Background: A key question in implementation science is how to balance adaptation and fidelity in translating interventions to new settings. There is growing consensus regarding the importance of planned adaptations to deliver interventions in contextually sensitive ways. However, less research has examined ad-hoc adaptations, or those that occur spontaneously in the course of intervention delivery.
View Article and Find Full Text PDFTo increase cultural relevance and maximize access for historically underserved populations, there is a need to explore mechanisms underlying treatment outcomes during piloting. We developed a mixed-method approach, Integrated Clinical and Implementation Mapping (ICIM), to explore clinical and implementation mechanisms to inform improvements in content and delivery. We applied ICIM in a pilot of Tuko Pamoja, a lay counselor-delivered family intervention in Kenya (10 families with adolescents ages 12-17).
View Article and Find Full Text PDFThis article highlights the profound and far-reaching impact of the Coronavirus disease 2019 (COVID-19) health crisis on persons with serious mental health conditions. To understand and mitigate against the negative effects of the crisis on this population, we offer a resilience intervention framework that attends to three key resilience processes, namely control, coherence, and connectedness (3Cs). We then detail interventions and associated evidence-informed intervention strategies at the individual, interpersonal, and systemic levels that behavioral health professionals can employ to bolster each of the 3Cs for persons with serious mental health conditions.
View Article and Find Full Text PDFThe behavioral health toll of the COVID-19 pandemic and systemic racism has directed increased attention to the potential of digital health as a way of improving access to and quality of behavioral health care. However, as the pandemic continues to widen health disparities in racially and ethnically minoritized groups, concerns arise around an increased reliance on digital health technologies exacerbating the digital divide and reinforcing rather than mitigating systemic health inequities in communities of color. As funding for digital mental health continues to surge, we offer five key recommendations on how the field can "REACT" to ensure the development of approaches that increase health equity by increasing real-world evidence, educating consumers and providers, utilizing adaptive interventions to optimize care, creating for diverse populations, and building trust.
View Article and Find Full Text PDFThis article proposes a framework for managing the behavioral health impacts of the COVID-19 global pandemic. This framework aligns and should be integrated with an existing public health pandemic intervals model. It includes six phases of a behavioral health pandemic response strategy: preplanning, response readiness, response mobilization, intervention, continuation, and amelioration.
View Article and Find Full Text PDFBackground: A key focus of health systems strengthening in low- and middle-income countries is increasing reach and access through task-shifting. As such models become more common, it is critical to understand the experiences of lay providers because they are on the forefront for delivering care services. A greater understanding would improve lay provider support and help them provide high-quality care.
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