Searched for: person:reh346
Dissemination of a reliable and valid family maltreatment determination model: 33-site, system-wide replication and extension of Heyman and Slep (2009a)
Zaninovic, ViniNatalie; Heyman, Richard E; Drew, Alison L; Slep, Amy M Smith; Lapshina, Natalia; Neglio, Brandon; Rhoades, Kimberly A; Daly, Kelly A
The need for standardized criteria in partner and child maltreatment response systems is critical for providing fair decisions, allocating family support, producing reliable research findings, and aiding prevention efforts, among other tasks. The primary goal of this study was to replicate Heyman and Slep's (see record 2009-23534-017) study-whether maltreatment incident determination committee decisions of local sites matched those of master reviewers. This study extended the prior work by testing if specific training techniques (i.e., social worker self-assessments, motivation-enhanced briefs, per-case feedback) increased the master reviewer-site concordance of the Field-Tested Assessment, Intervention-Planning, and Response (FAIR) system. Overall agreement between the master reviewers and the committees was 87%, indicating good agreement but falling just below the 91%-92% achieved in earlier FAIR dissemination studies. Sites were randomly assigned to one of eight training conditions using a multiphase optimization strategy design. The full factorial model was not statistically significant, indicating that the training techniques were not associated with committees' voting fidelity. The replicated agreement findings indicate that the FAIR system can be implemented successfully on a large scale and produce consistently good agreement on family maltreatment case decisions. Areas for future research are discussed (e.g., testing and usage of evidence-informed training techniques). (PsycInfo Database Record (c) 2025 APA, all rights reserved).
PMID: 39847003
ISSN: 1939-1293
CID: 5778022
A Response to Smith et al
Segura, Anna; Heyman, Richard E; Ochshorn, Jennie; Slep, Amy M Smith
PMID: 39361261
ISSN: 1930-613x
CID: 5739012
Examining barriers and facilitators of dental fear treatment adoption: A qualitative study of practicing dentists
Ochshorn, Jennie; Daly, Kelly A; Zaninovic, ViniNatalie; Heyman, Richard E; Smith Slep, Amy M; Wolff, Mark S
Over fifteen percent of the global population experiences dental fear, and although evidence-based treatments exist, adoption of these treatments is almost non-existent. Informed by our prior research examining barriers to adopting face-to-face behavioral treatments in dental operatories, this study examined dentists' responses to three stepped-care Cognitive Behavioral Therapy for Dental Fear (CBT-DF) formats that use technology. All approaches offer an automated component as the first step (a mobile app) and either an in-person, virtual reality (VR), or video telehealth session as the second step. This study aims to understand which of these approaches would most likely be adopted by private practice dentists and why. Eight focus groups/solo interviews with a total of 13 private practice dentists were conducted with the aim to assess barriers and facilitators to implementing three stepped-care approaches of CBT-DF. The qualitative data obtained from these interviews was coded and analyzed according to Rogers' framework of innovation (relative advantage, compatibility, complexity, trialability, and observability). The results indicated that participants acknowledged the value of interventions to address dental fear, as they had personal experiences with fearful patients that impacted their practices. Participants responded positively to the automated component of treatment (the app) and were more wary of treatment options requiring office space and staff time (in-person VR and in-person mental health provider). The telehealth option received the most favorable response, although some doubts were expressed regarding relative efficacy and patient accountability. Thus, dissemination of an app-telehealth treatment model that allows dentists to serve as referral partners is promising, given dentists' incentives to decrease patient fear while avoiding opportunity cost (e.g., occupied chairs and staff time).
PMCID:12063807
PMID: 40343897
ISSN: 1932-6203
CID: 5841062
A Pre-Adoption Assessment of a Collaborative Care Approach to Dental-Fear Treatment
Daly, Kelly A; Heyman, Richard E; Drew, Alison L; Smith Slep, Amy M; Bubis, Rochelle; Lee, Jahyung Jai; Pearce, Victoria V V; Jones, Racquel; Ruggiero, Marissa; Wolff, Mark S
BACKGROUND/UNASSIGNED:With an estimated global prevalence rate of over 30%, dental fear is a ubiquitous public health phenomenon. Dental fear's adverse effects on patient oral health and quality of life are well established; the stresses and financial repercussions it can pose to providers are increasingly recognized. Although dental fear is highly treatable, a disseminable intervention that satisfies the needs of patients and dental care providers has yet to be realized. OBJECTIVES/UNASSIGNED:We sought to understand allied dental professionals' experiences treating patients with dental fear and their impressions of, and receptivity to, a stepped-care approach, including perceived barriers and facilitators to its adoption. METHODS/UNASSIGNED:= 49) were conducted. Focus group discussions were recorded, transcribed, and thematically analyzed. RESULTS/UNASSIGNED:Participant responses supported the need for innovation in managing dental fear in practices, and supported hygienists as likely facilitators of any new behavioral approach. Overall, participants were receptive to the idea of a stepped-care treatment approach but identified several factors (e.g., accessibility, costs, treatment credibility) that would need to be addressed for its adoption by patients and dental professionals. CONCLUSION/UNASSIGNED:A stepped-care approach to dental fear treatment has promise to meet the needs of patients and dental professionals. Potential barriers and facilitators to adoption provide a roadmap for future intervention refinement and efficacy testing.
PMCID:12055299
PMID: 40330111
ISSN: 2673-6373
CID: 5841052
Afraid of the dentist? There's an app for that: Development and usability testing of a cognitive behavior therapy-based mobile app
Daly, Kelly A; Diaz-Gutierrez, Kiara A; Beheshtian, Armon; Heyman, Richard E; Smith Slep, Amy M; Wolff, Mark S
OBJECTIVES/OBJECTIVE:Although several brief cognitive behavior therapy (CBT)-based treatments for dental fear have proven efficacious, these interventions remain largely unavailable outside of the specialty clinics in which they were developed. Leveraging technology, we sought to increase access to treatment for individuals with dental fear through the development of a mobile application (Dental FearLess). MATERIALS AND METHODS/METHODS:To assess the resonance of our app as an avenue for dental fear treatment, we conducted a study assessing the usability, feasibility, and acceptability of the beta app. Participants with moderate to severe dental fear (N = 80) completed the app and reported on the perceived usability of the mobile interface (Systems Usability Scale, SUS; α = .82) and credibility of the intervention (Credibility and Expectancy Questionnaire, CEQ; α = .88). A sub-sample of participants naïve to the app (n = 10) completed the app during a think-aloud procedure, sharing their candid thoughts and reactions while using the app, prior to reporting on usability and credibility metrics. RESULTS:Overall usability (M = 78.5, SD = 17.7) and credibility (M = 21.7, SD = 5.5) of the beta version of the app were good. The think-aloud data further corroborated the app's acceptability, while highlighting several areas for user improvement (i.e., aesthetics, navigation, engagement). CONCLUSIONS:Usability and acceptability results are promising for the viability of an accessible, feasible, self-administered intervention for dental fear. Refinements made based on user feedback have produced a clinical-trial-ready mobile application. App refinement decisions, informed by user feedback, are representative of the larger literature-that is, of the ubiquitous negotiations m-health developers must make across treatment fidelity, usability, and engagement. Implications for future research are discussed.
PMCID:11633963
PMID: 39661616
ISSN: 2767-3170
CID: 5766042
Considering context: Current relationship satisfaction in a second-generation model of men's physical intimate partner violence
Slep, Amy M Smith; Heyman, Richard E; Daly, Kelly A; Baucom, Katherine J W
Despite a half-century of scholarship devoted to explicating and disrupting the intergenerational transmission of family violence, it remains a prominent and destructive social force in the United States. Theoretical models have posited a variety of historical and concurrent risk and protective factors implicated in the trajectory from childhood violence exposure to adult perpetration. Using a second-generation model of intimate partner violence (IPV), we integrated social learning and attachment conceptualizations to examine pathways from family-of-origin violence to IPV perpetration among adult men. A sample of mixed-sex couples (N = 233) completed self-report measures related to social learning and attachment-based factors (e.g., violence in past relationships, child exposure, IPV attitudes, adult attachment) and participated in a 10-min conversation about a desired area for change in their relationship. Following, each partner participated in a video-mediated-recall procedure assessing their anger volatility and eliciting attributions of their partners' behavior. We tested mediation pathways (consistent with social learning and attachment theories) between violence in men's families of origin and their adult IPV perpetration as a function of relationship satisfaction. The proposed model fit the data well (CFI = 0.95) but had notable modifications from the hypothesized model. Generally, social-learning pathways were more consistent with the data. Relationship satisfaction interacted with some parameters. Results support theoretical advances in understanding IPV. Although exposure to violence in men's family of origin confers risk for later IPV, and a social learning developmental pathway is consistent with results, some of these effects are altered by relationship context.
PMID: 38802987
ISSN: 1545-5300
CID: 5664312
Associations among psychological health problems, intimate-relationship problems, and suicidal ideation among United States Air Force active-duty personnel
Parsons, Aleja M; Slep, Amy M Smith; Heyman, Richard E; Kim, Sangwon; Mitnick, Danielle; Lorko, Kelsey; Gupta, Avantika; Balderrama-Durbin, Christina; Cigrang, Jeffrey A; Snyder, Douglas K
Linkages among psychological health problems, intimate relationship distress, and suicide risk have been widely studied, but less is known about how these factors interact, especially in military populations. With steady increases in suicide rates among active military and post-service members (SMs), it is critical to better understand the relation among known risk factors. The current study addresses this gap by testing a model hypothesizing that the association between intimate-relationship problems and suicidal ideation is mediated by individual mental health symptoms. We tested this model on a sample of 862 active-duty Air Force members in committed relationships. The sample consisted of 35.0% women and 64.8% men, with an average age of 21.9 years and a mean relationship length of 2.8 years. Findings supported the hypothesized statistical mediation model. Results indicated that relationship problems contribute to psychological health problems, which, in turn, are related to suicidal ideation. These findings may help direct suicide intervention and prevention protocols that consider intimate relationship distress as a significant risk factor. Limitations and further implications for policies regarding suicide prevention in the armed forces are discussed.
PMID: 39495505
ISSN: 1532-7876
CID: 5750922
Still "Don't Ask" more than a decade later: The impact of research barriers for LGB+ military couples
Balderrama-Durbin, Christina; Cigrang, Jeffrey A; Snyder, Douglas K; Gupta, Avantika; Slep, Amy M Smith; Heyman, Richard E; Parsons, Aleja M; Simonson, Jordan; Lindahl, Kristin M; Pound, Leah
Despite the repeal of "Don't Ask, Don't Tell" (DADT) over a decade ago, military processes and policies continue to function as significant structural and institutional barriers to research aimed at optimizing resources for military couples and families with marginalized sexual identities. Such research is essential given the apparent mental health and related disparities among lesbian, gay, bisexual, and those with other marginalized sexual identities (LGB+) active-duty service members (SMs), as well as the absence of appropriately tailored resources to support these members of the military community. In this paper, we review the empirical literature on the experiences and psychological health of LGB+ military couples, revealing severe limitations in our understanding of these diverse military romantic partnerships. We illuminate process-related barriers to conducting this essential research through an illustrative case example. Our review concludes with specific recommendations for reform and advocacy distinguished by coordinated efforts inclusive of all five military branches, policymakers, military leaders, researchers, and LGB+ stakeholders.
PMID: 39241155
ISSN: 1532-7876
CID: 5688542
Unlocking What Makes Military Behavioral Health Interventions Work, Stumble, or Fade Away
Slep, Amy M Smith; Rhoades, Kimberly A; Heyman, Richard E
INTRODUCTION/BACKGROUND:The Office of the Secretary of Defense and each of the services have made an unprecedented commitment to the prevention of sexual assault and related behavioral health phenomena. Indeed, the Department of Air Force has selected, in some cases tailored, and disseminated a wide array of evidence-based preventative programs, policies, and practices (EBPs) over the last few decades. However, many of these efforts seem to follow a predictable life course. EBPs are initially implemented with great enthusiasm, supported for a few years, then fall out of favor, and are replaced by a different effort. This research effort aims to build on the existing civilian implementation science research to (1) offer a military-specific model of sustained, high-quality implementation and (2) test this model in a series of interconnected studies. MATERIALS AND METHODS/METHODS:New York University's Institutional Review Board approved the study protocols, and the Army's Human Research Protection Office provided permission to collect data. We conducted interviews first with prevention leaders in the services and at the Office of the Secretary of Defense level regarding factors that they thought helped or hurt the sustainment of EBPs. We used these interviews to identify EBPs currently implemented in Department of Air Force and selected four EBPs out of the 25 identified for intensive study. We then interviewed implementers of those four EBPs regarding what they thought helped or hurt the sustainment of that EBP. We also gathered information about the 25 currently implemented EBPs themselves and gathered policy and guidance, as well as leadership communication about those EBPs and the target problems they focus on. We coded this information to allow us to test EBP parameters and policy and leader communication that predict sustained high-quality implementation. We conducted over 100 observations of the 4 EBPs we are studying intensively and have collected quantitative data from implementers and participants to help us test factors related to sustained high-quality implementation within each of those 4 EBPs and across the EBPs. RESULTS:Several military-specific factors were nominated for inclusion in the military-specific model of implementation sustainment. The implementation of even highly standardized EBPs varies greatly. Implementers and participants are generally highly engaged, but implementers vary in the extent to which they understand the mechanisms of action for the EBP they are implementing. CONCLUSIONS:We recommend training implementers in the mechanisms of action in the EBPs they are expected to implement and including quality assurance as a component of prevention efforts in a manner more similar to how the military addresses aspects of the operational mission. By moving beyond counting classes and attendance, and specifying how to engage participants in the EBPs in the manner that produces the key outcomes, it is likely that EBPs will have more robust implementations that can be better sustained over time.
PMID: 39160806
ISSN: 1930-613x
CID: 5681342
A meta-review of screening and treatment of electronic "addictions"
Hogan, Jasara N; Heyman, Richard E; Smith Slep, Amy M
Concerns surrounding electronic addictions, an umbrella term including any clinically significant technology-based addictive problem, have increased as technology has advanced. Although researchers and clinicians have observed detrimental effects associated with excessive technology use, there is no agreed-on definition or set of criteria for these problems. The lack of a consistent understanding of electronic addictions has led to a lack of consistency in both assessment and treatment studies, precluding strong recommendations for effective screening and clinical intervention. This meta-review integrates findings from 22 systematic reviews and meta-analyses of electronic addictions to determine which measures and interventions may effectively measure and treat electronic addictions. We conducted a meta-review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings suggest that although some measures may have good internal consistency and reliability among college students, there was a general lack of consistency in how measures were used across studies, making comparison difficult. Psychological and exercise-based interventions were shown to reduce symptoms of electronic addictions short-term, but no treatment was superior to others in overall symptom reduction. Most included reviews raise serious concerns about the lack of consensus on what constitutes an electronic addiction. Consequently, it was not possible to draw conclusions about the overall efficacy of any measurement tools or interventions. We provide suggestions for next steps to establish the phenomenology of electronic addictions before additional research on assessment and intervention is conducted.
PMID: 39168052
ISSN: 1873-7811
CID: 5681352