Outcomes of a Partnered Facilitation Strategy to Implement Primary Care-Mental Health
Outcomes of a Partnered Facilitation Strategy to Implement Primary Care-Mental Health
复制标题
DOI：
10.1007/s11606-014-3027-2
复制
发表时间：
2014-12-01
影响因子：
5.7
通讯作者：
Fortney, John C.
中科院分区：
文献类型：
--
作者：
Kirchner, JoAnn E.;Ritchie, Mona J.;Fortney, John C.
背景：实施新的计划和实践是具有挑战性的，即使它们是强制性的。专注于与站点合作的实施促进 (IF) 策略显示出解决这些挑战的希望。 目标：我们的目标是在退伍军人事务部 (VA) 初级保健-心理健康一体化 (PC-MHI) 授权的背景下评估外部/内部 IF 策略的有效性。 设计：这是一项准实验性混合 III 型研究。广义估计方程评估了不同地点的差异。参与者：接受 IF 干预和国家支持的 7 个 VA 初级保健诊所的患者和提供者以及仅接受国家支持的 7 个匹配比较诊所参与了本研究。干预：我们使用了高度合作的 IF 策略，结合了基于证据的实施干预措施。主要措施：我们使用 VA 管理数据和 RE-AIM 框架措施评估了两个 6 个月期间的 IF 策略。 结果：对前 6 个月期间 RE-AIM 措施的评估表明，IF 诊所的 PC 患者的几率是 9 倍（OR=8.93，p
BACKGROUND: Implementing new programs and practices is challenging, even when they are mandated. Implementation Facilitation (IF) strategies that focus on partnering with sites show promise for addressing these challenges.OBJECTIVE: Our aim was to evaluate the effectiveness of an external/internal IF strategy within the context of a Department of Veterans Affairs (VA) mandate of Primary Care-Mental Health Integration (PC-MHI).DESIGN: This was a quasi-experimental, Hybrid Type III study. Generalized estimating equations assessed differences across sites.PARTICIPANTS: Patients and providers at seven VA primary care clinics receiving the IF intervention and national support and seven matched comparison clinics receiving national support only participated in the study.INTERVENTION: We used a highly partnered IF strategy incorporating evidence-based implementation interventions.MAIN MEASURES: We evaluated the IF strategy using VA administrative data and RE-AIM framework measures for two 6-month periods.KEY RESULTS: Evaluation of RE-AIM measures from the first 6-month period indicated that PC patients at IF clinics had nine times the odds (OR=8.93, p