Depression affects millions of people all over the world and implies a great socioeconomic burden. Despite there are different effective evidence-based interventions for treating depression, only a small proportion of these patients receives an appropriate treatment. In this regard, information and communication technologies (ICTs) can be used with therapeutic aims and this can contribute to make interventions more accessible. One example is “Smiling is fun”, an internet-based treatment which has proved to be effective and cost-effective for treating depression in Spanish Primary Care (PC). However, the “know-do gap” between research and clinical settings implies that the actual implementation of such interventions could last up to 20 years. To overcome this obstacle, the implementation research establishes the methodology to implement the advances developed in the laboratories to the health care services maintaining the validity of the intervention and offering specific strategies for the implementation process. This is the protocol of an implementation study for the Internet-based program “Smiling is fun”, which will be conducted on patients with mild-to-moderate depression of Spanish PC settings. In the implementation study, the feasibility, efficacy, cost-efficacy, acceptability, adoption, appropriateness, fidelity, penetration, normalization, and sustainability will be assessed. The current investigation is a Hybrid Effectiveness-Implementation Type II design. A Stepped Wedge randomized controlled trial design will be used, with a cohort of 420 adults diagnosed with depression (mild-to-moderate) who will undergo a first control phase (no treatment) followed by the intervention, which will last 16 weeks, and finishing with an optional use of the intervention. All patients will be assessed at baseline, during the treatment, and at post-treatment. The study will be conducted in three Spanish regions: Andalusia, Aragon, and the Balearic Islands. Two primary care centers of each region will participate, one located in the urban setting and the other in the rural setting. The primary outcome will be implementation success of the intervention assessing the reach, clinical effect, acceptability, appropriateness, adoption, feasibility, fidelity, penetration, implementation costs and sustainability services. “Smiling is Fun”, which has already been established as effective and cost-effective, will be adapted according to users' experiences and opinions, and the efficacy and cost-efficacy of the program will again be assessed. The study will point out barriers and facilitators to consider in the implementation process of internet-based psychological interventions in health services. The ultimate goal is to break the research-to-practice split, which would undoubtedly contribute to reduce the high burden of depression in our society. ClinicalTrials.gov, Identifier: NCT05294614.

Depression is already the leading psychological disability around the world, impairing daily life, well-being, and social functioning and leading to personal and social costs. Despite the effectiveness of Evidence-Based Psychological Practices (EBPP), a significant percentage of depressive individuals remain untreated, especially in Primary Care (PC) settings in Spain. There are numerous barriers that limit access to EBPPs, including high costs, professional training, and adherence problems. Information and Communication Technologies (ICTs) offer a cost-effective way to disseminate and scale EBPPs to address these barriers. The iCBT program Smiling is Fun has been demonstrated to be a cost-effective treatment for depression in various Randomized Control Trials. However, adherence and implementation problems in real-world settings need to be addressed. Implementation research can help evaluate these challenges by identifying facilitators and barriers to the implementation process in PC. In this regard, including human support has been pointed out as a possible key factor in addressing the population's mental health needs and promoting treatment adherence. The current study aims to examine the effectiveness, adherence rates, and implementation process of Smiling is Fun to address depression in a PC setting considering the influence of telephone support vs no support. The proposed research is a Hybrid Effectiveness-Implementation Type I study, with a two-armed randomized controlled design, which will test a clinical intervention for major depressive disorder while gathering information on its implementation in a real-world setting. The study will include adult patients with mild to moderate symptoms of depression. Participants will be randomly assigned to one of two groups: self-applied psychotherapy or self-applied psychotherapy with psychotherapeutic telephone support. The trial will recruit 110 patient participants, with a loss-to-follow-up rate of 30 %. A study protocol for a hybrid effectiveness-implementation study is presented with the aim to assess the implementation of Smiling is Fun for the treatment of depression in PC. The study evaluates the influence of telephone support during a self-administered intervention compared to unguided self-administration. The main goal is to address the barriers and facilitators of the implementation process and to promote treatment adherence. Ultimately, the results of the study could help in the uptake of sustainable resources so that the population could gain better access to psychological interventions in mental health services. ClinicalTrials.gov; NCT06230237.

Traditional research in mental health often involves a delay between the research advancements and their practical application, making it difficult to access evidence-based psychological practices (EBPP). Hybrid studies bridge the gap between mental health research and practice by integrating effectiveness and implementation research. This paper illustrates lessons learned from three hybrid designs promoting EBPP: The choice of hybrid study was influenced by contextual demands and available resources, with urgency sometimes leading to the selection of Hybrid type III studies. Hybrid designs enrich outcomes by considering various agents and contextual factors, with frameworks aiding in the understanding of complex processes and promoting equity. Hybrid studies offer flexible designs to address multiple research questions, facilitating early barrier detection and implementation success. Challenges such as funding disparities and recruitment difficulties persist. Registration: Hybrid type I: NCT06230237; https://clinicaltrials.gov/study/NCT06230237 (registration date: 2024, January 18) Hybrid type II: NCT05294614; https://clinicaltrials.gov/study/NCT05294614 (registration date: 2022, March 23) Hybrid type III: NCT06297460; https://clinicaltrials.gov/study/NCT06297460 (registration date: 2024, March 6) Spanish http://links.lww.com/IJEBH/A570

Background: The depressed population needs to be treated and they do not have access to evidenced-based psychological practices (EBPPs). The consequences lead to significant daily impairments and huge economical costs. A large amount of research has focused on the demand for a more extensive use of EBPPs. However, despite these practices being essential to the mental health system, EBPPs are poorly applied in clinical settings. This situation has led to the development of Implementation Research (IR), a scientific field that aims to address the challenge of translation and identify the factors involved in the implementation process. Several implementation studies have been carried out in the field of health. However, the evidence from implementation studies of psychological treatments addressing depression has not yet been summarized. The aim of this study is to conduct a systematic review to assess implementation studies that use EBPPs to address depression. Methods: A systematic review was conducted following the PRISMA guidelines, including implementation studies that applied EBPPs to address depressive disorders. The following databases were used: PubMed, Embase, APA PsycInfo, Cochrane Central, Scopus, and Web of Science. Two independent reviewers revised the studies to determine whether the eligibility criteria were met. Results: A total of 8797 studies were identified through database searches. After removing duplicates, a total of 3757 studies were screened based on titles and abstracts. Finally, 127 full-text articles were reviewed, yielding 31 studies that satisfied the inclusion criteria. Conclusions: This review offers valuable insights into the current state of IR in the implementation of EBPPs for treating depressive disorders. It underlines the necessity for a standardized nomenclature for study designs within the realm of IR and emphasizes the potential of hybrid efficacy–implementation studies to help close the gap between research and clinical practice. Despite the challenges encountered, this review points to a positive outlook for the use of IR in clinical psychology. A gradual adoption of IR is likely to strengthen its role in psychology and support the development of more effective strategies for implementing evidence-based interventions in clinical settings.

Obsessive‐compulsive disorder (OCD) is characterized by its symptomatology heterogeneity, which poses challenges for its assessment and treatment. Ecological momentary assessment (EMA) has been proposed as a promising method for gathering information and may offer advantages over retrospective methods. The present study aims to conduct a systematic review of the use of EMA in OCD, examining the main variables assessed, methodological considerations, and the advantages of EMA compared with retrospective measures to assess OCD. The systematic search was conducted using databases including Scopus, Pubmed, Web of Science, PsycNET, and Cochrane Library. Of the identified studies, 28 met the inclusion criteria. These studies focused on the assessment of obsessions, compulsions, experiential avoidance, and sleep, with compulsions being the most studied variable. The studies reveal diverse EMA methods, with traditional paper recordings and smartphones differing in frequency and duration of the records. Some studies reported that EMA may serve as a valid and sensitive tool for detecting changes in OCD and overcome some limitations of retrospective assessments. Despite the potential of EMA, their validity is still questionable, and their application during intervention processes is limited, particularly given the heterogeneity of the available evidence and the limited application of EMA during intervention processes. Further research is essential to enhance their integration in clinical settings.