Sustainment of Trauma-Focused and Evidence-Based Practices Following Learning Collaborative Implementation
Sustainment of Trauma-Focused and Evidence-Based Practices Following Learning Collaborative Implementation
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DOI：
10.1007/s10488-020-01024-3
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发表时间：
2020-02-24
影响因子：
2.6
通讯作者：
Hanson, Rochelle F.
中科院分区：
文献类型：
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作者：
Helseth, Sarah A.;Peer, Samuel O.;Hanson, Rochelle F.
考虑到需要开发和验证有效的实施模式，从而实现可持续的改进，我们前瞻性地研究了在全州范围内以社区为基础的学习合作（CBLCs）促进以创伤为重点的循证实践（ebp）期间和之后的态度、行为和感知组织支持的变化。来自10个cblc的参与者（N = 857，即492名临床医生，218名经纪人和139名高级领导）在cblc之前和之后完成了调查；一个子样本（n = 146）在cblc后大约两年完成了随访调查。结果表明(a)临床报告中以创伤为重点的ebp使用中，持续增加；(b)对创伤为重点的ebp的感知组织支持中，持续增加；(c)对ebp的感知组织支持从小到小，持续增加。相比之下，临床医生报告的对ebp的总体态度在cblc前到cblc后下降到一个微不足道的程度，但在cblc后到随访期间增加到一个小的，具有统计学意义的程度。值得注意的是，对普通和创伤型ebp的组织支持的感知改善程度因专业角色而异。研究结果表明，CBLC实施策略可以增加和维持供应商实践和组织对ebp的支持，特别是那些CBLC明确针对的ebp。
Given the need to develop and validate effective implementation models that lead to sustainable improvements, we prospectively examined changes in attitudes, behaviors, and perceived organizational support during and after statewide Community-Based Learning Collaboratives (CBLCs) promoting trauma-focused evidence-based practices (EBPs). Participants (N = 857; i.e., 492 clinicians, 218 brokers, and 139 senior leaders) from 10 CBLCs completed surveys pre- and post-CBLC; a subsample (n = 146) completed a follow-up survey approximately two years post-CBLC. Results indicated (a) medium, sustained increases in clinician-reported use of trauma-focused EBPs, (b) medium to large, sustained increases in perceived organizational support for trauma-focused EBPs, and (c) trivial to small, sustained increases in perceived organizational support for EBPs broadly. In contrast, clinician-reported overall attitudes towards EBPs decreased to a trivial degree pre- to post-CBLC, but then increased to a small, statistically significant degree from post-CBLC to follow-up. Notably, the degree of perceived improvements in organizational support for general and trauma-focused EBPs varied by professional role. Findings suggest the CBLC implementation strategies may both increase and sustain provider practices and organizational support towards EBPs, particularly those EBPs a CBLC explicitly targets.