Suchergebnisse

Purpose - Effective treatments for juvenile sexual offenders are needed to reduce the societal impact of sexual crimes. The purpose of this paper is to review the empirical literature on treatments for this clinical population. Design/methodology/approach - The authors searched PsycInfo and MEDLINE (via PubMed) for studies that evaluated outcomes of treatments with juvenile sexual offenders. Findings - There are a small but growing number of treatment studies ( n =10) with juvenile sexual offenders, and all of these studies evaluated cognitive-behavioral therapy or multisystemic therapy for problem sexual behaviors. The results of these studies are promising, although conclusions about treatment effectiveness have been frequently limited by methodological problems. Originality/value - The authors provide recommendations for treatment providers and policymakers to consider in their decisions about interventions for juvenile sexual offenders. Furthermore, the authors offer suggestions for researchers who seek to develop effective interventions targeting this clinical population. Adapted from the source document.

Background:Implementing evidence-based practices (EBPs) within service systems is critical to population-level health improvements, but also challenging, especially for complex behavioural health interventions in low-resource settings. 'Mis-implementation' refers to poor outcomes from an EBP implementation effort; mis-implementation outcomes are an important, but largely untapped, source of information about how to improve knowledge exchange.

Aims and objectives:We present mis-implementation cases from three pragmatic trials of behavioural health EBPs in US Federally Qualified Health Centers (FQHCs).

Methods:We adapted the Consolidated Framework for Implementation Research and its Outcomes Addendum into a framework for mis-implementation and used it to structure the case summaries with information about the EBP and trial, mis-implementation outcomes, and associated determinants (barriers and facilitators). We compared the three cases to identify shared and unique mis-implementation factors.

Findings:Across cases, there was limited adoption and fidelity to the interventions, which led to eventual discontinuation. Barriers contributing to mis-implementation included intervention complexity, low buy-in from overburdened providers, lack of alignment between providers and leadership, and COVID-19-related stressors. Mis-implementation occurred earlier in cases that experienced both patient- and provider-level barriers, and that were conducted during the COVID-19 pandemic.

Discussion and conclusion:
Multilevel determinants contributed to EBP mis-implementation in FQHCs, limiting the ability of these health systems to benefit from knowledge exchange. To minimise mis-implementation, knowledge exchange strategies should be designed around common, core barriers but also flexible enough to address a variety of site-specific contextual factors, and should be tailored to relevant audiences such as providers, patients, and/or leadership.