Protocol for a quasi-experimental, 950 county study examining implementation outcomes and mechanisms of Stepping Up, a national policy effort to improve mental health and substance use services for justice-involved individuals.
Protocol for a quasi-experimental, 950 county study examining implementation outcomes and mechanisms of Stepping Up, a national policy effort to improve mental health and substance use services for justice-involved individuals.
复制标题
DOI：
10.1186/s13012-021-01095-2
复制
发表时间：
2021-03-29
期刊：
影响因子：
--
通讯作者：
Taxman FS
中科院分区：
文献类型：
--
作者：
Johnson JE;Viglione J;Ramezani N;Cuellar AE;Hailemariam M;Rosen R;Breno A;Taxman FS
刑事司法系统是美国最大的心理健康服务提供者。许多司法管辖区对减少司法系统对精神健康问题的使用感兴趣。国家加强行动计划帮助各县内的机构更有效地合作，减少监狱中精神病患者的人数，并改善社区获得精神卫生服务的机会。本研究将比较逐步加强县与匹配的比较县，以（1）检查逐步加强的有效性，（2）测试假设的实施机制，以更广泛地为多机构实施工作提供信息。该研究将在基线、18个月和36个月时对950个县进行调查，比较475个加强县和475个匹配的比较县之间的实施机制和结果。调查将发送给每个县最多四名受访者，包括监狱管理员，缓刑，社区精神卫生服务和社区物质使用治疗服务（3800名受访者）。我们将研究加强县是否在实施结果方面表现出更快的改善（接受行为健康服务的涉及司法的客户数量，可用于涉及司法的个人的行为健康循证实践和政策[EBPP]的数量，以及涉及司法的个人的行为健康EBPP资源）比匹配的比较县。我们还将评估假设机制的参与是否解释了实施结果的差异。执行目标机制包括（1）业绩监测的使用和能力，（2）机构间小组的使用和运作，（3）机构间的共同目标和使命，以及（4）系统整合（即，建立一个综合的护理系统，而不是增加一个方案或培训）。最后，我们将使用调查响应和定性访谈来描述实施过程和关键事件。很少有严格的，前瞻性的研究，检查实施机制及其与行为健康的实施结果在司法和相关的社区行为健康设置的关系。对具有多个目标的系统之间的实施机制的理解也很有限。本研究将描述“加强行动”的实施成果，并将阐明在多目标、多机构系统中有效的目标机制。在线版本包含补充材料，可通过10.1186/s13012-021-01095-2获得。
The criminal justice system is the largest provider of mental health services in the USA. Many jurisdictions are interested in reducing the use of the justice system for mental health problems. The national Stepping Up Initiative helps agencies within counties work together more effectively to reduce the number of individuals with mental illness in jails and to improve access to mental health services in the community. This study will compare Stepping Up counties to matched comparison counties over time to (1) examine the effectiveness of Stepping Up and (2) test hypothesized implementation mechanisms to inform multi-agency implementation efforts more broadly. The study will survey 950 counties at baseline, 18 months, and 36 months in a quasi-experimental design comparing implementation mechanisms and outcomes between 475 Stepping Up counties and 475 matched comparison counties. Surveys will be sent to up to four respondents per county including administrators of jail, probation, community mental health services, and community substance use treatment services (3800 total respondents). We will examine whether Stepping Up counties show faster improvements in implementation outcomes (number of justice-involved clients receiving behavioral health services, number of behavioral health evidence-based practices and policies [EBPPs] available to justice-involved individuals, and resources for behavioral health EBPP for justice-involved individuals) than do matched comparison counties. We will also evaluate whether engagement of hypothesized mechanisms explains differences in implementation outcomes. Implementation target mechanisms include (1) use of and capacity for performance monitoring, (2) use and functioning of interagency teams, (3) common goals and mission across agencies, and (4) system integration (i.e., building an integrated system of care rather than adding one program or training). Finally, we will characterize implementation processes and critical incidents using survey responses and qualitative interviews. There are few rigorous, prospective studies examining implementation mechanisms and their relationship with behavioral health implementation outcomes in justice and associated community behavioral health settings. There is also limited understanding of implementation mechanisms that occur across systems with multiple goals. This study will describe implementation outcomes of Stepping Up and will elucidate target mechanisms that are effective in multi-goal, multi-agency systems. The online version contains supplementary material available at 10.1186/s13012-021-01095-2.
登录
查看更多内容
影响因子：
2.3
作者：
Browne, A;Miller, B;Maguin, E
通讯作者：
Maguin, E
影响因子：
7.2
作者：
Cook, Joan M.;O'Donnell, Casey;Schnurr, Paula P.
通讯作者：
Schnurr, Paula P.
DOI：
10.1097/phh.0b013e318205413c
发表时间：
2011-09-01
影响因子：
3.3
作者：
Kanarek, Norma;Tsai, Hua-Ling;Stanley, Jennifer
通讯作者：
Stanley, Jennifer
影响因子：
3.3
作者：
Fickenscher, A;Lapidus, J;Becker, T
通讯作者：
Becker, T
影响因子：
4
作者：
Gale NK;Heath G;Cameron E;Rashid S;Redwood S
通讯作者：
Redwood S