News Center for Dissemination & Implementation

From evidence-based practice to improvements in patient care – A D&I Spotlight on Byron J. Powell

Byron J. Powell

Byron Powell never intended to become an academic. He wanted to become a high school social worker and a basketball coach, and to have the opportunity to support the growth and development of young people and their families. In preparation, he earned an MA from the School of Social Service Administration at the University of Chicago and he spent a few years working in group home and residential care settings. Byron quickly gained an appreciation for the ways in which organizations can influence the quality of care delivered to children and youth. He also realized just how hard it is, even for well-functioning organizations, to integrate new therapies and other effective practices that might improve care. This motivated him to pursue a career as a researcher who identifies more effective ways of integrating evidence-based practices across service settings, which is the focus of the field of implementation science.

Byron looked nationally to see who was doing this work, and it was clear that Enola Proctor (previous director of the Center for Dissemination and Implementation) and her colleagues were at the top of the list. “It was obvious that Enola and her colleagues were leaders in the field of implementation science,” says Powell. “I was also impressed by their commitment to improving the quality of mental health services.” Byron spent 5 years at the Brown School working toward a PhD in Social Work under the direction of Proctor, after which he obtained further experience related to implementation science through a postdoctoral fellowship at the University of Pennsylvania and through his work as an Assistant Professor of Health Policy and Management at the UNC Gillings School of Global Public Health (he remains an Adjunct Assistant Professor and avid Tar Heel fan). He was invited back to become Assistant Professor at the Brown School in the summer of 2019, and currently co-directs the Center for Mental Health Services Research.

While Byron never became a coach, he is applying some of those same skills to support systems, organizations, and clinicians to implement evidence-based practices that ultimately will lead to improvements in care for children, youth, and families. His work involves collaborative efforts with interdisciplinary colleagues locally and internationally to advance the methods of implementation science and find ways to move effective practices into routine care. They have done so by systematically identifying barriers to implementing evidence-based practices, and by identifying specific strategies that can be used to overcome those barriers.

He is currently working to develop and apply methods for tailoring implementation strategies to address organization-specific barriers to implementing and scaling-up evidence-based interventions in Vietnam and North Carolina.

The project in North Carolina is funded by the National Institute of Mental Health through a career development award, and involves a close partnership with the North Carolina Child Treatment Program and the National Child Traumatic Stress Network, two groups that are doing excellent work to promote the dissemination and implementation of evidence-based interventions (such as Trauma-Focused Cognitive Behavioral Therapy or TF-CBT) for children and youth who experience trauma-related emotional or behavioral difficulties. “Much like other interventions,” Powell says, “It’s sometimes difficult to get TF-CBT implemented, scaled-up, and sustained in community settings due to barriers at the patient, clinician, organizational, and system levels.”

His team has developed and is currently piloting an intervention that involves collaborating closely with organizations that are implementing TF-CBT to assess barriers to implementing the intervention and then develop a tailored implementation plan to address those barriers. Organizations often vary tremendously with respect to their overall level of experience implementing evidence-based interventions; attitudes, knowledge, and skill of their clinicians; leaders’ ability to understand the demands of implementing new treatments and support and reward their use; organizational structure (e.g., some community mental health organizations have sites that are geographically dispersed) and context (e.g., organizational culture and climate); and their policy and financial context (e.g., some organizations are reimbursed at different rates for delivering evidence-based treatments like TF-CBT). “We believe that organizations all have unique strengths and challenges, and that a ‘one-size fits all’ approach to implementation is likely to be ineffective. Using implementation strategies that are well-matched to each organization is key,” suggests Powell. “We hope this line of research will result in more systematic ways of delivering organizational support, here and across the globe.”

In addition to his research and scholarship, Byron is active in national and international service. He has served as faculty for numerous training institutes including the Implementation Research Institute, Training Institute for Dissemination and Implementation Research in Health (TIDIRH), TIDIRH-Ireland, TIDIRH-Australia, and the Knowledge Translation Canada Summer Institute. He also serves on the editorial boards of Implementation Science and Implementation Research and Practice. He has recently been elected as President of the Society for Implementation Research Collaboration, an international professional society dedicated to promoting innovative and rigorous research; nurturing partnerships between diverse stakeholders across practice, policy, and research contexts; and supporting individuals and teams at every career stage to persist in the difficult work of improving quality of care. Many members of the Washington University in St. Louis community are actively engaged in SIRC. “I am humbled to have the opportunity to serve as SIRC President, as I consider it my professional home and have been actively involved from its inception in 2011,” Powell says. “SIRC’s priorities are highly consistent with my personal and professional value. I am excited to collaborate with a fabulous team of SIRC officers to advance the mission of SIRC, invite and involve an increasingly diverse community, and extend our collective impact internationally.”

Byron J. Powell, PhD, LCSW, is an assistant professor at the Brown School; co-director of the Center for Mental Health Services Research; a faculty scholar at the Institute for Public Health; and president of the Society for Implementation Research Collaboration (SIRC)