Using the Exploration-Preparation-Implementation-Sustainment (EPIS) Framework to prepare for the implementation of evidence-based practices into adolescent HIV settings

• Published in: AIDS and behavior Vol. 26; no. 12; pp. 4093 - 4106
• Main Authors: Carcone, April Idalski, Coyle, Karin, Butame, Seyram, Harper, Gary W., Aarons, Gregory A., Naar, Sylvie
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2022; Springer Nature B.V
• Subjects: Adolescent; Adolescents; Adult; Disease prevention; Evidence-Based Practice; Health Psychology; Health risks; HIV; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Infectious Diseases; Interviews; Medicine; Medicine & Public Health; Motivation; Motivational Interviewing; Original Paper; Pediatrics; Prevention; Public Health; Strategic planning; Teenagers; Young Adult; Youth; EPIS framework; Evidence-based practices; Implementation science; Adolescent
• ISSN: 1090-7165; 1573-3254; 1573-3254
• DOI: 10.1007/s10461-022-03735-0

Despite advances in evidence-based practices (EBP) to support HIV prevention and treatment, youth ages 13–24 experience significant disparities in HIV risk and outcomes. An important factor in this disparity is poor EBP implementation, yet implementation research is limited, particularly in youth-serving settings. This study used the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to guide the implementation of four Motivational Interviewing (MI) and MI-framed interventions into youth-serving HIV prevention and treatment settings. Key stakeholders (n = 153) across 13 sites completed pre-implementation interviews. Stakeholders’ comments identified two critical factors for effective implementation: fit with the patient population and provider receptivity, including concerns about scope of practice, buy-in, and time. Stakeholders recommended strategies for structuring training, fidelity monitoring, and facilitating implementation including engaging informal leaders, collaboratively developing the implementation strategy, and site-wide implementation. Results highlight the importance of pre-implementation contextual assessment and strategic planning for identifying provider concerns and developing responsive implementation strategies.