Category: Dissemination / Implementation
The construct of behavioral intentions is a key component in theories of behavior. Despite its frequent application to innovation-adoption behaviors of health care providers, the study of behavioral intentions has not yet been applied to community mental health care providers’ evidence-based practice (EBP) adoption. The current study examines therapists’ intentions to use specific practice elements (PEs) when treating an anxious or disruptive behavior (DBD) youth.
A total of 51 ethnically-diverse, community-based therapists (74% female) have participated in the study to date, reporting a mean age of 38.5 (SD=12.5) and an average of six years (SD=5.6) full-time clinical experience. Seven of 15 contracted agencies with the Child and Adolescent Mental Health Division of the Hawai‘i Department of Health participated, and four additional agencies will be included in the final presentation of results. The current study focuses on participants’ responses on the Therapist Behavioral Intentions Survey, which involves responding to two case scenarios by reporting an intention to either (a) use, (b) not use, or (c) possibly use 60 specific PEs (e.g., exposure, hypnosis) over the first six months of treatment for each case. The cases are straightforward and uniform across various domains of complexity. Background characteristics and theorized predictors of EBP intentions, such as attitudes, subjective norms, and perceived behavioral control, were assessed in the survey battery.
Descriptive and inferential statistics were used to explore patterns across therapists’ endorsement of intentions (i.e., to use, not use, or possibly use) toward the 60 evidence- and non-evidence-based PEs. On average, therapists reported intending to use over half of the PEs for both the anxiety (M=31.0, SD=8.8) and DBD (M=33.7, SD=8.4) cases, and endorsed an average of 11.7 (SD=8.9) and 10.3 (SD=1.2) additional PEs as possible intentions for the anxiety and DBD cases, respectively. Therapists reported significantly more PEs under “intention to use” for the DBD case [t(50)=4.20, p < .001], and endorsed significantly more PEs as “intention to possibly use” for the anxiety case [t(50)=2.43, p < .05], which may reflect greater therapist confidence in treating DBD youth. Further inspection of therapists’ intentions revealed alignment with the evidence-base for each problem area. For example, 100% and 80% of the five most frequently reported PE intentions for the DBD and anxiety case, respectively, aligned with the disorder-specific evidence base. Additional findings will be reported regarding the relationship between intention patterns and hypothesized predictors. All results will be discussed within the larger context of dissemination and implementation of EBP within public sector mental health.
Kaitlin Hill– Graduate Student, University of Hawaii at Manoa, Honolulu, Hawaii
Albert Mah– Graduate Student, University of Hawaii at Manoa, Honolulu, Hawaii
Tommie Yamamoto– University of Hawaii at Manoa
Hilary Gould– Clinical Respecialization Student, University of Hawai‘i at Mānoa, Poway, California
Brad Nakamura– Associate Professor, University of Hawaii at Manoa, Honolulu, Hawaii
Clinical Respecialization Student
University of Hawai‘i at Mānoa