Employing survival analysis of administrative claims to identify prospective predictors of evidence-based practice sustainment versus provider turnover.

Objective: This study described therapists' delivery of six child mental health evidence-based practices (EBPs) over 33 months during the sustainment phase of a system-driven implementation aimed at improving access to EBPs in community settings.

Method: Seven hundred seventy-seven therapists and 162 program leaders delivering at least one of six EBPs of interest completed surveys, and these data were matched to therapist administrative claims data. Survival analyses examined (a) therapists' discontinuation of delivery of all Los Angeles County Department of Mental Health direct client services (i.

Trajectories of Change in Parent-Child Interaction Therapy Outcomes in Latinx Families: Implications for Cultural Adaptation.

Objective: Parent-Child Interaction Therapy (PCIT) is a parenting program in which caregivers must achieve "skill criteria" in using and avoiding to complete treatment. Despite PCIT's emphasis on these skills, little is known about how Latinx caregivers acquire these Western-based parenting practices and whether cultural mismatches lead to inequities in outcomes. This study compared the trajectories of change in PCIT skills and treatment outcomes of Latinx and non-Latinx White families.

Outside the Clinic Door: How Neighborhood Sociodemographic Disadvantage is Associated with Community Therapist Secondary Traumatic Stress and Emotional Exhaustion.

Therapists serving families with high rates of trauma exposure in community mental health clinics face the potential risk of experiencing secondary traumatic stress and emotional exhaustion, both of which pose barriers for the implementation and sustainment of evidence-based practices. Previous research documents negative effects of living in socioeconomic disadvantaged neighborhoods on child development but has not examined the effects of working in these neighborhoods on therapist well-being. The current study merges publicly available data, administrative claims data on mental health services, and therapy survey data to 1) identify associations between neighborhood sociodemographic disadvantage and two community therapist well-being constructs, specifically secondary traumatic stress and emotional exhaustion; and 2) examine potential clinic- and therapist-level explanatory factors in the associations between neighborhood sociodemographic disadvantage and therapist well-being.

Outer-context determinants in the sustainment phase of a reimbursement-driven implementation of evidence-based practices in children's mental health services.

Background: Although there is increasing investment to implement evidence-based practices (EBPs) in public systems across the USA, continued or sustained use of EBPs after initial implementation remains a challenge. The low integration of EBPs in routine practice severely limits their public health impact, highlighting the need to understand factors that affect the return on costly investments in EBP implementation. This study aims to (1) characterize trajectories of EBP delivery volume through a reimbursement-driven implementation and (2) examine impacts of system-level policy regulatory activity and state-level mental health services funding on the implementation reimbursement strategy.

Bivalirudin in pediatric patients maintained on extracorporeal life support.

Objective: Anticoagulation with heparin is standard of care for patients maintained on extracorporeal life support. Very limited evidence exists for the use of alternative anticoagulants during extracorporeal life support. Patients with heparin-induced thrombocytopenia, heparin resistance, and evidence of significant thrombosis while on heparin may be candidates for alternative anticoagulation.

Alternate item types: continuing the quest for authentic testing.

Many test developers suggest that multiple-choice items can be used to evaluate critical thinking if the items are focused on measuring higher order thinking ability. The literature supports the use of alternate item types to assess additional competencies, such as higher level cognitive processing and critical thinking, as well as ways to allow examinees to demonstrate their competencies differently. This research study surveyed nurses after taking a test composed of alternate item types paired with multiple-choice items.