Symposia
Dissemination & Implementation Science
Amanda Sanchez, Ph.D.
Assistant Professor
George Mason University
Philadelphia, Pennsylvania
Michal Weiss, B.S.
Clinical Research Coordinator
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania
Temma L. Schaechter, PhD
Clinical Research Coordinator
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania
Ana Baumann, PhD
Assistant Professor
Division of Public Health Sciences, Department of Surgery Washington University School of Medicine
St. Louis, Missouri
Amber Calloway, Ph.D.
Research Associate
The Penn Collaborative for CBT and Implementation Science, Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
Darlene M. Davis Goodwine, PhD, LP
Clinical Psychologist
Aidan Behavioral Health & Consulting
Frankfort, Kentucky
Vanesa Mora Ringle, Ph.D.
Postdoctoral Fellow
The Penn Collaborative for CBT and Implementation Sclence, University of Pennsylvania
Philadelphia, PA
Emily M. Becker-Haimes, Ph.D.
Assistant Professor
University of Pennsylvania
Philadelphia, Pennsylvania
Background: Improving the quality of evidence-based interventions (EBIs) for pediatric obsessive-compulsive disorders (OCD) and anxiety for marginalized youth is a critical step in reducing mental health care inequities. Youth from marginalized and minoritized backgrounds are severely underrepresented in clinical trials research and face additional challenges (i.e., stigma, mistrust, discrimination) that may undermine their ability to engage in and benefit from leading EBIs. There is strong evidence that current EBIs need systematic adaptation to improve the cultural responsiveness and fit for marginalized youth and families, but little guidance exists for clinicians on what and how to systematically adapt. This presentation will describe a systematic user-centered process that incorporates stakeholders’ voices and emphasizes collaborative decision making to develop a clinician-facing toolkit to improve the cultural responsiveness of services for youth with OCD and anxiety.
Methods: The systematic user-centered process included 1) interviewing clinicians and clients about needs related to improving EBI cultural responsiveness, 2) rapid qualitative coding, 3) expert stakeholder feedback and literature review, and 4) iterative refinement of the toolkit with an advisory board.
Results: Qualitative interviews with clinicians (N=16) and clients or their caregivers (N=4; 12 to be completed) were conducted. To date, rapid coding has elicited 12 cultural and contextual factors and associated clinical strategies that will be incorporated into the toolkit. The advisory board comprises community clinicians, experts in CBT, cultural adaptation, and implementation scientists and will meet three times by May 2022 to iteratively develop the toolkit. Toolkit format will be driven by board feedback, but it is anticipated that the toolkit will focus on general strategies (e.g., cultural assessment, alignment of treatment strategies with family goals and values) and specific strategies related to leading EBIs (e.g., tailoring exposure and cognitive restructuring to address realistic fears and experiences of discrimination).
Conclusion: The systematic user-centered process aids in the development of a practical toolkit that has the potential to improve the quality of exposure-based CBT for marginalized youth and families. Implications of stakeholder involvement in development of implementation supports and application of this process to other patient populations will be discussed.