Harnessing the Single-Session Intervention approach to promote scalable implementation of evidence-based practices in healthcare

Abstract

Effective implementation of evidence-based practices often involves multi-level strategies targeting individual-, organizational-, and system-level determinants of change. Although these multi-level implementation approaches can successfully facilitate EBP uptake, they tend to be complex and resource intensive. Accordingly, there is a need for theory-driven, generalizable approaches that can enhance efficiency, cost-effectiveness, and scalability of existing implementation approaches. We propose the Single-Session Intervention approach as an unexplored path to developing low-cost and scalable implementation strategies, especially those targeting individual-level behavior change. We argue that single-session strategies (S3) for implementation, which can simultaneously target myriad barriers to individual behavior change, may promote clinicians' EBP uptake and sustainment in a manner that is low-resource and scalable. We first overview the evidence-base supporting the Single-Session Intervention approach for patient-level outcomes; situate this approach within the implementation science literature by outlining its intersections with a leading framework, the Theoretical Domains Framework (TDF), as an exemplar; and illustrate how the TDF might directly inform the design and evaluation of single-session strategies for EBP implementation. Overall, single-session strategies (S3) for implementation reflect a promising but yet-to-be-tested means of streamlining and scaling individual-level behavior change efforts in healthcare settings. Future partnered research is needed to gauge the potential of this approach across diverse clinical and community contexts.

Keywords: Single-Session Intervention; Theoretical Domains Framework; behavior change; implementation science; implementation strategy.

Conflict of interest statement

JS serves on the Scientific Advisory Board for Walden Wise and the Clinical Advisory Board for Koko, is Co-Founder and Co-Director of Single Session Support Solutions. Inc., and receives book royalties from New Harbinger, Oxford University Press, and Little Brown Book Group. RB is principal at Implementation Science & Practice, LLC, she receives royalties from Oxford University Press, consulting fees from United Behavioral Health and OptumLabs, and serves on the advisory boards for Optum Behavioral Health, AIM Youth Mental Health Foundation, and the Klingenstein Third Generation Foundation outside of the submitted work. In addition to the above potential conflicts, the authors would like to note that JS leads a research lab whose mission involves designing, evaluating, and disseminating single-session mental health interventions, including those discussed in the present manuscript.

Copyright © 2022 Schleider and Beidas.

Figures

Figure 1

Conceptual model illustrating how Single-Session Interventions (targeting patient-level outcomes) and single-session strategies (targeting clinician EBP implementation) may shape distal outcomes of interest (patient health; clinician EBP use) by proximally shaping shared determinants to individual-level behavior change. Notably, mechanisms theorized to underlie the effects of SSI and S3 are shared, but S3 may be evaluated as a means of improving uptake of any EBP, including and beyond SSIs.