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Dissemination & Implementation Science

Innovation and recipients: An I-PARIHS framework tracking tool in an ongoing randomized suicide prevention clinical trial of Dialectical Behavior Therapy Skills Group in VHA

(PS9-30) Innovation and Recipients: An I-PARIHS Framework Tracking Tool in an Ongoing Randomized Suicide Prevention Clinical Trial of Dialectical Behavior Therapy Skills Group in VHA

Saturday, November 16, 2024

11:30 AM – 12:30 PM EST

Location: Franklin Hall, Level 4, Marriott Downtown

Author(s)

Suzanne Decker, Ph.D. (she/her/hers)

Psychologist / Associate Professor
VA Connecticut Healthcare System / Yale School of Medicine
West Haven, Connecticut, United States

Co-Author(s)

Scarlett Baird, Ph.D.

Psychologist / Assistant Clinical Professor
VA San Diego Healthcare System / University of California San Diego School of Medicine
San Diego, California, United States
JR

Jennifer K. Rielage, Ph.D.

Section Chief, Psychology / Associate Professor
VA New Mexico Healthcare System / University of New Mexico School of Medicine
Albuquerque, New Mexico, United States
JR

Josephine Ridley, Ph.D.

Assistant Chief of Psychology / Adjunct Associate Professor of Psychology
VA Northeast Ohio Healthcare System / Case Western Reserve University
Cleveland, Ohio, United States
JB

Jenny Bannister, Ph.D.

Psychologist
James A. Haley Veterans Hospital / University of South Florida Morsani College of Medicine
Tampa, Florida, United States
TG

Thorayya Giovannelli, Psy.D. (she/her/hers)

Psychologist
James A. Haley Veterans Hospital & University of South Florida Morsani College of Medicine
Tampa, Florida, United States
FA

Frances Aunon, Ph.D. (she/her/hers)

Clinical Research Psychologist
Connecticut VA Healthcare System
West Haven, Connecticut, United States
EG

Elizabeth Galliford, M.P.H.

Health Science Specialist
VA Connecticut Healthcare System
West Haven, Connecticut, United States
AK

Aimee Kroll-Desrosiers, Ph.D.

Research Health Scientist / Assistant Professor
VA Central Western Massachusetts / University of Massachusetts Chan Medical School / University of Massachusetts Amherst
Leeds, Massachusetts, United States
ED

Eric DeRycke, M.P.H.

Health Science Specialist
VA Connecticut Healthcare System
West Haven, Connecticut, United States
CS

Chris L. Shriver, M.A.

Health Science Specialist
VA San Diego Healthcare System
San Diego, California, United States
ES

Ethan Spana, B.S.

Health Science Specialist
VA New Mexico Healthcare System
Albuquerque, New Mexico, United States
MH

Mark Honsberger, M.S.

Health Science Specialist
VA Northeast Ohio Healthcare System
Cleveland, Ohio, United States
ES

Elena Shest, B.A.

Health Science Specialist
James A. Haley Veterans Hospital
Tampa, Florida, United States
SM

Steve Martino, Ph.D.

Chief of Psychology / Professor
VA Connecticut Healthcare System / Yale School of Medicine
West Haven, Connecticut, United States

Abstract Text: Dialectical Behavior Therapy (DBT) is a multi-component psychotherapy that is well-supported for reducing suicidal self-directed violence (DeCou, Comtois, & Landes, 2019). In public mental health settings, DBT barriers have included challenges related to phone coaching (Landes et a., 2017), turnover of trained practitioners (King et al., 2018), limited provider time (Landes et al., 2017), and low administrative support (Carmel et al., 2014). A less resource-intensive adaptation of DBT, the DBT Skills Group (DBT-SG) with therapist consultation team, may be feasible and effective in the complex Veterans Health Administration (VHA). The Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS; Harvey & Kitson, 2015) framework suggests that successful implementation of an innovation requires identifying implementation determinants such as characteristics of the innovation (DBT-SG), the recipients who will provide (therapists) or participate in (clients) the innovation, and the context (inner and outer) and to develop facilitation strategies based on this understanding. We developed an i-PARIHS tracking tool for use in an ongoing multi-site hybrid effectiveness-implementation study examining DBT-SG implementation at four VHA medical centers and are using this process data to augment more formal formative evaluation during the trial. We used a well-established rapid qualitative coding approach (Hamilton, 2013) to identify 1) i-PARIHS-derived implementation determinants arising within discussions during our clinical trial site-specific and multi-site team meetings, and 2) emerging implementation strategies to support the use of DBT-SG in VHA. Codes from an i-PARIHS codebook are applied during or shortly after the meetings, and review of codes by investigators provides an ongoing evaluation of concepts and strategies. We will present emerging data on characteristics of the innovation (e.g., group format, focus on skills) and recipients (e.g., rurality, familiarity with technology) that appear to influence implementation. Findings have implications for strategies to support suicide prevention clinical trials in complex healthcare systems.