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Implementation of an evidence-based biobehavioral treatment for cancer patients

  • Original Research
  • Published:
Translational Behavioral Medicine

Abstract

One aim of dissemination and implementation (DI) research is to study the translation of evidence-based treatments (EBTs) from the research environments of their development and testing to broader communities where they are needed. There are few behavioral medicine DI studies and none in cancer survivorship. A determinant model (Setting, Therapist, Education, imPlementation, and Sustainability (STEPS)) was used to conceptualize DI of mental health treatment and frame a longitudinal study of implementation of a behavioral medicine EBT—a biobehavioral intervention (BBI) for cancer patients. Using effective dissemination strategies, therapists were trained in the BBI and followed to determine if implementation occurred. Participants (N = 108) were psychologists, social workers, and other oncology mental health providers from diverse settings to whom the BBI had been disseminated. BBI trainers then provided 6 months of support for implementation (e.g., monthly conference calls). Therapists reported number of patients treated, with or without the BBI, at 2, 4, and 6 months; use of support strategies was tracked. Generalized linear mixed models show that the proportion of patients treated with BBI ranged from 58 to 68%, with a 2% increase across follow-ups. Therapist and setting characteristics did not predict usage. Implementation of a behavioral medicine EBT provides a “real-world” demonstration of a BBI moved from the research setting to diverse communities. As the first study in cancer, it is an encouraging example of training and supporting mental health providers to deliver evidence-based psychological treatment and finding their success in doing so.

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Acknowledgments

This study was supported by grants from the NIH/National Cancer Institute (CA163917, CA098133). The authors thank the mental health professionals who attended the C2H training institutes and thank them for their research participation and that of their supervisors/managers. We thank Project Coordinator, Sarah Hwang, Data Manager, Matt McShane, and the Stress and Immunity Cancer Projects research staff and graduate students, including Claire Conley, Travis Westbrook, David Weiss, and Kristen Williams.

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Authors and Affiliations

  1. Department of Psychology, The Ohio State University, Columbus, OH, USA

    Marlena M. Ryba PhD & Barbara L. Andersen PhD

  2. Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA

    Brittany M. Brothers PhD

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  1. Marlena M. Ryba PhD
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Correspondence to Marlena M. Ryba PhD.

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All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Implications

Practice: STEPS is a conceptual model for operationalizing setting, therapist, and patient aspects of evidence-based, psychological treatment implementations.

Policy: The impact of behavioral medicine interventions for patients will remain limited without dramatic expansion into integrated care and the provision of convincing evidence of provider uptake.

Research: Research on the implementation of existing cancer control psychological interventions for cancer patients has been neglected and requires immediate attention if empirically based cancer control is to reach the community.

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Ryba, M.M., Brothers, B.M. & Andersen, B.L. Implementation of an evidence-based biobehavioral treatment for cancer patients. Behav. Med. Pract. Policy Res. 7, 648–656 (2017). https://doi.org/10.1007/s13142-016-0459-8

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