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Implementation of an evidence-based biobehavioral treatment for cancer patients
Marlena M Ryba1, Brittany M Brothers2, Barbara L Andersen3
1Department of Psychology, The Ohio State University, Columbus, OH, USA. Ryba.16@osu.edu.
Abstract:
One aim of dissemination and implementation (DI) research is to study the translation of evidence-based treatments (EBTs) from the research environments of their development and testing to broader communities where they are needed. There are few behavioral medicine DI studies and none in cancer survivorship. A determinant model (Setting, Therapist, Education, imPlementation, and Sustainability (STEPS)) was used to conceptualize DI of mental health treatment and frame a longitudinal study of implementation of a behavioral medicine EBT-a biobehavioral intervention (BBI) for cancer patients. Using effective dissemination strategies, therapists were trained in the BBI and followed to determine if implementation occurred. Participants (N = 108) were psychologists, social workers, and other oncology mental health providers from diverse settings to whom the BBI had been disseminated. BBI trainers then provided 6 months of support for implementation (e.g., monthly conference calls). Therapists reported number of patients treated, with or without the BBI, at 2, 4, and 6 months; use of support strategies was tracked. Generalized linear mixed models show that the proportion of patients treated with BBI ranged from 58 to 68%, with a 2% increase across follow-ups. Therapist and setting characteristics did not predict usage. Implementation of a behavioral medicine EBT provides a "real-world" demonstration of a BBI moved from the research setting to diverse communities. As the first study in cancer, it is an encouraging example of training and supporting mental health providers to deliver evidence-based psychological treatment and finding their success in doing so.
Insights
Dissemination and implementation research successfully translated a behavioral medicine intervention for cancer patients into community practice. Oncology mental health providers effectively delivered this evidence-based treatment, showing its real-world applicability.
Area of Science:
- Behavioral Medicine
- Cancer Survivorship
- Implementation Science
Background:
- Dissemination and implementation (DI) research is crucial for translating evidence-based treatments (EBTs) into community settings.
- Few DI studies exist in behavioral medicine, and none specifically address cancer survivorship.
- The Setting, Therapist, Education, imPlementation, and Sustainability (STEPS) model guided the conceptualization of DI for mental health treatment.
Purpose of the Study:
- To conduct a longitudinal study on the implementation of a behavioral medicine EBT, specifically a biobehavioral intervention (BBI), for cancer patients.
- To assess the effectiveness of dissemination strategies in training oncology mental health providers in the BBI.
- To determine the extent to which therapists implemented the BBI in their practice.
Main Methods:
- A cohort of 108 oncology mental health providers (psychologists, social workers) received training in the BBI.
- Providers were supported for 6 months with implementation strategies, including monthly calls.
- Therapists reported patient treatment numbers at 2, 4, and 6 months; support strategy use was tracked.
Main Results:
- The proportion of patients treated with the BBI ranged from 58% to 68% across follow-ups, showing a 2% increase.
- Therapist and setting characteristics did not significantly predict BBI usage.
- The study demonstrated successful real-world implementation of a BBI in diverse community settings.
Conclusions:
- This study provides the first demonstration of implementing a behavioral medicine EBT in cancer survivorship care.
- Training and supporting mental health providers can lead to successful delivery of evidence-based psychological treatments.
- The findings encourage the broader adoption of EBTS in community oncology settings.
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