Use of Human-Centered Design to Improve Implementation of Evidence-Based Psychotherapies in Low-Resource Communities: Protocol for Studies Applying a Framework to Assess Usability
Use of Human-Centered Design to Improve Implementation of Evidence-Based Psychotherapies in Low-Resource Communities: Protocol for Studies Applying a Framework to Assess Usability
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DOI：
10.2196/14990
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发表时间：
2019-10-01
影响因子：
1.7
通讯作者：
Arean, Patricia A.
中科院分区：
文献类型：
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作者：
Lyon, Aaron R.;Munson, Sean A.;Arean, Patricia A.
背景：本文介绍了由美国国家精神卫生研究所（NIMH）资助的华盛顿大学ALACRITY（加速青少年和成人精神疾病治疗范围和影响的先进实验室）中心（UWAC）的方案，该中心使用以人为本的设计（HCD）方法来改进循证心理社会干预（ebpi）的实施。我们提出可用性——干预措施和实施策略可以轻松、高效、有效和满意地使用的程度——是实施的基本决定因素，但人们对其知之甚少。目的：我们提出了一个新的发现、设计/构建和测试（DDBT）框架来研究可用性作为实现决定因素。DDBT将应用于整个中心项目，以开发可扩展和有效的实施策略（例如，培训工具），修改现有的ebpi以增强可用性，并为ebpi的高质量交付创建可用且无负担的决策支持工具。方法：利益相关者参与者将是资源不足社区非专业精神卫生机构的实施从业人员/中介、精神卫生临床医生和精神疾病患者。三个预先计划的项目和12个试点研究将采用DDBT模型来(1)确定在资源不足的环境中实施ebpi的可用性挑战；(2)迭代设计解决方案以克服这些挑战；(3)将解决方案与原始版本的EPBI或实施策略在可用性、护理质量和患者报告结果方面进行比较。该中心的最终产品将是一个精简的修改和重新设计的模型，它将提高EBPI的可用性和实施策略（例如，支持EBPI教育和决策的工具）；修改目标（即可用性问题）的矩阵，这些目标对ebpi、策略、设置和患者群体来说既常见又独特；以及重新设计策略的汇编，以及与原始EBPI或策略相比，重新设计的解决方案的相对有效性。结果：UWAC于2018年3月获得了机构审查委员会对这三项独立研究的批准，并于2018年5月获得资助。结论：本中心的结果将通过识别影响这些干预措施的使用和可接受性的EBPI的交叉特征和实施策略，积极让利益相关者临床医生和实施从业人员参与EBPI修改或实施策略解决方案的设计，并确定hcd知情的修改和解决方案对干预效果和质量的影响，为EBPI的实施提供信息。
Background: This paper presents the protocol for the National Institute of Mental Health (NIMH)-funded University of Washington's ALACRITY (Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness) Center (UWAC), which uses human-centered design (HCD) methods to improve the implementation of evidence-based psychosocial interventions (EBPIs). We propose that usability-the degree to which interventions and implementation strategies can be used with ease, efficiency, effectiveness, and satisfaction-is a fundamental, yet poorly understood determinant of implementation.Objective: We present a novel Discover, Design/Build, and Test (DDBT) framework to study usability as an implementation determinant. DDBT will be applied across Center projects to develop scalable and efficient implementation strategies (eg, training tools), modify existing EBPIs to enhance usability, and create usable and nonburdensome decision support tools for quality delivery of EBPIs.Methods: Stakeholder participants will be implementation practitioners/intermediaries, mental health clinicians, and patients with mental illness in nonspecialty mental health settings in underresourced communities. Three preplanned projects and 12 pilot studies will employ the DDBT model to (1) identify usability challenges in implementing EBPIs in underresourced settings; (2) iteratively design solutions to overcome these challenges; and (3) compare the solution to the original version of the EPBI or implementation strategy on usability, quality of care, and patient-reported outcomes. The final products from the center will be a streamlined modification and redesign model that will improve the usability of EBPIs and implementation strategies (eg, tools to support EBPI education and decision making); a matrix of modification targets (ie, usability issues) that are both common and unique to EBPIs, strategies, settings, and patient populations; and a compilation of redesign strategies and the relative effectiveness of the redesigned solution compared to the original EBPI or strategy.Results: The UWAC received institutional review board approval for the three separate studies in March 2018 and was funded in May 2018.Conclusions: The outcomes from this center will inform the implementation of EBPIs by identifying cross-cutting features of EBPIs and implementation strategies that influence the use and acceptability of these interventions, actively involving stakeholder clinicians and implementation practitioners in the design of the EBPI modification or implementation strategy solution and identifying the impact of HCD-informed modifications and solutions on intervention effectiveness and quality.