Joshua Patras

Measurement of implementation components ten years after a nationwide introduction of empirically supported programs – a pilot study

BackgroundTen years after the nationwide dissemination of two evidence-based treatment programs, the status of the implementation components was evaluated in a cross-sectional study. The aim of the study was to pilot a standardized measure of implementation components by examining the factor structure, the reliabilities of the scores, and their association with implementation outcome variables. The aim was also to compare implementation profiles of the two evidence-based programs based on multi informant assessments.MethodsThe 218 participants in the study were therapists, supervisors, and agency leaders working with Parent Management Training, the Oregon model (PMTO), and Multisystemic Therapy (MST) in Norway. Interviewers filled in an electronic version of the Implementation Components Questionnaire during a telephone interview.ResultsThe factor analysis of the eight one-dimensional subscales resulted in an individual clinical-level factor and an organizational system-level factor. Age, experience, and number of colleagues in the workplace were negatively correlated with positive ratings of the implementation process, but the number of colleagues working with the same program predicted positive ratings. MST and PMTO had different implementation profiles and therapists, supervisors, and managers evaluated some of the implementation drivers significantly differently.ConclusionsThe psychometric quality of the questionnaire was supported by measures of internal consistency, factor analyses of the implementation components, and the comparisons of implementation profiles between programs and respondent groups. A moderate, but consistent association in the expected direction was found with the implementation outcome variables.

Development of a collective efficacy measure for use in social service organizations

• Summary: The present study summarizes the development of a collective efficacy measure for use in social service organizations: The Collective Efficacy Measure for Social Services (CEMSS). The measure was adapted from Goddards Collective Efficacy Scale (2002). Factorial validity was assessed for a sample of 278 respondents employed at child welfare and child psychiatric agencies across Norway. Exploratory factor analysis (EFA) was conducted with a random split-half sample of 139 respondents; the second random split-half sample (nu2009=u2009139) was tested using confirmatory factor analysis (CFA). Tests for construct validity were conducted using Teamwork, Leadership, and Organizational Culture subscales from the Readiness for Organizational Learning and Evaluation Questionnaire (ROLE; Preskill & Torres, 1999). • Findings: A six-item scale was identified in the first sample using EFA. The CFA conducted with the second sample, indicated good model fit, χ2(10)u2009=u200914.34, pu2009=u2009.16; CFIu2009=u2009.97; RMSEAu2009=u2009.06. Scale reliability for the entire sample was adequate (αu2009=u2009.74). As expected, the six-item scale was significantly correlated with Teamwork, r(250)u2009=u2009.34, pu2009<u2009.01; Leadership, r(273)u2009=u2009.36, pu2009<u2009.01; and Organizational Culture, r(276)u2009=u2009.41, pu2009<u2009.01. • Applications: The results of the analyses support the use of the CEMSS as a valid measure of collective efficacy. This measure has a variety of possible applications for organizational assessment and research in social service agencies.

Effects of universally offered parenting interventions for parents with infants: a systematic review.

Objectives From a developmental perspective, infancy is a critical stage of life. Early childhood interventions aim to support caretakers, but the effects of universal interventions for parents with infants are unknown. The objective is to determine the effects of universal parenting interventions offered to parents with infants 0–12u2005months on measures of child development and parent–child relationship. Design A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We extracted publications from 10 databases in June 2013, January 2015 and June 2016 and supplemented with grey and hand search. Risk of bias was assessed, and effect sizes were calculated. Participants Inclusion criteria are: (1) randomised controlled trials of structured, psychosocial interventions offered to a universal population of parents with infants 0–12u2005months old in western OECD countries, (2) interventions that include a minimum of 3 sessions with at least half of the sessions delivered postnatally and (3) programme outcomes reported for child development or parent–child relationship. Results 14 papers representing 7 studies are included. There were no statistically significant effects of the intervention for the majority of the primary outcomes across the studies. Conclusions The findings of this review are mixed. No clear conclusions can be drawn regarding the effects of universally offered parenting interventions on child development and parent–child relationship for this age group.

Group size and therapists’ workplace ratings: Three is the magic number

Summary The present implementation study compares therapists’ workplace ratings of collective efficacy, collaboration, and teamwork in Norwegian child welfare and child psychiatric agencies. Participating therapists were trained in Parent Management Training Oregon model (PMTO) as part of a nationwide implementation of the program. Participating therapists (Nu2009=u200983) worked in 67 Norwegian social service agencies. Respondents were part of three conditions: (1) PMTO therapists working in agencies with no other PMTO therapists (nu2009=u200945), (2) two PMTO therapists working together in the same agency (nu2009=u200923), and (3) three therapists working together in the same agency (nu2009=u200915). Findings Therapists working in clusters of 3 rated their workplaces more positively than therapists who worked in agencies with 1 or 2 PMTO interventionists, βu2009=u2009.29, pu2009=u2009.03; Cohen’s du2009=u2009.80. The result was independent of agency size, leadership quality, service population, and therapist education. There was no difference in workplace ratings between PMTO therapists working in agencies in pairs (2 PMTO therapists) and those working in agencies alone (1 PMTO therapist), pu2009=u2009.45. Applications PMTO therapists working in clusters of three appeared to have better experiences with their workplace than therapists with no other PMTO colleagues, and those with only one other PMTO colleague. This result suggests that clustering therapists together in groups of at least three may create a better work environment for therapists using newly-implemented interventions.

Study protocol of an RCT of EMOTION: An indicated intervention for children with symptoms of anxiety and depression

BackgroundHigh levels of anxiety and depression are common psychological symptoms among children and adolescents. These symptoms affect young people in multiple life domains and are possible precursors of long-term psychological distress. Despite relatively high prevalence, few children with emotional problems are referred for clinical treatment, indicating the need for systematic prevention. The primary aim of this study is to evaluate an indicated preventive intervention, EMOTION Coping Kids Managing Anxiety and Depression (EMOTION), to reduce high levels of anxiety and depressive symptoms.Methods/DesignThis is a clustered randomized controlled trial involving 36 schools, which are assigned to one of two conditions: (a) group cognitive behavioral intervention EMOTION or (b) treatment as usual (TAU). Assessments will be undertaken at pre-, mid - intervention, post-, and one year after intervention. The children (8–11xa0years old) complete self-report questionnaires. Parents and teachers report on children. The primary outcome will be changes in depressive and anxiety symptoms as measured by the Short Mood and Feelings Questionnaire (SMFQ) and Multidimensional Anxiety Scale for Children (MASC) respectively. Secondary outcomes will be changes in self-esteem, quality of life, and school and daily functioning. Observers will assess implementation quality with ratings of fidelity based on video recordings of group leaders leading the EMOTION group sessions.DiscussionThe present study is an important contribution to the field regarding working with children with symptoms of anxiety and depression. The results of this study will provide an indication whether or not the EMOTION program is an effective intervention for the prevention of later depression and/or anxiety in children. The study will also provide information about the EMOTION program’s effect on quality of life, self-esteem, and school functioning of the children participating in the study. Finally, the project will provide insight into implementation of an indicated intervention for school-aged children within Norwegian health, education, and mental health services.Trial registrationClinical Trials NCT02340637, Registered on June 12, 2014, last updated on January 15, 2015. Retrospectively registered.

Linking interprofessional work to outcomes for employees: A meta-analysis

The aim of this meta-analysis of studies of workers in the health and social care sector was to examine the relationship between interprofessional work and employee outcomes of job stress, autonomy, burnout, engagement, job satisfaction, turnover intention, and perceived service quality, and to examine the influence of different moderators on those relationships. A systematic literature search of the PsycInfo, Embase, Medline, and the Cumulative Index to Nursing and Allied Health Literature databases was conducted to identify relevant articles. A total of 45 articles with results for 53 independent samples was included in the meta-analysis. A random effects model was used to estimate the mean effect sizes (correlations). Most employees were nurses working in hospitals. Interprofessional work was weakly negatively associated with job stress, burnout, and turnover intention (range mean ru2009=u2009-.13 to -.22); and was moderately positively associated with autonomy, engagement, job satisfaction, and perceived service quality (range mean ru2009=.33 to .46). When feasible, interprofessional work was categorized as teamwork (most intensive), collaboration, or cooperation. Teamwork, the most intense of three forms of interprofessional work, promoted lower burnout and turnover intention. The results of this meta-analysis suggest that interprofessional work is linked to better well-being for employees in health and social care.

Emotion regulation and its relation to symptoms of anxiety and depression in children aged 8–12 years: does parental gender play a differentiating role?

BackgroundSymptoms of anxiety and depression are prevalent and highly comorbid in children, contributing to considerable impairment even at a subclinical level. Difficulties with emotion regulation are potentially related to both anxious and depressive symptoms. Research looking at maternal contributions to children’s mental health dominates the literature but ignores the potentially important contributions of fathers.MethodThe present study is part of the Coping Kids study in Norway, a randomized controlled study of a new indicated preventive intervention for children, EMOTION. EMOTION aims to reduce levels of anxious and depressive symptoms in children aged 8–12xa0years. Using cross sectional data and multiple regression analyses, we investigated the relations between anxious and depressive symptoms and emotion regulation in nu2009=u2009602 children. Symptoms were reported by the child, mothers and fathers. Emotion regulation was reported by mothers and fathers.ResultsSymptoms of anxiety, as reported by parents, were associated with poorer emotion regulation. This association was also demonstrated for depressive symptoms as reported by both parents and children. When analyzing same gender reports, parental gender did not differentiate the relationship between anxiety symptoms and emotion regulation. For depressive symptoms, we did find a differentiating effect of parental gender, as the association with dysregulation of emotion was stronger in paternal reports, and the association with adaptive emotion regulation was stronger in maternal reports. When using reports from the opposite parent, the emotion regulation difficulties were still associated with depressive and anxiety symptoms, however exhibiting somewhat different emotional regulation profiles.ConclusionProblems with emotion regulation probably coexists with elevated levels of internalizing symptoms in children. In future research, both caregivers should be included.Trial registrationThe regional ethics committee (REC) of Norway approved the study. Registration number: 2013/1909; Project title: Coping Kids: a randomized controlled study of a new indicated preventive intervention for children with symptoms of anxiety and depression. ClinicalTrials.gov; Protocol ID 228846/H10.

Reorganisation of healthcare services for children and families: Improving collaboration, service quality, and worker well-being

ABSTRACT This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers’ experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T1) and after (T2, T3) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T1 to T2. No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T3) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.

Effects of parenting interventions for at-risk parents with infants: A systematic review and meta-analyses

Objectives Infancy is a critical stage of life, and a secure relationship with caring and responsive caregivers is crucial for healthy infant development. Early parenting interventions aim to support families in which infants are at risk of developmental harm. Our objective is to systematically review the effects of parenting interventions on child development and on parent–child relationship for at-risk families with infants aged 0–12 months. Design This is a systematic review and meta-analyses. We extracted publications from 10 databases in June 2013, January 2015 and June 2016, and supplemented with grey literature and hand search. We assessed risk of bias, calculated effect sizes and conducted meta-analyses. Inclusion criteria (1) Randomised controlled trials of structured psychosocial interventions offered to at-risk families with infants aged 0–12 months in Western Organisation for Economic Co-operation and Development (OECD) countries, (2) interventions with a minimum of three sessions and at least half of these delivered postnatally and (3) outcomes reported for child development or parent–child relationship. Results Sixteen studies were included. Meta-analyses were conducted on seven outcomes represented in 13 studies. Parenting interventions significantly improved child behaviour (d=0.14; 95%u2009CI 0.03 to 0.26), parent–child relationship (d=0.44; 95%u2009CI 0.09 to 0.80) and maternal sensitivity (d=0.46; 95%u2009CI 0.26 to 0.65) postintervention. There were no significant effects on cognitive development (d=0.13; 95%u2009CI −0.08 to 0.41), internalising behaviour (d=0.16; 95%u2009CI −0.03 to 0.33) or externalising behaviour (d=0.16; 95%u2009CI −0.01 to 0.30) post-intervention. At long-term follow-up we found no significant effect on child behaviour (d=0.15; 95%u2009CI −0.03 to 0.31). Conclusions Interventions offered to at-risk families in the first year of the child’s life appear to improve child behaviour, parent–child relationship and maternal sensitivity post-intervention, but not child cognitive development and internalising or externalising behaviour. Future studies should incorporate follow-up assessments to examine long-term effects of early interventions.