What is the Sustainability of a Biobehavioural Intervention Implemented by Therapists & Sustainment in Community Settings?

Research Paper Title

Sustainability of a biobehavioral intervention implemented by therapists and sustainment in community settings.


The ultimate aim of dissemination and implementation of empirically supported treatments (ESTs) in behavioural medicine is:

  • Sustainability of the therapist/provider’s EST usage; and
  • Sustainment of EST delivery in the setting.

Thus far, sustainability has been understudied, and the therapist and setting variables that may be influential are unclear.

The purpose of the study was to test the therapists’ sustainability of a cancer-specific EST using a prospective longitudinal design and examine its predictors.


Oncology mental health therapists (N = 134) from diverse settings (N = 110) completed training in the biobehavioural intervention (BBI) and were provided with 6 months of support for implementation, with no support thereafter. BBI usage (percent of patients treated) was reported at 2, 4, 6, and 12 months.

Using a generalised estimating equation with a logistic link function, 12-month sustainability (a non-significant change in usage from 6 to 12 months) was studied along with therapist, supervisor, and setting variables as predictors.


BBI usage increased through 6 months and, importantly, usage was sustained from 6 (68.4% [95% CI = 62.2%-73.9%]) to 12 months (70.9% [95% CI = 63.6%-77.3%]), with sustainment in 66 settings (60.0%).

Predictors of implementation-to-sustainability usage were therapists’ early intentions to use the BBI (p < .001) and from the setting, supervisors’ positive attitudes toward ESTs (p = .016).


Adding to the DI literature, a health psychology intervention was disseminated, implemented, and found sustainable across diverse therapists and settings.

Therapists and setting predictors of usage, if modified, might facilitate future sustainability/sustainment of ESTs.


Ryba, M.M., Lo, S.B. & Andersen, B.L. (2019) Sustainability of a biobehavioral intervention implemented by therapists and sustainment in community settings. Translational Behavioral Medicine. pii: ibz175. doi: 10.1093/tbm/ibz175. [Epub ahead of print].

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