Widespread clinical implementation of the teen online problem-solving program: Progress, barriers, and lessons learned.
Shari L Wade, Kathleen Walsh, Beth S Slomine and 16 others
PMID 36824180WHAT IT FOUND
Implementing the Teen Online Problem Solving program across 15 hospitals reached 381 patients, falling short of enrollment targets.
Therapist-guided delivery saw much higher completion rates than self-guided online modules, while speech-language pathologists were successfully trained to deliver the intervention.
Key findings
01A total of 381 patients were enrolled over 26 months, with enrollment rates varying substantially across sites and falling short of the projected two patients per site per month.
02Adherence differed sharply by delivery mode: 53% of families in therapist-guided treatment completed at least five sessions, compared to only 5% in the self-guided online program.
03While 307 providers were trained, only 66 delivered the program, including 13 speech-language pathologists who were integrated into the workforce after training materials were adapted for their scope.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a quality improvement initiative, not a controlled trial, so it cannot determine if the program improved patient outcomes compared to usual care. Enrollment data is incomplete because patient screening procedures varied across sites, making it difficult to know how many eligible patients were simply not referred. The study took place during the COVID-19 pandemic, which disrupted clinics and created unique barriers to both in-person and telehealth engagement that may not reflect typical practice. Attrition was high in the self-guided arm, but the reasons for non-engagement were not systematically tracked for all families.
Declared interests
The research was funded by the Patient-Centered Outcomes Research Institute (PCORI) and the State of Ohio. No commercial conflicts of interest were reported.
The easy way to misread this
Do not interpret the low enrollment numbers as evidence that families reject this type of intervention. The paper identifies significant systemic barriers, such as fragmented follow-up care and lack of screening workflows, which likely prevented eligible patients from ever being offered the program.