A two-way street: bridging implementation science and cultural adaptations of mental health treatments.
A two-way street: bridging implementation science and cultural adaptations of mental health treatments.
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DOI：
10.1186/1748-5908-8-90
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发表时间：
2013-08-19
期刊：
影响因子：
--
通讯作者：
Baumann AA
中科院分区：
文献类型：
--
作者：
Cabassa LJ;Baumann AA
在美国，种族和民族差异沿着整个精神卫生保健的连续性，从获得和使用服务到护理的质量和结果。为解决精神卫生保健中的这些不平等现象，人们的努力集中在使循证治疗适应客户的不同文化背景。然而，像许多循证治疗一样，适应文化的干预措施在通常的护理环境中仍然基本上未被使用。我们建议，解决这一关键问题的一个可行途径是在执行科学和文化适应领域之间建立对话。在本文中，我们将讨论如何整合这两个领域可以作出重大贡献，以减少种族和民族之间的差距，在精神卫生保健。在实施科学中使用文化适应模型可以加深对文化的明确关注，特别是在客户和提供者层面，在实施研究中使循证治疗更能满足不同人群的需求和偏好。这两个领域的整合有助于澄清和具体说明应调整哪些内容，以便在调整和忠实度之间实现最佳平衡，并解决重要的实施成果（例如，可接受性，适当性）。这两个领域之间的对话有助于澄清谁应促进执行进程的知识、技能和作用，特别是在需要文化适应的情况下。实施科学的生态学视角提供了一个扩展的透镜，以研究环境因素如何影响治疗（适应或不适应）最终如何在通常的护理环境中使用和维持。整合这两个领域也有助于具体说明在实施过程中何时可以考虑调整，以提高循证治疗的采用率和可持续性。实施科学和文化适应带来了宝贵的见解和方法，如何以及在何种程度上治疗和/或背景应定制，以加强实施循证治疗跨设置和人群。在这两个领域之间建立一条双向通道，可以为将现有的最佳治疗方法付诸实践提供更好的途径，并有助于减少精神卫生保健方面的种族和民族差异。
Racial and ethnic disparities in the United States exist along the entire continuum of mental health care, from access and use of services to the quality and outcomes of care. Efforts to address these inequities in mental health care have focused on adapting evidence-based treatments to clients’ diverse cultural backgrounds. Yet, like many evidence-based treatments, culturally adapted interventions remain largely unused in usual care settings. We propose that a viable avenue to address this critical question is to create a dialogue between the fields of implementation science and cultural adaptation. In this paper, we discuss how integrating these two fields can make significant contributions to reducing racial and ethnic disparities in mental health care. The use of cultural adaptation models in implementation science can deepen the explicit attention to culture, particularly at the client and provider levels, in implementation studies making evidence-based treatments more responsive to the needs and preferences of diverse populations. The integration of both fields can help clarify and specify what to adapt in order to achieve optimal balance between adaptation and fidelity, and address important implementation outcomes (e.g., acceptability, appropriateness). A dialogue between both fields can help clarify the knowledge, skills and roles of who should facilitate the process of implementation, particularly when cultural adaptations are needed. The ecological perspective of implementation science provides an expanded lens to examine how contextual factors impact how treatments (adapted or not) are ultimately used and sustained in usual care settings. Integrating both fields can also help specify when in the implementation process adaptations may be considered in order to enhance the adoption and sustainability of evidence-based treatments. Implementation science and cultural adaptation bring valuable insights and methods to how and to what extent treatments and/or context should be customized to enhance the implementation of evidence-based treatments across settings and populations. Developing a two-way street between these two fields can provide a better avenue for moving the best available treatments into practice and for helping to reduce racial and ethnic disparities in mental health care.
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影响因子：
3.6
作者：
Aarons, Gregory A.;Hoagwood, Kimberly;Landsverk, John;Glisson, Charles;Kelleher, Kelly;Cafri, Guy
通讯作者：
Cafri, Guy
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
5.8
作者：
Addis, ME;Wade, WA;Hatgis, C
通讯作者：
Hatgis, C
影响因子：
5.9
作者：
Barrera, Manuel, Jr.;Castro, Felipe G.;Strycker, Lisa A.;Toobert, Deborah J.
通讯作者：
Toobert, Deborah J.
DOI：
10.1186/1748-5908-6-80
发表时间：
2011-07-26
期刊：
Implementation science : IS
影响因子：
--
作者：
Cabassa LJ;Druss B;Wang Y;Lewis-Fernández R
通讯作者：
Lewis-Fernández R