A Digital Feedback System to Support Implementation of Measurement-Based Care by School-Based Mental Health Clinicians.
A Digital Feedback System to Support Implementation of Measurement-Based Care by School-Based Mental Health Clinicians.
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支持学校心理健康临床医生实施基于测量的护理的数字反馈系统。
DOI：
10.1080/15374416.2017.1280808
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
McCauley,Elizabeth
中科院分区：
文献类型：
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作者：
Lyon,AaronR;Pullmann,MichaelD;Whitaker,Kelly;Ludwig,Kristy;Wasse,JessicaKnaster;McCauley,Elizabeth
证据支持测量为基础的护理（MBC）的效用，以改善青年心理健康的结果，但临床医生很少从事MBC的做法。数字测量反馈系统（MFS）可以反映支持MBC采用和维持的可行策略。这项试点研究的目的是评估MFS和简短咨询支持的影响，以促进教育部门心理健康临床医生的MBC吸收和维持，这是青年最常见的心理健康服务提供环境。在MBC的初步培训后，14名临床医生被随机分配到数字MFS和简短的咨询支持或对照组。收集MBC态度、技能和使用的基线评分。此外，每日评估评级跟踪了MBC的2个核心做法（即，评估工具管理、提供反馈）。在MFS条件下的临床医生表现出两种MBC实践的快速增加，而对照组没有显着变化。对于MFS组的临床医生来说，咨询效果对于反馈来说很重要，对于管理来说也很重要。在随访期间，本研究中的平均降低为中度，2个结局变量中仅1个（给药）显著降低。对个体临床医生轨迹的检查显示组内趋势变化显著。MFS可能是一种有效的MBC实施策略，超出了最初的培训，虽然个别临床医生的反应是可变的。鉴于MBC支持精准医疗的能力，确定可行且有效的实施策略至关重要。
Evidence supports the utility of measurement-based care (MBC) to improve youth mental health outcomes, but clinicians rarely engage in MBC practices. Digital measurement feedback systems (MFS) may reflect a feasible strategy to support MBC adoption and sustainment. This pilot study was initiated to evaluate the impact of a MFS and brief consultation supports to facilitate MBC uptake and sustainment among mental health clinicians in the education sector, the most common mental health service delivery setting for youth. Following an initial training in MBC, 14 clinicians were randomized to either a digital MFS and brief consultation supports or control. Baseline ratings of MBC attitudes, skill, and use were collected. In addition, daily assessment ratings tracked 2 core MBC practices (i.e., assessment tool administration, provision of feedback) over a 6-month follow-up period. Clinicians in the MFS condition demonstrated rapid increases in both MBC practices, whereas the control group did not significantly change. For clinicians in the MFS group, consultation effects were significant for feedback and approached significance for administration. Over the follow-up period, average decreases in the current study were moderate with only 1 of the 2 outcome variables (administration) decreasing significantly. Inspection of individual clinician trajectories revealed substantial within-group trend variation. MFS may represent an effective MBC implementation strategy beyond initial training, although individual clinician response is variable. Identifying feasible and impactful implementation strategies is critical given the ability of MBC to support precision health care.