Abstract
BackgroundThis paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners.MethodsThe EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the mapping of implementation strategies to EPIS stages, articulation of research questions, and selection, content, and timing of measurement protocols. Among other key developments, the project led to a reconceptualization of its governing implementation science framework into cyclical form as the EPIS Wheel. The EPIS Wheel is more consistent with rapid-cycle testing principles and permits researchers to track both progressive and recursive movement through EPIS. Moreover, because this randomized controlled trial was predicated on a bundled strategy method, JJ-TRIALS was designed to rigorously test progress through the EPIS stages as promoted by facilitation of data-driven decision making principles. The project extended EPIS by (1) elucidating the role and nature of recursive activity in promoting change (yielding the circular EPIS Wheel), (2) by expanding the applicability of the EPIS framework beyond a single evidence-based practice (EBP) to address varying process improvement efforts (representing varying EBPs), and (3) by disentangling outcome measures of progression through EPIS stages from the a priori established study timeline.DiscussionThe utilization of EPIS in JJ-TRIALS provides a model for practical and applied use of implementation frameworks in real-world settings that span outer service system and inner organizational contexts in improving care for vulnerable populations.Trial registrationNCT02672150. Retrospectively registered on 22 January 2016.
Highlights
IntroductionThis paper describes how a particular implementation science model developed to facilitate implementation and sustainment in public sectors, Exploration, Preparation, Implementation, and Sustainment (EPIS) (Aarons, Hurlburt, & Horwitz, 2011), and was applied within a multi-site, multi-research center initiative
This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJTRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative
This paper describes how a particular implementation science model developed to facilitate implementation and sustainment in public sectors, Exploration, Preparation, Implementation, and Sustainment (EPIS) (Aarons, Hurlburt, & Horwitz, 2011), and was applied within a multi-site, multi-research center initiative
Summary
This paper describes how a particular implementation science model developed to facilitate implementation and sustainment in public sectors, Exploration, Preparation, Implementation, and Sustainment (EPIS) (Aarons, Hurlburt, & Horwitz, 2011), and was applied within a multi-site, multi-research center initiative. This National Institute on Drug Abuse (NIDA)-funded initiative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), used an implementation science approach from its inception with the goal of improving substance use treatment outcomes for justiceinvolved youth on community supervision (Knight et al, 2016). This paper aims to illustrate how a guiding framework was used in the development and execution of an implementation intervention project designed to improve service delivery for justiceinvolved youth who receive services within complex, multiagency systems
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