title: Evaluation of an implementation model: a national investigation of VA residential programs.
abstract: This national investigation utilizes qualitative data to evaluate an implementation model regarding factors influencing provider use of two evidence-based treatments for posttraumatic stress disorder (PTSD). Semi-structured qualitative interviews with 198 mental health providers from 38 Department of Veterans Affairs' (VA) residential treatment programs were used to explore these issues regarding prolonged exposure (PE) and cognitive processing therapy (CPT) in VA residential PTSD programs. Several unique and some overlapping predictors emerged. Leadership was viewed as an influence on implementation for both CPT and PE, while a lack of dedicated time and resources was viewed as a deterrent for both. Compatibility of CPT with providers' existing practices and beliefs, the ability to observe noticeable patient improvement, a perceived relative advantage of CPT over alternative treatments, and the presence of a supportive peer network emerged as influential on CPT implementation. Leadership was associated with PE implementation. Implications for the design and improvement of training and implementation efforts are discussed.
authors.affiliation: Yale School of Medicine and National Center for PTSD, 950 Campbell Avenue, NEPEC/182, West Haven, CT, 06516, USA, joan.cook@yale.edu.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Cook
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dinnen
authors.forename: James C
authors.initials: JC
authors.lastname: Coyne
authors.forename: Richard
authors.initials: R
authors.lastname: Thompson
authors.forename: Vanessa
authors.initials: V
authors.lastname: Simiola
authors.forename: Josef
authors.initials: J
authors.lastname: Ruzek
authors.forename: Paula P
authors.initials: PP
authors.lastname: Schnurr
mesh_terms: D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy; D055317:Evidence-Based Practice; D006801:Humans; D007171:Implosive Therapy; D007857:Leadership; D036301:Qualitative Research; D012114:Residential Treatment / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs