Knowledge Bank

Background: Implementation of empirically supported treatments (ESTs) is conceptualized to be on a continuum, yet there is limited empirical testing the transition from EST dissemination to adoption and implementation. Purpose: Study I) tested for replication of the effectiveness of a multimodal education to disseminate the Biobehavioral Intervention (BBI) for cancer patients to diverse oncology mental health providers (Brothers et al., 2015). Study II) described providers’ implementation of BBI and tested possible mechanisms linking dissemination to implementation. Methods: For Study I, BBI was disseminated to oncology mental health providers (N=104; cohorts 3-6) by provision of treatment manuals, lectures, role play/group discussion, and small group practices. Using repeated measures ANOVA, pre to post changes in dissemination outcomes (attitudes toward ESTs/BBI, self-efficacy to deliver BBI/other therapies, and BBI knowledge) were tested. In Study II, providers (N=166; cohorts 1-6) reported usage of BBI with patients at 2- (adoption) and 4-months (implementation) post-dissemination. Regression-based path analyses tested change in dissemination outcomes as predictors of usage. Results: In Study I, increases from pre- to post-training was replicated with BBI knowledge (p<.001), but not with self-efficacy (ps<.001) or attitudes (p=.523). In Study II, the gains from dissemination in providers’ self-efficacy (ps<.05) predicted greater usage during adoption and implementation, while the gains in attitudes (p=.008) predicted greater usage during implementation. Conclusions: This study is the only replication of dissemination of a psychological EST in cancer control. It also identified providers’ self-efficacy and positive attitudes as key variables to change during dissemination to increase in EST usage.