Sustainment of Multiple EBP's Fiscally Mandated in Children's MH Services

维持儿童 MH 服务中的多项 EBP 财政授权

• 批准号: 8632885
• 负责人: LAUREN BROOKMAN-FRAZEE
• 金额: $ 78.29万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8632885
• 关键词: Address; Adherence; Adoption; Affect; Attitude; Characteristics; Child; Child Mental Health; Climate; Communities; Community Mental Health Services; Community Services; Consultations; Contracts; County; Data; Development; Early Intervention; Evidence based practice; Health system; Intervention; Investments; Leadership; Los Angeles; Measurement; Measures; Mental Health; Methods; Metric; Modeling; Organizational Policy; Outcome; Penetration; Phase; Policies; Positioning Attribute; Preparation; Prevention; Provider; Public Health; Relative (related person); Research; Role; Services; System; Testing; Time; Time Study; Training; United States; Work; child mental health service; flexibility; improved; innovation; interest; intervention program; multilevel analysis; primary outcome; public health relevance; routine practice; success; tool

DESCRIPTION (provided by applicant): Evidence-based practices (EBPs) are increasingly being implemented in large community mental health systems. Much of the research to date has focused on policy, organizational and practitioner variables that predict adoption and initial implementation of EBPs, yet understanding sustainment is crucial to facilitate a return on costly investments in EBP development. Furthermore, most studies focus on the implementation of a single EBP, limiting opportunities to examine theoretically important predictors of implementation success concerning fit between EBPs and the contexts in which they are utilized. The proposed study will examine the impact of a major policy change mandating use of EBPs and organizational context, organizational accommodation, and practitioner attitudes and adaptations as determinants of EBP sustainment in the largest public mental health system in the United States. Our primary outcomes of interest are two aspects of sustainment: practitioner-level penetration and agency and practitioner structural and intervention fidelity to EBP models. Specific aims are as follows: (1) Characterize sustainment outcomes (Penetration, Fidelity); (2) Use mixed methods to characterize inner context factors and early implementation conditions that potentially predict EBP sustainment; (3) Identify inner context (organizational and practitioner) and early implementation conditions that determine sustainment outcomes. This project will yield new understanding of whether and how multiple EBPs can be sustained in public mental health systems undergoing a policy-driven community implementation effort. We will produce generalizable models for characterizing sustainment, including feasible and flexible measurement of fidelity across multiple EBPs. The findings will inform the development of implementation interventions to promote sustained delivery of EBPs to maximize their public health impact.

描述（由申请人提供）：循证实践（EBP）越来越多地在大型社区心理健康系统中实施。迄今为止，大部分研究都集中在预测 EBP 的采用和初步实施的政策、组织和从业者变量上，但了解维持性对于促进 EBP 开发的昂贵投资获得回报至关重要。此外，大多数研究都集中在单个 EBP 的实施上，限制了检验理论上重要的实施成功预测因素（涉及 EBP 与其使用环境之间的契合度）的机会。拟议的研究将研究一项重大政策变化的影响，该政策变化要求使用 EBP 和组织环境、组织适应以及从业者的态度和适应，作为美国最大的公共心理健康系统中 EBP 维持的决定因素。我们感兴趣的主要结果是维持的两个方面：从业者层面的渗透以及机构和从业者对 EBP 模型的结构和干预保真度。具体目标如下： (1) 描述维持结果（渗透、保真度）； (2) 使用混合方法来表征可能预测 EBP 维持的内部背景因素和早期实施条件； (3) 识别内部背景（组织和 实践者）和决定维持结果的早期实施条件。该项目将对公共精神卫生系统在政策驱动的社区实施工作中是否以及如何维持多个 EBP 产生新的认识。我们将生成用于表征维持的通用模型，包括跨多个 EBP 的保真度的可行且灵活的测量。研究结果将为制定实施干预措施提供信息，以促进 EBP 的持续交付，从而最大限度地发挥其公共卫生影响。