Adherence Special Interest Group report

A subcommittee of the Adherence Special Interest Group conducted a workshop detailing strategies for facilitating the dissemination of adherence-promotion and behavioral interventions.

By Elizabeth Kuhl, PhD

This year at SPPAC, the Dissemination Subcommittee of the Adherence Special Interest Group conducted a workshop detailing strategies for facilitating the dissemination of adherence-promotion and behavioral interventions. The workshop structure was guided by the RE-AIM framework, a method of considering internal and external validity at the onset of treatment development to minimize the research to practice gap. The RE-AIM framework includes five domains focused on assessment at the individual (Reach, Efficacy/Effectiveness) and organizational (Adoption, Implementation and Maintenance) level. While RE-AIM is a well-established model (over 300 publications and 53 active NIH grants), the benefits of this model within pediatric psychology have likely not been realized, as only a few manuscripts published in the Journal of Pediatric Psychology and Clinical Practice of Pediatric Psychology have referenced this framework.

Workshop attendees learned about RE-AIM through two panel discussions and an introductory presentation on conducting cost-effectiveness analyses by experts in dissemination research, pediatric psychologists with exemplary multidisciplinary programs, and members of community organizations. Key take-away messages from the workshop suggest that the following RE-AIM components can be targeted by:

Reach

  • Integrating adherence and behavioral interventions into routine medical care or delivery through alternative methodologies (telehealth) and settings (e.g., home-based or the YMCA).
  • Implementing newer approaches to reimbursement like community health workers and social impact bonds.

Efficacy/Effectiveness

  • Collecting economic outcome data alongside clinical trials.
  • Partnering with economists to evaluate the potential economic benefits of adherence-promotion and behavioral interventions.

Adoption

  • Searching for organizations and individuals with a shared vision for program impact who can leverage change within the organization.
  • Developing an awareness of the organization’s infrastructure and aspects of care delivery in that setting are non-modifiable up front.
  • Involving health care professionals and staff from partnering organizations in all stages and levels of treatment development.
  • Developing and implementing a communication feedback loop for all members of the partnership.

Implementation

  • Developing intervention content that can be delivered by someone other than a licensed clinical psychologist.
  • Creating intervention materials that meet the needs of the organization and are flexible enough to apply to a variety of patients.

Maintenance

  • Designing interventions with the end in mind that ideally require few resources and limited time to sustain.

We would like to thank all of our panelists and presenters for an informative workshop and hope this presentation will encourage future efforts to integrate the RE-AIM framework into dissemination research and practice within the field of pediatric psychology.