Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA.

Autor: Connors EH; Department of Psychiatry, Yale University, 389 Whitney Avenue, Office 106, New Haven, CT, 06511, USA. elizabeth.connors@yale.edu., Lyon AR; Department of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA, 98115, USA., Garcia K; Department of Psychiatry, Yale University, 389 Whitney Avenue, Office 106, New Haven, CT, 06511, USA.; Department of Psychology, University of South Carolina, 1512 Pendelton Street, Columbia, SC, 29208, USA., Sichel CE; Department of Psychiatry, Yale University, 389 Whitney Avenue, Office 106, New Haven, CT, 06511, USA.; Division of Child/Adolescent Psychiatry, Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA., Hoover S; Department of Psychiatry, University of Maryland, 737 West Lombard Street, 4th Floor, Baltimore, MD, 21201, USA., Weist MD; Department of Psychology, University of South Carolina, 1512 Pendelton Street, Columbia, SC, 29208, USA., Tebes JK; Department of Psychiatry, Yale University, 389 Whitney Avenue, Office 106, New Haven, CT, 06511, USA.
Jazyk: angličtina
Zdroj: Implementation science communications [Implement Sci Commun] 2022 Jun 21; Vol. 3 (1), pp. 67. Date of Electronic Publication: 2022 Jun 21.
DOI: 10.1186/s43058-022-00319-w
Abstrakt: Background: Despite an established taxonomy of implementation strategies, minimal guidance exists for how to select and tailor strategies to specific practices and contexts. We employed a replicable method to obtain stakeholder perceptions of the most feasible and important implementation strategies to increase mental health providers' use of measurement-based care (MBC) in schools. MBC is the routine use of patient-reported progress measures throughout treatment to inform patient-centered, data-driven treatment adjustments.
Methods: A national sample of 52 school mental health providers and researchers completed two rounds of modified Delphi surveys to rate the relevance, importance, and feasibility of 33 implementation strategies identified for school settings. Strategies were reduced and definitions refined using a multimethod approach. Final importance and feasibility ratings were plotted on "go-zone" graphs and compared across providers and researchers to identify top-rated strategies.
Results: The initial 33 strategies were rated as "relevant" or "relevant with changes" to MBC in schools. Importance and feasibility ratings were high overall for both survey rounds; on a scale of 1 to 5, importance ratings (3.61-4.48) were higher than feasibility ratings (2.55-4.06) on average. Survey 1 responses resulted in a reduced, refined set of 21 strategies, and six were rated most important and feasible on Survey 2: (1) assess for readiness and identify barriers and facilitators; (2) identify and prepare champions; (3) develop a usable implementation plan; (4) offer a provider-informed menu of free, brief measures; (5) develop and provide access to training materials; and (6) make implementation easier by removing burdensome documentation tasks. Provider and researcher ratings were not significantly different, with a few exceptions: providers reported higher feasibility and importance of removing burdensome paperwork than researchers, providers reported higher feasibility of train-the trainer approaches than researchers, and researchers reported higher importance of monitoring fidelity than providers.
Conclusions: The education sector is the most common setting for child and adolescent mental health service delivery in the USA. Effective MBC implementation in schools has the potential to elevate the quality of care received by many children, adolescents, and their families. This empirically derived, targeted list of six implementation strategies offers potential efficiencies for future testing of MBC implementation in schools.
(© 2022. The Author(s).)
Databáze: MEDLINE
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