Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis
Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis
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DOI：
10.2105/ajph.2009.161711
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发表时间：
2009-11-01
影响因子：
12.7
通讯作者：
Palinkas, Lawrence A.
中科院分区：
文献类型：
--
作者：
Aarons, Gregory A.;Wells, Rebecca S.;Palinkas, Lawrence A.
目标。我们试图找出被认为促进或阻碍公共心理健康服务系统中基于证据的实践（EBP）实施的因素，作为开发在未来研究中测试的理论的一个步骤。方法。我们关注整个大型公共部门青少年心理健康服务系统的各个层面，吸引了来自 6 个利益相关群体的参与者：县官员、机构主管、项目经理、临床工作人员、行政人员和消费者。 结果。参与者生成了 105 份独特的陈述，确定了实施障碍和促进因素。参与者对每个陈述的重要性和可改变性进行评分（即每个障碍或促进因素被认为可改变的程度）。数据分析将陈述提炼为 14 个因素或维度。描述性分析表明，不同利益相关者群体对重要性和可变性的看法各不相同。结论。 EBP的实施是一个复杂的过程。需要跨系统级别的方法来揭示不同和趋同的观点。例如，机构和项目主管通过支持员工来促进 EBP 的实施，积极与政策制定者和管理人员分享有关 EBP 有效性的信息并满足客户的需求和偏好，以及帮助临床医生展示和提供 EBP 并解决消费者的担忧。 （美国公共卫生杂志。2009；99：2087-2095。doi：10.2105/AJPH.2009.161711）
Objectives. We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies.Methods. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers.Results. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups.Conclusions. Implementation of EBP is a complex process. Cross-system-level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns. (Am J Public Health. 2009;99:2087-2095. doi:10.2105/AJPH.2009.161711)