Social Work Commons^™

Improving Measurement-Based Care Implementation In Youth Mental Health Through Organizational Leadership And Climate: A Mechanistic Analysis Within A Randomized Trial, Nathaniel J. Williams, Mark G. Ehrhart, Gregory A. Aarons, Susan Esp, Marisa Sklar, Kristine Carandang, Nallely R. Vega, Lauren Brookman-Frazee, Steven C. Marcus

Social Work Faculty Publications and Presentations

Background Theory and correlational research indicate organizational leadership and climate are important for successful implementation of evidence‑based practices (EBPs) in healthcare settings; however, experimental evidence is lacking. We addressed this gap using data from the WISDOM (Working to Implement and Sustain Digital Outcome Measures) hybrid type III effectiveness‑implementation trial. Primary outcomes from WISDOM indicated the Leadership and Organizational Change for Implementation (LOCI) strategy improved fidelity to measurement‑based care (MBC) in youth mental health services. In this study, we tested LOCI’s hypothesized mechanisms of change, namely: (1) LOCI will improve implementation and transformational leadership, which in turn will (2) mediate LOCI’s …

Eliminating Monitor Overuse (Emo) Type Iii Effectiveness-Deimplementation Cluster-Randomized Trial: Statistical Analysis Plan, Rui Xiao, Christopher P. Bonafide, Nathaniel J. Williams, Zuleyha Cidav, Christopher P. Landrigan, Jennifer Faerber, Spandana Makeneni, Courtney Benjamin Wolk, Amanda C. Schondelmeyer, Patrick W. Brady, Rinad S. Beidas, Enrique F. Schisterman

Social Work Faculty Publications and Presentations

Background: Deimplementing overused health interventions is essential to maximizing quality and value while minimizing harm, waste, and inefficiencies. Three national guidelines discourage continuous pulse oximetry (SpO₂) monitoring in children who are not receiving supplemental oxygen, but the guideline-discordant practice remains prevalent, making it a prime target for deimplementation. This paper details the statistical analysis plan for the Eliminating Monitor Overuse (EMO) SpO₂ trial, which compares the effect of two competing deimplementation strategies (unlearning only vs. unlearning plus substitution) on the sustainment of deimplementation of SpO₂ monitoring in children with bronchiolitis who are in room air.

Methods: …

Paternity And Child Welfare, Nafees Alam

Social Work Faculty Publications and Presentations

This theoretical and conceptual analysis, rooted and organized by frameworks and empirical literature, aims to explain biases against fathers in the United States’ family court system. Positive paternal involvement has been shown to be correlated with positive child outcomes, placing an emphasis not just on quantity, but quality as well. Despite these findings, fathers are societally expected to be less involved than mothers. Fathers are also in positions to be held financially hostage even when alternatives to pregnancy are legally accessible, suggesting that paternal financial contributions are viable substitutes for paternal involvement. The court of law and the court of …

Eight Characteristics Of Rigorous Multilevel Implementation Research: A Step-By-Step Guide, Rebecca Lengnick-Hall, Nathaniel J. Williams, Mark G. Ehrhart, Cathleen E. Willging, Alicia C. Bunger, Rinad S. Beidas, Gregory A. Aarons

Social Work Faculty Publications and Presentations

Background Although healthcare is delivered in inherently multilevel contexts, implementation science has no widely endorsed methodological standards defining the characteristics of rigorous, multilevel implementation research. We identify and describe eight characteristics of high-quality, multilevel implementation research to encourage discussion, spur debate, and guide decision-making around study design and methodological issues.

Recommendations Implementation researchers who conduct rigorous multilevel implementation research demonstrate the following eight characteristics. First, they map and operationalize the specific multilevel context for defined populations and settings. Second, they define and state the level of each construct under study. Third, they describe how constructs relate to each other within …

Post-Sport Male Athlete Nutrition And Mental Health, Nafees Alam

Social Work Faculty Publications and Presentations

This publication aims to bring to light the experiences of current and former adult male athletes and their nutrition and mental health. Although there is literature on female athlete nutrition, there is a general gap in literature on male athlete nutrition. Thus, we've decided to conduct a qualitative case study research design to begin studying this topic. The goal of this study was to collect, analyze, and disseminate data related to this topic in order to further research and hopefully set the table for quantitative studies on this topic in the future. We’ve collected detailed accounts from 5 current and …

Point/Counterpoint: Transgender Sport Participation Policy, Matt Moore, Nafees Alam

Social Work Faculty Publications and Presentations

I am looking forward to a spirited point/counterpoint regarding the NCAA (2022) policy on transgender sport participation. The NCAA Board of Governors voted in support of a sport-by-sport approach to transgender participation that preserves opportunity for transgender student-athletes while balancing fairness, inclusion, and safety for all who compete. The national governing bodies for each sport will determine policies for transgender participation (e.g., USA Swimming). The NCAA policy became effective in January. The policy requires transgender student-athletes to document sport specific testosterone levels beginning four weeks before their sport’s championship selections. In the 2022-2023 competition season, transgender student-athletes will need documented …

From Childhood Obesity Risk To Healthy Growth In The U.S.: A 10-Year Social Work Research & Policy Update, Brittany R. Schuler, Christian E. Vazquez, Nicole O'Reilly

Social Work Faculty Publications and Presentations

Childhood obesity is a major health issue and a prominent chronic health condition for children in the United States (U.S.), caused by a multitude of factors. Most existing models of childhood obesity prevention have not worked, yielding little to no effect on improving weight status or the proximal health behaviors most attributed to obesity risk: nutritional intake, physical activity, sedentary behaviors, and sleep. There is an urgent need for new approaches to prevent health disparities that are responsive to impacts of economic inequality on healthy child growth in marginalized populations. In this Short Commentary, a social justice update is …

Sustainable Deimplementation Of Continuous Pulse Oximetry Monitoring In Children Hospitalized With Bronchiolitis: Study Protocol For The Eliminating Monitor Overuse (Emo) Type Iii Effectiveness-Deimplementation Cluster-Randomized Trial, Nathaniel J. Williams

Social Work Faculty Publications and Presentations

Background: Methods of sustaining the deimplementation of overused medical practices (i.e., practices not supported by evidence) are understudied. In pediatric hospital medicine, continuous pulse oximetry monitoring of children with the common viral respiratory illness bronchiolitis is recommended only under specific circumstances. Three national guidelines discourage its use for children who are not receiving supplemental oxygen, but guideline-discordant practice (i.e., overuse) remains prevalent. A 6-hospital pilot of educational outreach with audit and feedback resulted in immediate reductions in overuse; however, the best strategies to optimize sustainment of deimplementation success are unknown.

Methods: The Eliminating Monitor Overuse (EMO) trial will compare two …

Required Sample Size To Detect Mediation In 3-Level Implementation Studies, Nathaniel J. Williams, Kristopher J. Preacher, Paul D. Allison, David S. Mandell, Steven C. Marcus

Social Work Faculty Publications and Presentations

Background: Statistical tests of mediation are important for advancing implementation science; however, little research has examined the sample sizes needed to detect mediation in 3-level designs (e.g., organization, provider, patient) that are common in implementation research. Using a generalizable Monte Carlo simulation method, this paper examines the sample sizes required to detect mediation in 3-level designs under a range of conditions plausible for implementation studies.

Method: Statistical power was estimated for 17,496 3-level mediation designs in which the independent variable (X) resided at the highest cluster level (e.g., organization), the mediator (M) resided at the intermediate …

Practice Note: Using Yoga For Emotional Regulation In Intermediate School Teenagers, Nafees Alam

Social Work Faculty Publications and Presentations

Background: This paper examines techniques used in yoga, including breathing techniques, various forms of meditation and physical postures that can impact youth diagnosed with emotional and behavioral disorders (EBD) learning to regulate their emotions to enhance their academic performance. Methods: The intervention was administered to teens at an intermediate public school for six weeks. Seventeen participants were chosen by mental health counselors and worked together with a yoga facilitator to better serve teens struggling with emotional regulation. Results: Pre- and post-tests show that meditation was the overall preferred technique chosen by students as a method to aid with emotional regulation. …

Christian Mindfulness And Mental Health: Coping Through Sacred Traditions And Embodied Awareness, Veronica L. Timbers, Jennifer C. Hollenberger

Social Work Faculty Publications and Presentations

Mindfulness is increasingly implemented as a tool in mental health practice for coping and self-care. Some Christians worry that these practices might be in conflict with their own tradition, while other Christian contexts are reclaiming the contemplative aspects of the faith. Though clinicians are not trained to teach on religious topics and ethically must avoid pushing religion onto clients, conceptualization and research extend the benefits of mindfulness practices for religious clients. This paper will discuss the evidence for using mindfulness in mental health treatment and connect mindfulness to the Christian tradition. The authors explore how intentional awareness and embodiment of …

Home And Neighborhood Physical Activity Location Availability Among African American Adolescent Girls Living In Low-Income, Urban Communities: Associations With Objectively Measured Physical Activity, Nicole O'Reilly

Social Work Faculty Publications and Presentations

Based on the ecological model of active living, the neighborhood environment may relate to individual physical activity (PA) behaviors. The purposes of this study were to (1) generate a replicable neighborhood-level physical activity location availability score (PALAS) from data variables associated with physical activity among adolescents and adults, and apply this score to Baltimore City, Maryland, and (2) determine if relationships exist between PA and PA location availability. Geographic information systems (GISs) were used to create the PALAS. Using linear regression models, we examined relations between objectively measured PA among low-income, urban, predominantly African American adolescent girls (n = …

Community Stakeholder Preferences For Evidence-Based Practice Implementation Strategies In Behavioral Health: A Best-Worst Scaling Choice Experiment, Nathaniel J. Williams

Social Work Faculty Publications and Presentations

Background: Community behavioral health clinicians, supervisors, and administrators play an essential role in implementing new psychosocial evidence-based practices (EBP) for patients receiving psychiatric care; however, little is known about these stakeholders’ values and preferences for implementation strategies that support EBP use, nor how best to elicit, quantify, or segment their preferences. This study sought to quantify these stakeholders’ preferences for implementation strategies and to identify segments of stakeholders with distinct preferences using a rigorous choice experiment method called best-worst scaling.

Methods: A total of 240 clinicians, 74 clinical supervisors, and 29 administrators employed within clinics delivering publicly-funded behavioral health services …

Relationship Quality And Sexuality: A Latent Profile Analysis Of Long-Term Heterosexual And Lgb Long-Term Partnerships, Jill M. Chonody, Mike Killian, Jacqui Gabb, Priscilla Dunk-West

Social Work Faculty Publications and Presentations

Purpose: Drawing on survey data (N = 7,826) collected in the United Kingdom, Australia, and the United States, this paper examines whether sexual orientation is a differentiating factor in explaining relationship quality and maintenance. Previous research suggests that sexual orientation is not significant in determining relationship satisfaction; however, these analyses have used traditional variable driven approaches, which do not provide an holistic view of the relationship by considering the unique combination of characteristics.

Method: In this study, latent profile analyses were used, which is a person-centered approach that allows for identification of different types of long-term relationships. …

Linking Molar Organizational Climate And Strategic Implementation Climate To Clinicians’ Use Of Evidence-Based Psychotherapy Techniques: Cross-Sectional And Lagged Analyses From A 2-Year Observational Study, Nathaniel J. Williams, Mark G. Ehrhart, Gregory A. Aarons, Steven C. Marcus, Rinad S. Beidas

Social Work Faculty Publications and Presentations

Background: Behavioral health organizations are characterized by multiple organizational climates, including molar climate, which encompasses clinicians’ shared perceptions of how the work environment impacts their personal well-being, and strategic implementation climate, which includes clinicians’ shared perceptions of the extent to which evidence-based practice implementation is expected, supported, and rewarded by the organization. Theory suggests these climates have joint, cross-level effects on clinicians’ implementation of evidence-based practice and that these effects may be long term (i.e., up to 2 years); however, no empirical studies have tested these relationships. We hypothesize that molar climate moderates implementation climate’s concurrent and long-term relationships with …

Measurement Issues, Randy Magen

Social Work Faculty Publications and Presentations

Examining groups from a systems perspective may be natural for contemporary social workers. The systems perspective, or group-as a-whole orientation, provides a solid conceptual foundation for understanding groups (Agazarian, 1992). However, to engage in evidence-based group work practice or to conduct research on groups, abstract group concepts must be conceptualized and operationalized (Engel & Schutt, 2009). In qualitative approaches the conceptualization occurs after data have been collected to extract meaning from the observations. In quantitative approaches, operationalization is the process of assigning values to observable indicators of constructs prior to collecting data (Bonito, Ruppel, & Keyton, 2012). Whether inductive or …

A Library And The Disciplines: A Collaborative Project Assessing The Impact Of Ebooks And Mobile Devices On Student Learning, Barbara C. Glackin, Roy Rodenhiser, Brooke Herzog

Social Work Faculty Publications and Presentations

With the proliferation of technology usage, it is essential to understand the effect of implementation of technology in the academic setting. Specifically, this article examines the impact of eBooks and mobile devices on student learning. A pilot study was conducted with three areas of interest. The first question of interest found that owning or having access to two or more mobile devices significantly increased respondents' frequency of accessing eBooks. The second question examined the pros and cons of using mobile devices. Accessibility and cost savings were found as pros; while functionality and pedagogy were reported as drawbacks to mobile device …