Sustainability of a biobehavioral intervention implemented by therapists and sustainment in community settings
The ultimate aim of dissemination and implementation of empirically supported treatments (ESTs) in behavioral medicine is a) sustainability of the therapist/provider’s EST usage and b) sustainment of EST delivery in the setting. Thus far sustainability has been understudied and the therapist and setting variables that may be influential are unclear. The purpose of the study was to test the therapists’ sustainability of a cancer-specific EST using a prospective longitudinal design and examine its predictors. Oncology mental health therapists (N = 134) from diverse settings (N = 110) completed training in the biobehavioral intervention BBI) and were provided with 6 months of support for implementation with no support thereafter. BBI usage (percent of patients treated) was reported at 246 and 12 months. Using a generalized estimating equation with a logistic link function 12-month sustainability a nonsignificant change in usage from 6 to 12 months) was studied along with therapist supervisor and setting variables as predictors. BBI usage increased through 6 months and importantly usage was sustained from (6 68.4% [95% CI = 62.2%-73.9%]) to 12 months 70.9% [95% CI = 63.6%-77.3%]) with sustainment in 66 settings (60.0%). Predictors of implementation-to-sustainability usage were therapists’ early intentions to use the BBI (p < .001) and from the setting supervisors’ positive attitudes toward ESTs (p = .016). Adding to the DI literature a health psychology intervention was disseminated implemented and found sustainable across diverse therapists and settings. Therapists and setting predictors of usage if modified might facilitate future sustainability/sustainment of ESTs.
Ryba M. M. L. S. B. Andersen B. L. 2019). Sustainability of a biobehavioral intervention implemented by therapists and sustainment in community settings. Transl Behav Med. doi:10.1093/tbm/ibz175