A policy implementation study of earmarked taxes for mental health services: study protocol.
A policy implementation study of earmarked taxes for mental health services: study protocol.
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DOI：
10.1186/s43058-023-00408-4
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发表时间：
2023-03-31
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资金不足常常被认为是实施和维持循证做法的关键障碍。因此，增加获得资金的机会被认为是一项执行战略。创建专用税的政策--定义为收入只能用于特定活动的税收--是一种越来越常见的心理健康融资战略，可以扩大EBP的覆盖范围。该项目的具体目标是(1)确定美国所有已为精神健康实施专项税收的司法管辖区，并编目有关税收设计的信息；(2)描述地方(例如县、市)心理健康机构领导人以及其他政府和社区组织官员实施专项税收的经验，并评估他们对不同类型政策实施战略的可接受性和可行性的看法；以及(3)制定一个框架，以指导有效的专项税收设计，为实施战略的选择提供信息，并向政策受众传播该框架。该项目使用探索、准备、实施和可持续(EPIS)框架来收集关于税收实施的决定因素和过程的数据，并使用Leeman的实施战略类型学来审查可以支持专用税收政策实施的可接受性和可行性战略。将进行法律测绘，以实现目标1。为实现目标2，将对300名地方精神卫生机构领导人以及参与实施精神卫生专项税的其他政府和社区组织官员进行调查。调查结束后，将对这些官员进行约50次访谈。为实现目标3，将通过一个系统的框架制定和传播过程整合定量和定性数据。这项探索性的政策执行过程研究将通过重点关注为精神健康服务指定税收的政策，为外部环境执行决定因素和战略建立证据基础。网上版载有补充材料，可在10.1186/s43058023-00408-4查阅。
Insufficient funding is frequently identified as a critical barrier to the implementation and sustainment of evidence-based practices (EBPs). Thus, increasing access to funding is recognized as an implementation strategy. Policies that create earmarked taxes—defined as taxes for which revenue can only be spent on specific activities—are an increasingly common mental health financing strategy that could improve the reach of EBPs. This project’s specific aims are to (1) identify all jurisdictions in the USA that have implemented earmarked taxes for mental health and catalogue information about tax design; (2) characterize experiences implementing earmarked taxes among local (e.g., county, city) mental health agency leaders and other government and community organization officials and assess their perceptions of the acceptability and feasibility of different types of policy implementation strategies; and (3) develop a framework to guide effect earmarked tax designs, inform the selection of implementation strategies, and disseminate the framework to policy audiences. The project uses the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to inform data collection about the determinants and processes of tax implementation and Leeman’s typology of implementation strategies to examine the acceptability and feasibility strategies which could support earmarked tax policy implementation. A legal mapping will be conducted to achieve aim 1. To achieve aim 2, a survey will be conducted of 300 local mental health agency leaders and other government and community organization officials involved with the implementation of earmarked taxes for mental health. The survey will be followed by approximately 50 interviews with these officials. To achieve aim 3, quantitative and qualitative data will be integrated through a systematic framework development and dissemination process. This exploratory policy implementation process study will build the evidence base for outer-context implementation determinants and strategies by focusing on policies that earmarked taxes for mental health services. The online version contains supplementary material available at 10.1186/s43058-023-00408-4.