Prospective predictors of sustainment of multiple EBPs in a system-driven implementation context: Examining sustained delivery based on administrative claims.

Autor:	Lau AS; Department of Psychology, University of California, Los Angeles, CA, USA., Lind T; Department of Child and Family Development, San Diego State University, San Diego, CA, USA.; Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA., Motamedi M; Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA.; Department of Psychiatry, University of California, La Jolla, CA, USA., Lui JHL; Department of Psychology, University of Maryland, College Park, MD, USA., Kuckertz M; Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA.; Department of Psychiatry, University of California, La Jolla, CA, USA., Innes-Gomberg D; Los Angeles County Department of Mental Health, Los Angeles, CA, USA., Pesanti K; Los Angeles County Department of Mental Health, Los Angeles, CA, USA., Brookman-Frazee L; Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA.; Department of Psychiatry, University of California, La Jolla, CA, USA.
Jazyk:	angličtina
Zdroj:	Implementation research and practice [Implement Res Pract] 2021 Dec 23; Vol. 2, pp. 26334895211057884. Date of Electronic Publication: 2021 Dec 23 (Print Publication: 2021).
DOI:	10.1177/26334895211057884
Abstrakt:	Background: System-driven scale-up of multiple evidence-based practices (EBPs) is an increasingly common method used in public mental health to improve care. However, there are little data on the long-term sustained delivery of EBPs within these efforts, and previous studies have relied on retrospective self-report within cross-sectional studies. This study identified prospective predictors of sustained EBP delivery at the EBP-, therapist-, and organizational-levels using survey and administrative claims data within a large-scale system-driven implementation effort. Methods: 777 therapists and 162 program leaders delivering at least one of six EBPs of interest completed surveys assessing perceptions of EBPs and organizational context. These surveys were linked to administrative data to examine prospective predictors of therapists' EBP delivery over 33 months. Results: Five of the six EBPs implemented showed sustained delivery in the system, with volume varying by EBP. Although total EBP claim volume per therapist decreased over time, the volume ratio (ratio of EBP-specific claims to total EBP and non-EBP claims) stayed relatively stable. Multilevel models revealed that EBPs that required consultation, had unstructured content, higher therapist self-efficacy with the EBP, and more positive program leader perceptions of the EBP were associated with greater sustained volume and volume ratio of the EBP. Therapists who were trained in fewer EBPs, who were unlicensed, and who worked in agencies rated by program leaders as lower on organizational staff autonomy and stress showed greater sustained EBP volume and volume ratio. Finally, more direct service hours per week provided by therapist predicted greater sustained EBP volume, but lower volume ratio. Conclusions: The results point to the importance of EBP, therapist, and organizational factors that may be targeted in implementation strategies to promote the sustainment of EBPs. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2021.)
Databáze:	MEDLINE
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