Prompt dependence can be a serious problem for individuals diagnosed with autism spectrum disorder or intellectual disabilities. The ability to perform skills independently is important for a high-quality life and assimilation in the community among many other things. Assessments of instructional strategies may be an effective tool for identifying instructional strategies that decrease one’s reliance on prompts. An alternating treatment design was used to evaluate the effectiveness of an assessment of instructional strategies on independent responses during auditory-visual discrimination tasks. Assessment conditions included positional prompt, gestural prompt, physical prompt, and identity matching to sample. The most effective instructional strategy was identified as the strategy that corresponded to quickest acquisition of independent responses. Results of the assessment demonstrated differences in individual learning patterns for each of the 3 participants. However, the differences observed in the assessment among instructional strategies were not significant. Implications of these results do suggest to educators that conducting an assessment of instructional strategies may be a useful strategy for identifying differences in learning patterns. Limitations and directions for future research are also discussed.

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Indiana University-Purdue University Indianapolis (IUPUI) / More than 20 million people in the United States have a substance use disorder, resulting in negative individual and societal outcomes. An evidence-based intervention, Screening, Brief Intervention, and Referral to Treatment (SBIRT), involves screening patients to assess for substance use and then providing a brief intervention and referral to treatment when indicated. This evidence-based intervention is underutilized in healthcare settings. The purpose of this dissertation was to contribute to the body of evidence regarding the implementation of SBIRT in healthcare settings. Specifically, the aims of this dissertation were to 1) provide an overview of the evidence regarding the use of implementation strategies to facilitate the implementation of SBIRT, 2) describe implementation of SBIRT by nurses in acute care hospitals, and 3) examine individual and organizational characteristics associated with the intra-organizational adoption of SBIRT. To review the literature, a scoping review was completed on 18 articles that met the inclusion criteria. The review found that leaders often train and educate stakeholders to facilitate the implementation of SBIRT, but less attention has been given to adapting the intervention or engaging patients. Additionally, implementation efforts led to increases in screening, but the evidence regarding the effect on brief intervention is inconclusive, and evidence regarding referral to treatment is scarce. Eighteen nurses participated in a qualitative descriptive study of the implementation of SBIRT, and data were analyzed using content analysis. Participants identified barriers and facilitators associated with the nurses’ attitudes and beliefs about SBIRT, organizational factors, and patients’ response to the SBIRT process. Participants indicated that SBIRT was a useful intervention that was best implemented by providing a clear process and incorporating SBIRT into an established workflow. To examine factors related to intra-organizational adoption of a tool to screen patients for substance use, two hundred twenty-two nurses participated in a crosssectional study. Results of this study indicate that training and the perception of peer usage of the intervention were significantly related to individual nurses’ use of the intervention in practice. The findings of this dissertation can inform research and practice regarding the implementation of SBIRT in healthcare settings.

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Abstract  Aim: The aim of this study was to evaluate the effects of the structured implementation of screening and diagnostics of orofacial pain and jaw function in the affiliated general dentistry clinics of FTV VGR. Furthermore, evaluate differences in treatment between patients with and without a dental care subscription.   Material and method: Data regarding TMD treatments (600-series treatments) performed every month were gathered from the affiliated clinics over a 24-month timespan stretching between 2019-2021. Each treatment code was divided into three categories, all patients, patients with dental care subscription and patients without a dental care subscription. Parametrical statistics were used to assess the change of each treatment code performed before compared to after the implementation of Brief DC/TMD. The student's paired t-test was used and a probability level of P<0.05 was considered significant.    Results: The proportion of patients that received treatments and number of treatments performed saw a significant increase after the implementation project. Each specific treatment within the 600-series increased except for 604 (soft occlusalt splint) and 607 (occlusal adjustment) which decreased. Among the three treatments that increased, two were significant: 601, hard acrylic maxillary occlusal splint and 606, jaw exercises. Patients with a dental care subscription received TMD-treatment in a significantly higher degree.    Conclusion: The present study indicates that the implementation of Brief DC/TMD increased diagnostics and treatment of TMD within the general dentistry practice of Folktandvården Västra Götaland during the analysed time periods. Further research is needed to determine the cause behind the performance disparities among the individual clinics. / Sammanfattning Syfte: Att utvärdera effekten av en strukturerad implementation av screening och diagnostik av orofacial smärta och käkfunktion inom Folktandvården Västra Götalands tandvårdskliniker. Samt jämföra patienter med och utan Frisktandvård. Material och metod: Data gällande behandling av bettfysiologiska besvär (600-serie åtgärdskoder) samt undersökningar utförda varje månad var samlade från de 118 anslutna klinikerna under en 24-månadersperiod som varade mellan 2019–2021. Varje parameter delades upp i tre kategorier, alla patienter, patienter med Frisktandvård och patienter utan Frisktandvård. Parametrisk statistik användes för att bedöma förändringarna som utfördes före jämfört med efter implementationen av kort DC/TMD. Students parade t-test användes för att beräkna signifikansen av de observerade förändringarna där ett P-värde <0,05 ansågs signifikant. Resultat: Andelen patienter som fick behandling och antalet utförda behandlingar som en helhet såg en signifikant ökning efter implementationsprojektet i jämförelse med före (procentuell skillnad på 46,8% respektive, 56,5%). Varje enskild behandling inom 600-serien såg en ökning, förutom kod 604 (mjukplastskena) och 607 (bettslipning för ocklusal stabilisering) vilket minskade. Bland de tre behandlingarna som såg en ökning, var två signifikanta: 601 (Bettskena i hård akrylat i överkäken, utförd på bettfysiologisk indikation) samt 606, (motorisk aktivering). Patienter med Frisktandvård fick behandling mot sina bettfysiologiska besvär i en signifikant högre grad. Slutsats: Denna studie indikerar att implementation av kort DC/TMD ökade diagnostik och behandling av TMD inom Folktandvården Västra Götaland under de analyserade tidsperioderna. Vidare forskning behövs för att utvärdera orsaken bakom prestationsskillnaderna mellan de individuella klinikerna.

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This study examined the utility of a pilot "call-in service" coordinated with two rural pediatric primary care clinics. This service provided practical, empirically supported recommendations to parents with concerns about their children's development, behavior, or emotional well-being. Over 70 weeks, 81 calls were received. Five specific concerns including daytime wetting, conduct problems, anxiety, sleep, and repetitive behavior comprised 75% of all calls. In addition to describing the service overall, the current article examined the top concerns in terms of their process and outcomes in this brief intervention format. Overall, calls averaged 21 min, and parents reported high satisfaction and positive outcomes at follow-up. This format appeared to be most useful for calls regarding daytime wetting and repetitive behaviors/habits. The utility of a call-in service has not been recently explored. Moreover, specific pediatric problems amenable to brief intervention in primary care have rarely been researched. This study provides direction for the future use of call-in services or brief interventions in primary care. (PsycINFO Database Record (c) 2012 APA, all rights reserved)