Gregory A Aarons
Biographic Data
| ID | 337450 |
|---|---|
| NAME | Gregory A Aarons |
| GIVEN NAMES | Gregory A |
| FAMILY NAME | Aarons |
| SIGNATURE | AARONS G A |
| AFFILIATIONS | University of California San Diego |
| ORCID | 0000-0001-8969-5002 |
| VERIFIED | Yes |
| TOTAL WORKS | 62 |
| TOTAL CITATIONS | 119 |
| AUTHOR COUNT | 62 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2001 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 6 |
Multi-method Analysis of Implementation Determinants and Strategies to Support the Implementation of Contingency Management for Methamphetamine Use in an HIV Care Setting
Methamphetamine use is prevalent among people with HIV (PWH) and complicates HIV care. Integrated substance use and HIV care services are recommended, yet rarely available. Contingency management (CM) is an evidence-based treatment for methamphetamine use, but its implementation within HIV primary care is limited. This study identified determinants and strategies to support CM implementation in HIV care. Key informants from an HIV clinic at an ac…
Productivity benefits of treatment of depression and post-traumatic stress disorder in Kenya
INTRODUCTION: Depression and post-traumatic stress disorder (PTSD) significantly contribute to the global disease burden, adversely affecting health, medical costs and economic productivity. The SMART-DAPPER project in western Kenya approached this challenge by deploying trained non-specialists to administer proven depression and PTSD treatments. METHODS: Participants were public sector primary care outpatients at Kiumu County Hospital with major…
Site engagement in implementation research: Introducing Seamlis as a conceptual and measurement framework
Improving Implementation of Fertility Preservation Benefit Mandates
In this study, multiple barriers and facilitators were systematically identified to assist in improving implementation of FP benefit mandates. These findings support policies and intervention development for FP patients and clinics, and future legislative and regulatory efforts aimed at increasing timely access to FP insurance benefits
Promises and challenges of cultural exchange for use of research evidence in child welfare
Incorporating research evidence within child welfare systems can improve services and health equity for vulnerable youth. Bidirectional collaboration between researchers and system-level actors may foster evidence-informed policies and programs through cultural exchange. This anthropological analysis of longitudinal qualitative data from the Community-Academic Partnership for Translational Use of Research Evidence (CAPTURE) illuminates the comple…
Defining a screening tool for post-traumatic stress disorder in East Africa: A penalized regression approach
Background: Scalable PTSD screening strategies must be brief, accurate and capable of administration by a non-specialized workforce. Methods: We used PTSD as determined by the structured clinical interview as our gold standard and considered predictors sets of (a) Posttraumatic Stress Checklist-5 (PCL-5), (b) Primary Care PTSD Screen for the DSM-5 (PC-PTSD) and, (c) PCL-5 and PC-PTSD questions to identify the optimal items for PTSD screening for …
“The peace that I wanted, I got”: Qualitative insights from patient experiences of SMART Dapper interventions for major depression and traumatic stress disorders in Kenya
SMART DAPPER is an implementation science study responding to mental health treatment gaps for depression and trauma-related disorders in Sub-Saharan Africa (SSA). We report on patient experiences in a study using a Sequential, Multiple Assignment Randomized Trial (SMART) design to test first and second line non-specialist treatment using psychotherapy (Interpersonal Psychotherapy [IPT] or medication (fluoxetine [FLX]), integrated within public s…
Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria
Background: Cervical cancer constitutes a huge burden among women in Nigeria, particularly HIV-infected women. However, the provision and uptake of cervical cancer screening and treatment is limited in Nigeria. Understanding implementation determinants is essential for the effective translation of such evidence-based interventions into practice, particularly in low-resource settings. COVID-19 pandemic necessitated online collaboration making impl…
Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southe…
Adverse Childhood Experiences (ACEs) are defined as traumatic events occurring before age 18, such as maltreatment, life-threatening accidents, harsh migration experiences, or violence. Screening for ACEs includes asking questions about an individual's early exposure to these types of events. ACEs screenings have potential value in identifying children exposed to chronic and significant stress that produces elevated cortisol levels (i.e., toxic s…
Building a national framework for multicentre research and clinical trials: Experience from the Nigeria Implementation Science Alliance
There is limited capacity and infrastructure in sub-Saharan Africa to conduct clinical trials for the identification of efficient and effective new prevention, diagnostic and treatment modalities to address the disproportionate burden of disease. This paper reports on the process to establish locally driven infrastructure for multicentre research and trials in Nigeria known as the Nigeria Implementation Science Alliance Model Innovation and Resea…
Using the Exploration-Preparation-Implementation-Sustainment (Epis) Framework to prepare for the implementation of evidence-based practices into adolescent HIV settings
Enacting competition, capacity, and collaboration: Performing neoliberalism in the U.S. in the era of evidence-based interventions
Funders increasingly encourage social and health service organizations to strengthen their impact on public health through the implementation of evidence-based interventions (EBIs). Local governments in the U.S. often utilize market-based contracting to facilitate EBI delivery via formal relationships with non-governmental community-based organizations (CBOs). We sought to understand how the discourses embedded within contracting to compete and p…
Caregiver strain among biological, foster, and adoptive caregivers caring for youth receiving outpatient care in a public mental health system
Individual level predictors of implementation climate in child welfare services
Child welfare services (CWS) are characterized by having demanding work environments, large diversity in client needs, and limited use of evidence-based practices (EBPs). Thus, CWSs can benefit from quality improvement strategies. Accumulating evidence suggests that an organization’s strategic climate towards implementation of change and EBPs (i.e., Implementation Climate [IC]) is a critical determinant for quality improvement, such as implementa…
Toward the data-driven dissemination of findings from psychological science
The public health impact of psychological science is maximized when it is disseminated clearly and compellingly to audiences who can act on it. Dissemination research can generate knowledge to help achieve this, but dissemination is understudied in the field of implementation science. As a consequence, the designs of dissemination strategies are typically driven by anecdote, not evidence, and are often ineffective. We address this issue by synthe…
Systematic review of the Exploration, Preparation, Implementation, Sustainment (Epis) framework
Let’s talk about adaptation! How individuals discuss adaptation during evidence-based practice implementation
Purpose Researchers suggest that adaptation should be a planned process, with practitioners actively consulting with program developers or academic partners, but few studies have examined how adaptation unfolds during evidence-based practice (EBP) implementation. The purpose of this paper is to describe real-world adaptation discussions and the conditions under which they occurred during the implementation of a new practice across multiple county…
Evidence-based practice adaptation during large-scale implementation: A taxonomy of process and content adaptations
Purpose The purpose of this paper is twofold: first, to identify the types of adaptations made by service providers (i.e. practitioners) during a large-scale US statewide implementation of SafeCare®, an evidence-based intervention to reduce child neglect; and second, to place adaptations within a taxonomy of types of adaptations. Design/methodology/approach Semi-structured interviews and focus groups were conducted with 138 SafeCare providers and…
The Influence of Transformational Leadership and Leader Attitudes on Subordinate Attitudes and Implementation Success
Recent literature has focused on identifying factors that facilitate or impede the implementation of innovation in organizations. Attitudes toward change and transformational leadership are regarded as important determinants of implementation success. This study tested a multilevel model of transformational leadership and leaders’ attitudes toward the innovation being implemented as predictors of staff attitudes and implementation success. Partic…
Predicting Turnover: The Moderating Effect of Functional Climates on Emotional Exhaustion and Work Attitudes
A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (Epis) framework in the design and measurement of a large scale collaborative multi-site study
BACKGROUND: This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agenc…
The good coach: Implementation and sustainment factors that affect coaching as evidence-based intervention fidelity support
This paper demonstrates that coaching can accomplish more than provision of EBI fidelity support. Stakeholders characterized coaches as operating as boundary spanners who link inner and outer contexts to enable EBI implementation and sustainment
Methods to Improve the Selection and Tailoring of Implementation Strategies
“Scaling-out” evidence-based interventions to new populations or new health care delivery systems
BACKGROUND: Implementing treatments and interventions with demonstrated effectiveness is critical for improving patient health outcomes at a reduced cost. When an evidence-based intervention (EBI) is implemented with fidelity in a setting that is very similar to the setting wherein it was previously found to be effective, it is reasonable to anticipate similar benefits of that EBI. However, one goal of implementation science is to expand the use …
Implementation-effectiveness trial of an ecological intervention for physical activity in ethnically diverse low income senior centers
ClinicalTrials.gov, USA ( NCT02405325 ). Date of registration, March 20, 2015. This website also contains all items from the World Health Organization Trial Registration Data Set
Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis
Objectives. We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Methods. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, …
Cultural Exchange and the Implementation of Evidence-Based Practices: Two Case Studies
Objective: The dynamics of interactions between evidence-based intervention (EBI) developers and trainers and organizations and providers that deliver the EBI was examined in two case studies, a statewide randomized effectiveness trial of an EBI to reduce child neglect and a randomized trial of EBIs for depression, anxiety, and conduct problems in children and adolescents. Methods: Data were collected using ethnographic methods of participant obs…
Transformational Leadership Moderates the Relationship Between Emotional Exhaustion and Turnover Intention Among Community Mental Health Providers
The Influence of Transformational Leadership and Leader Attitudes on Subordinate Attitudes and Implementation Success
Recent literature has focused on identifying factors that facilitate or impede the implementation of innovation in organizations. Attitudes toward change and transformational leadership are regarded as important determinants of implementation success. This study tested a multilevel model of transformational leadership and leaders’ attitudes toward the innovation being implemented as predictors of staff attitudes and implementation success. Partic…
Measuring Use of Research Evidence: The Structured Interview for Evidence Use
The SIEU is easy to use and can be administered as a complete scale or as three smaller scales to separately examine evidence in acquisition, evaluation, or application. The measure demonstrates potential in understanding the role of research evidence in service settings and in monitoring the process of evidence-based practice and application of scientific principles in social work practice
Leadership, Organizational Climate, and Working Alliance in a Children’s Mental Health Service System
Caregiver strain among biological, foster, and adoptive caregivers caring for youth receiving outpatient care in a public mental health system
The Role of Leadership in Organizational Implementation and Sustainment in Service Agencies
Implementation is posited as a multiphasic process, influenced by a range of factors, within a multilevel context. While there appears to be a general consensus that every implementation initiative will have a unique combination of influences that vary in importance across the implementation phases, leadership is an essential tenant throughout implementation frameworks, models, and theories. The exploration, preparation, implementation, sustainme…
Research-Supported Intervention and Discretion Among Frontline Workers Implementing Home Visitation Services
Workers dynamically negotiated multiple system- and provider-level (or outer- and inner-contextual) demands influencing RSI provision for clients with complex service needs. Results affirm the need to attend to the unintended consequences of implementing new contract, reimbursement, and other system organizational processes and to address the "committed work" supporting RSI delivery
Adaptation happens: A qualitative case study of implementation of The Incredible Years evidence‐based parent training programme in a residential substance abuse treatment programme
Purpose – Evidence‐based practices (EBPs) are increasingly being implemented in real‐world settings. While intervention effectiveness is dependent on fidelity, interventions are often adapted to service settings according to the needs of stakeholders at multiple levels. This study aims to examine the naturalistic implementation of The Incredible Years (IY) parenting programme in a residential substance abuse treatment programme for pregnant and p…
Measuring collaboration and communication to increase implementation of evidence-based practices: The cultural exchange inventory
The Cultural Exchange Inventory (CEI) is a 15-item instrument designed to measure the process (7 items) and outcomes (8 items) of exchanges of knowledge, attitudes and practices between members of different organisations collaborating in implementing evidence-based practice. We conducted principal axis factor analyses and parallel analyses of data describing exchanges with intermediary organisations, treatment developers, other agencies in the sa…
Cultural adaptation of an evidence-based home visitation programme: Latino clients’ experiences of service delivery during implementation
Purpose – The purpose of this paper is to examine the experiences of Latino clients following a naturalistic cultural adaptation made to SafeCare, an evidence-based home visiting intervention designed to address specific linguistic and cultural issues affecting the Latino community during implementation in San Diego County, California. Design/methodology/approach – Hierarchical linear models examined whether Latino clients experienced differences…
Interagency Collaborative Team model for capacity building to scale-up evidence-based practice
Predicting Turnover: The Moderating Effect of Functional Climates on Emotional Exhaustion and Work Attitudes
Mental Health Recovery in the Patient-Centered Medical Home
Objectives. We examined the impact of transitioning clients from a mental health clinic to a patient-centered medical home (PCMH) on mental health recovery. Methods. We drew data from a large US County Behavioral Health Services administrative data set. We used propensity score analysis and multilevel modeling to assess the impact of the PCMH on mental health recovery by comparing PCMH participants (n = 215) to clients receiving service as usual …
Longitudinal Patterns of Health Insurance Coverage Among a National Sample of Children in the Child Welfare System
Objectives. We sought to describe health insurance coverage over time among a national sample of children who came into contact with child welfare or child protective services agencies. Methods. We used data from 4 waves of the National Survey of Child and Adolescent Well-Being to examine insurance coverage among 2501 youths. Longitudinal insurance trajectories were identified using latent class analyses, a technique used to classify individuals …
Individual level predictors of implementation climate in child welfare services
Child welfare services (CWS) are characterized by having demanding work environments, large diversity in client needs, and limited use of evidence-based practices (EBPs). Thus, CWSs can benefit from quality improvement strategies. Accumulating evidence suggests that an organization’s strategic climate towards implementation of change and EBPs (i.e., Implementation Climate [IC]) is a critical determinant for quality improvement, such as implementa…
Toward the data-driven dissemination of findings from psychological science
The public health impact of psychological science is maximized when it is disseminated clearly and compellingly to audiences who can act on it. Dissemination research can generate knowledge to help achieve this, but dissemination is understudied in the field of implementation science. As a consequence, the designs of dissemination strategies are typically driven by anecdote, not evidence, and are often ineffective. We address this issue by synthe…
Let’s talk about adaptation! How individuals discuss adaptation during evidence-based practice implementation
Purpose Researchers suggest that adaptation should be a planned process, with practitioners actively consulting with program developers or academic partners, but few studies have examined how adaptation unfolds during evidence-based practice (EBP) implementation. The purpose of this paper is to describe real-world adaptation discussions and the conditions under which they occurred during the implementation of a new practice across multiple county…
Evidence-based practice adaptation during large-scale implementation: A taxonomy of process and content adaptations
Purpose The purpose of this paper is twofold: first, to identify the types of adaptations made by service providers (i.e. practitioners) during a large-scale US statewide implementation of SafeCare®, an evidence-based intervention to reduce child neglect; and second, to place adaptations within a taxonomy of types of adaptations. Design/methodology/approach Semi-structured interviews and focus groups were conducted with 138 SafeCare providers and…
The good coach: Implementation and sustainment factors that affect coaching as evidence-based intervention fidelity support
This paper demonstrates that coaching can accomplish more than provision of EBI fidelity support. Stakeholders characterized coaches as operating as boundary spanners who link inner and outer contexts to enable EBI implementation and sustainment
Prevalence of Psychiatric Disorders in Youths Across Five Sectors of Care
Adolescent substance use and sexual risk-taking behavior
Mental Health Provider Attitudes Toward Adoption of Evidence-Based Practice: The Evidence-Based Practice Attitude Scale (Ebpas)
Race and Ethnic Differences in Attempts to Cut Down or Quit Substance Use in a High School Sample
Much attention has been given to the initiation and progression of substance involvement of youth. Less is known about decrements in substance use and cessation efforts among adolescents from diverse race/ethnic backgrounds. The present study examined substance use and attempts to reduce or quit substance use among adolescents from three race/ethnic groups. Participants were 3,756 Asian-American, Latino, and White high-school students surveyed re…
Race/Ethnic Disparity and Correlates of Substance Abuse Service Utilization and Juvenile Justice Involvement Among Adolescents with Substance Use Disorders
This study examines correlates of level of specialty alcohol/drug services care and juvenile justice system involvement for adolescents with substance use disorders. Participants were 420 adolescents 13-18 years of age randomly sampled from all youths active in at least one of five youth sectors of care in San Diego County, California. Adolescents were assessed using structured diagnostic interviews including the Diagnostic Interview Schedule for…
Ethnie Variation in the Prevalence of Substance Use Disorders in Youth Sectors of Care
Objective: Examine ethnic variation in the prevalence of substance use disorders (SUDs) among adolescents who received services in one or more public sectors of care including: Alcohol and Drug, Juvenile Justice, Mental Health, Public School-based services for youths with serious emotional disturbance, and Child Welfare, in relation to age, gender, and service sector affiliation. Methods: Participants included 936 adolescents 13-18 years of age r…
Organizational culture and climate and mental health provider attitudes toward evidence-based practice.
Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49…
Implementation of Evidence-based Practice in Child Welfare: Service Provider Perspectives
Enhancing Organizational Change and Improvement Prospects: Lessons from an HIV Testing Intervention for Veterans
Most research on why health care quality improvement implementation succeeds or fails focuses on front-line or provider-based factors. However, background factors related to the structures and processes of projects themselves also pose challenges. Using a focused ethnographic assessment approach, we undertook a case study to characterize particularly challenging background factors in an ongoing implementation effort. We found that the organizatio…
Direct and Indirect Links Between Childhood Maltreatment, Posttraumatic Stress Disorder, and Women's Health
The authors evaluated the relationships among childhood maltreatment, sexual trauma in adulthood, posttraumatic stress disorder (PTSD), and health functioning in women. Female Veterans' Affairs (VA) primary care patients (N = 200) completed self-report measures of childhood maltreatment, adult sexual trauma, PTSD symptoms, and current health functioning. The authors used structural equation modeling to test models of the relationship among these …
Longitudinal Patterns of Health Insurance Coverage Among a National Sample of Children in the Child Welfare System
Objectives. We sought to describe health insurance coverage over time among a national sample of children who came into contact with child welfare or child protective services agencies. Methods. We used data from 4 waves of the National Survey of Child and Adolescent Well-Being to examine insurance coverage among 2501 youths. Longitudinal insurance trajectories were identified using latent class analyses, a technique used to classify individuals …
Substance involvement among youths in child welfare: The role of common and unique risk factors
This study examines risk factors for substance involvement for youths involved with the child welfare (CW) system. In addition to common risk factors examined in general population studies; this research examines risk factors unique to youths in the CW system, including age at entry into CW and number of out-of-home placements. Participants included 214 youths ages 13 to 18, randomly sampled from youths active to CW in San Diego County, Californi…
Implementation Research in Mental Health Services: An Emerging Science with Conceptual, Methodological, and Training challenges
The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: Evidence for a protective effect.
Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff retention in a children's services system. The study took place in the context of a statewide, regional…
Cultural Exchange and the Implementation of Evidence-Based Practices: Two Case Studies
Objective: The dynamics of interactions between evidence-based intervention (EBI) developers and trainers and organizations and providers that deliver the EBI was examined in two case studies, a statewide randomized effectiveness trial of an EBI to reduce child neglect and a randomized trial of EBIs for depression, anxiety, and conduct problems in children and adolescents. Methods: Data were collected using ethnographic methods of participant obs…
Effects of Placement Changes on Health Insurance Stability Among a National Sample of Children in the Child Welfare System
Children in the child welfare system have entitlements to health insurance coverage—critical because of their considerable physical and mental health needs—based largely on their placement status. This study conducted path and transitions analyses on data from the National Survey of Child and Adolescent Well-Being (3,801 children followed-up for 3 years) to examine the interplay between placement changes and insurance stability. Children maintain…
Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis
Objectives. We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Methods. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, …
Mixed Method Designs in Implementation Research
This paper describes the application of mixed method designs in implementation research in 22 mental health services research studies published in peer-reviewed journals over the last 5 years. Our analyses revealed 7 different structural arrangements of qualitative and quantitative methods, 5 different functions of mixed methods, and 3 different ways of linking quantitative and qualitative data together. Complexity of design was associated with n…
Smoking Behavior of US Youths: A Comparison Between Child Welfare System and Community Populations
Objectives. We compared rates of smoking for 2 groups of youths aged 12 to 14 years: those involved in the child welfare system (CW) and their counterparts in the community population. We then investigated factors associated with smoking for each group. Methods. We drew data from 2 national-level US sources: the National Survey of Child and Adolescent Well-Being and the National Longitudinal Study of Adolescent Health. We estimated logistic regre…
Transformational Leadership Moderates the Relationship Between Emotional Exhaustion and Turnover Intention Among Community Mental Health Providers
Dynamic adaptation process to implement an evidence-based child maltreatment intervention
BACKGROUND: Adaptations are often made to evidence-based practices (EBPs) by systems, organizations, and/or service providers in the implementation process. The degree to which core elements of an EBP can be maintained while allowing for local adaptation is unclear. In addition, adaptations may also be needed at the system, policy, or organizational levels to facilitate EBP implementation and sustainment. This paper describes a study of the feasi…
Adaptation happens: A qualitative case study of implementation of The Incredible Years evidence‐based parent training programme in a residential substance abuse treatment programme
Purpose – Evidence‐based practices (EBPs) are increasingly being implemented in real‐world settings. While intervention effectiveness is dependent on fidelity, interventions are often adapted to service settings according to the needs of stakeholders at multiple levels. This study aims to examine the naturalistic implementation of The Incredible Years (IY) parenting programme in a residential substance abuse treatment programme for pregnant and p…
Leadership, Organizational Climate, and Working Alliance in a Children’s Mental Health Service System
The implementation leadership scale (ILS): Development of a brief measure of unit level implementation leadership
BACKGROUND: In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation…
Cultural adaptation of an evidence-based home visitation programme: Latino clients’ experiences of service delivery during implementation
Purpose – The purpose of this paper is to examine the experiences of Latino clients following a naturalistic cultural adaptation made to SafeCare, an evidence-based home visiting intervention designed to address specific linguistic and cultural issues affecting the Latino community during implementation in San Diego County, California. Design/methodology/approach – Hierarchical linear models examined whether Latino clients experienced differences…
Medicine (43 works) · Psychology (43 works) · Health Policy Implementation Science (33 works) · Psychiatry (24 works) · Computer Science (23 works) · Nursing (23 works) · Political science (22 works) · Mental health (19 works) · Clinical Psychology (18 works) · Business (16 works)