treatment into HIV care in South Africa and to promote linkage and retention in OUD care locally.

Mothers and Babies: Scaling an Evidence-Based Intervention Nationally to Improve Perinatal Mental Health

Shiv Darius Tandon, PhD
Institute for Public Health and Medicine
Northwestern University, Feinberg School of Medicine

ABSTRACT:
An estimated 1 in 7 women are affected by postpartum depression. Experiencing postpartum depression makes it more likely that someone will have recurring depression in the future, poor attachment with her baby, relationship problems with her partner, and diminished economic stability. Mothers and Babies (MB) is a manualized intervention that has demonstrated efficacy via multiple RCTs in preventing onset of postpartum depression and reducing depressive symptoms. Recently, MB was highlighted as one of the two most efficacious perinatal depression preventive interventions by the United States Preventive Services Task Force. With increased national attention, our research lab has received a growing number of inquiries from healthcare systems, community-based organizations, and city and state health departments to train their providers to deliver MB. This presentation will describe our model for scaling MB via training and technical assistance. It will also share results from research studies we have conducted examining the implementation and sustainment of MB.