The cost of implementing new strategies (COINS): A method for mapping implementation resources using the stages of implementation completion
The cost of implementing new strategies (COINS): A method for mapping implementation resources using the stages of implementation completion
复制标题
DOI：
10.1016/j.childyouth.2013.10.006
复制
发表时间：
2014-04-01
影响因子：
3.3
通讯作者：
Landsverk, John
中科院分区：
文献类型：
--
作者：
Saldana, Lisa;Chamberlain, Patricia;Landsverk, John
目的：说明用于测量的成本和资源的实施过程中使用的策略的价值超过和以上的干预本身的成本的上下文中的双臂随机对照trial.Methods：县在加州和俄亥俄州（网站）被邀请实施多维治疗寄养（MTFC），一种替代聚集的照顾青年。参与研究中心（n = 53）被随机分配至两种实施策略之一：（1）社区发展团队（CDT），其中研究中心共享信息，并在MTFC供应商的协助下作为一个队列完成实施过程;或（2）单独实施（IND：“照常”），其中研究中心单独与MTFC供应商合作。使用实施完成阶段（SIC）对一些可观察到的活动进行监测，作为将实施过程分为8个实施阶段的试验的一部分。从实施承办商和现场参与者收集的资源数据用于将成本映射到8个阶段中的每个阶段，以生成按每个研究组的资源类型和实施阶段分层的总成本衡量标准。结果：SIC提供了一个可行的成本计算模板，将成本映射到可观察的活动上，并能够检查实施策略的重要差异，以实现循证实践。CDT项目启动前的平均总实施成本为133，106美元; IND成本为118，699美元。虽然CDT在若干阶段的成本较高，但与IND相比，它使用的国家工作人员工时较少，平均执行时间较短。在重视快速执行以减少执行所需的工作人员时间的情况下，CDT将是更可取的执行方法。SIC是确定新证据所需的实施资源的有用工具-为青年提供的实践方案，特别是比较可能在试点方案中尝试的不同实施战略。(C)2013爱思唯尔有限公司保留所有权利。
Objective: Illustrate the value of a strategy used for measuring the costs and resources used in the implementation process over and above the costs of the intervention itself in the context of a two-arm randomized controlled trial.Methods: Counties in California and Ohio (sites) were invited to implement Multidimensional Treatment Foster Care (MTFC), an alternative to congregate care for youth. Participating sites (n = 53) were randomized to one of two implementation strategies, (1) Community Development Teams (CDT) where sites share information and move through the implementation process as a cohort facilitated by an MTFC purveyor or (2) Individual Implementation (IND: "as usual") where sites work individually with the MTFC purveyor. The implementations were monitored using the Stages of Implementation Completion (SIC) measure of a number of observable activities, developed as part of the trial to segment the implementation process into 8 stages of implementation. Resource data gathered from the implementation purveyors and site participants were used to map costs onto each of the 8 stages to generate total cost measures stratified by type of resource and stage of implementation for each of the study arms.Results: The SIC provided a feasible costing template to map costs onto observable activities and to enable the examination of important differences in implementation strategies for an evidence-based practice. The average total implementation cost prior to program start-up of CDT was $133,106; IND costs $118,699. While CDT costs more in a number of stages, it resulted in fewer county staff hours being used and shorter mean times to implementation than IND. In cases where rapidity of implementation of reducing staff time required for implementation is valued, then CDT would be the preferable implementation approach.Conclusions: The SIC is a useful tool for determining implementation resources needed for new evidence-based practice programs for youth and particularly for comparing different implementation strategies that might be tried in pilot programs. (C) 2013 Elsevier Ltd. All rights reserved.