Advancing implementation frameworks with a mixed methods case study in child behavioral health
| Autor: | Lindsay M. Akrong, Tim Godden, Sabine N Johnson, Charles E. Cunningham, Raluca Barac, Graham Ashbourne, Melissa Kimber, Kathryn Bennett, Melanie Barwick |
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| Rok vydání: | 2019 |
| Předmět: |
Adolescent
Process (engineering) media_common.quotation_subject Applied psychology Motivational interviewing Fidelity Context (language use) AcademicSubjects/SCI02170 Consolidated Framework for Implementation Research External validity 03 medical and health sciences Behavioral Neuroscience 0302 clinical medicine Child behavioral health Humans AcademicSubjects/MED00860 0501 psychology and cognitive sciences AcademicSubjects/MED00760 030212 general & internal medicine Child Applied Psychology Original Research media_common 05 social sciences Child Health Active Implementation Frameworks Focus group Mental health 3. Good health Mental Health Research Design 13. Climate action Implementation science Implementation research Psychology 050104 developmental & child psychology |
| Zdroj: | Translational Behavioral Medicine |
| ISSN: | 1613-9860 1869-6716 |
| DOI: | 10.1093/tbm/ibz005 |
| Popis: | Despite a growing policy push for the provision of services based on evidence, evidence-based treatments for children and youth with mental health challenges have poor uptake, yielding limited benefit. With a view to improving implementation in child behavioral health, we investigated a complementary implementation approach informed by three implementation frameworks in the context of implementing motivational interviewing in four child and youth behavioral health agencies: the Active Implementation Frameworks (AIF) (process), the Consolidated Framework for Implementation Research (factors), and the Implementation Outcomes Framework (evaluation). The study design was mixed methods with embedded interrupted time series and motivational interviewing (MI) fidelity was the primary outcome. Focus groups and field notes informed perspectives on the implementation approach, and a questionnaire explored the salience of Consolidated Framework for Implementation Research (CFIR) factors. Findings validate the process guidance provided by the AIF and highlight CIFR factors related to implementation success. Novel CFIR factors, not elsewhere reported in the literature, are identified that could potentially extend the framework if validated in future research. Introducing fidelity measurement in practice proved challenging and was not sustained beyond the study. A complementary implementation approach was successful in implementing MI in child behavioral health agencies. In contrast with the typical train and hope approach to implementation, practice change did not occur immediately post-training but emerged over a 7 month period of consultation and practice following a discrete interactive training period. The saliency of CFIR constructs aligned with findings from studies conducted in other contexts, demonstrating external validity and highlighting common factors that can focus planning and measurement. A complementary implementation approach was successful in implementing MI in child behavioral health agencies over a 7-month consultation and practice period. New factors for the Consolidated Framework for Implementation Research are proposed. |
| Databáze: | OpenAIRE |
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