System-Level Influences on the Sustainability of a Cognitive Therapy Program in a Community Behavioral Health Network.
System-Level Influences on the Sustainability of a Cognitive Therapy Program in a Community Behavioral Health Network.
复制标题
系统级对社区行为健康网络中认知治疗计划可持续性的影响。
DOI：
10.1176/appi.ps.201400147
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Creed,Torrey
中科院分区：
文献类型：
--
作者：
Stirman,ShannonWiltsey;Matza,Alexis;Gamarra,Jennifer;Toder,Katherine;Xhezo,Regina;Evans,ArthurC;Hurford,Matthew;Beck,AaronT;Crits-Christoph,Paul;Creed,Torrey
本研究的目的是检查对一个计划的可持续性的影响，以实施循证心理治疗在精神卫生system.MethodsInterviews与计划管理员，培训顾问，机构管理员，和主管（N=24），沿着计划评估数据和计划文件的摘要，与直接内容分析法进行了分析。ResultsFindings建议了一些相互关联和相互作用的影响可持续性，包括与新出现的社会政治影响以及系统和组织优先事项保持一致;方案一级的适应和演变;干预的灵活性;强有力的沟通、协作、规划和支持;以及预期的效益。这些个别因素似乎相互影响，并有助于在系统一级实现的程序的可持续性的程度。虽然大多数的影响是积极的，财务规划和支持出现潜在的促进者和障碍，并在病人层面的利益评估仍然是一个挑战.ConclusionsSeveral因素似乎有助于在一个大型城市心理健康系统的心理社会干预的可持续性，值得进一步调查。了解多个单独的促进者和障碍之间的相互联系似乎是至关重要的，以促进对动态系统中可持续性的理解，并增加了新的建议，为其他实施工作。特别是，调查结果的影响包括实施战略的重要性，如长期规划，联盟建设，澄清作用和期望，有计划的适应，评估，融资战略的多样化，以及激励实施。
ObjectiveThe purpose of this study was to examine influences on the sustainability of a program to implement an evidence-based psychotherapy in a mental health system.MethodsInterviews with program administrators, training consultants, agency administrators, and supervisors (N=24), along with summaries of program evaluation data and program documentation, were analyzed with a directed content-analytic approach.ResultsFindings suggested a number of interconnected and interacting influences on sustainability, including alignment with emerging sociopolitical influences and system and organizational priorities; program-level adaptation and evolution; intervention flexibility; strong communication, collaboration, planning, and support; and perceived benefit. These individual factors appeared to mutually influence one another and contribute to the degree of program sustainability achieved at the system level. Although most influences were positive, financial planning and support emerged as potentially both facilitator and barrier, and evaluation of benefits at the patient level remained a challenge.ConclusionsSeveral factors appeared to contribute to the sustainability of a psychosocial intervention in a large urban mental health system and warrant further investigation. Understanding interconnections between multiple individual facilitators and barriers appears critical to advancing understanding of sustainability in dynamic systems and adds to emerging recommendations for other implementation efforts. In particular, implications of the findings include the importance of implementation strategies, such as long-term planning, coalition building, clarifying roles and expectations, planned adaptation, evaluation, diversification of financing strategies, and incentivizing implementation.