Implementation-as-Usual in Community-Based Organizations Providing Specialized Services to Individuals with Autism Spectrum Disorder: A Mixed Methods Study.
Implementation-as-Usual in Community-Based Organizations Providing Specialized Services to Individuals with Autism Spectrum Disorder: A Mixed Methods Study.
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DOI：
10.1007/s10488-020-01084-5
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Aarons GA
中科院分区：
文献类型：
--
作者：
Drahota A;Meza RD;Bustos TE;Sridhar A;Martinez JI;Brikho B;Stahmer AC;Aarons GA
自闭症谱系障碍（ASD）是一种非常普遍的神经发育障碍。尽管有大量可用的 EBP 来治疗 ASD，但 ASD 社区组织 (ASD-CBO) 并未充分利用或不一致地利用循证实践 (ASD-EBP)。尽管如此，ASD-CBO 仍定期对实践进行改变。了解 ASD-CBO 的照常实施 (IAU) 流程可能有助于制定战略，以促进 ASD-EBP 的采用、实施和维持。采用收敛混合方法（quan+QUAL）设计。来自 21 个 ASD-CBO 的 20 名 ASD-CBO 机构领导 (AL) 和 26 名直接提供者 (DP) 完成了自闭症模型实施调查组，包括人口统计和机构 IAU 流程问题。通过描述性分析和内容分析对调查进行分析。 10 名 AL 的子集提供了定性访谈数据，并使用编码、共识和比较方法对这些数据进行了分析，以便更全面地了解其 ASD-CBO 内的 IAU 流程。利用联合显示合并定量分析和定性编码并进行比较。结果表明，IAU 流程遵循探索、准备、实施、维持 (EPIS) 框架中确定的一些阶段，但以非正式方式进行，缺乏 ASD-CBO 之间和内部的特异性、结构和一致性。此外，数据表明在框架中添加了特定的采用决策阶段。尽管如此，大多数 AL 认为之前的实施工作是成功的。对 IAU 流程进行了探索，以确定实施流程是否可以成为提高 ASD-CBO 中 ASD-EBP 利用率的干预领域。开发系统化的实施流程可能有助于在日常护理环境中更广泛地利用高质量的 ASD-EBP，并最终改善 ASD 患者及其家人的生活质量。
Autism spectrum disorder (ASD) is a highly prevalent neurodevelopmental disorder. ASD community-based organizations (ASD-CBOs) underutilize or inconsistently utilize evidence-based practices (ASD-EBPs) despite numerous available EBPs to treat ASD. Despite this, ASD-CBOs implement changes to practices regularly. Understanding ASD-CBO’s implementation-as-usual (IAU) processes may assist to develop strategies to facilitate ASD-EBP adoption, implementation and sustainment. A convergent mixed methods (quan+QUAL) design was utilized. Twenty ASD-CBO agency leaders (ALs) and 26 direct providers (DPs), from 21 ASD-CBOs, completed the Autism Model of Implementation Survey Battery, including demographic and agency IAU process questions. Surveys were analyzed through descriptive and content analyses. A subset of 10 ALs provided qualitative interview data that were analyzed using coding, consensus and comparison methods to allow for a more comprehensive understanding of the IAU process within their ASD-CBOs. Quantitative analyses and qualitative coding were merged utilizing a joint display and compared. Results suggest that the IAU process follows some phases identified in the Exploration, Preparation, Implementation, Sustainment (EPIS) framework but were conducted in an informal manner—lacking specificity, structure and consistency across and within ASD-CBOs. Moreover, data suggest adding a specific adoption decision phase to the framework. Nonetheless, most ALs felt previous implementation efforts were successful. IAU processes were explored to determine whether the implementation process may be an area for intervention to increase ASD-EBP utilization in ASD-CBOs. Developing a systematized implementation process may facilitate broader utilization of high quality ASD-EBPs within usual care settings, and ultimately improve the quality of life for individuals with ASD and their families.
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影响因子：
3.5
作者：
Becan, Jennifer E;Bartkowski, John P;Aarons, Gregory A
通讯作者：
Aarons, Gregory A
影响因子：
7.2
作者：
Drahota, Amy;Aarons, Gregory A.;Stahmer, Aubyn C.
通讯作者：
Stahmer, Aubyn C.
影响因子：
3.9
作者：
Brookman-Frazee, Lauren I.;Taylor, Robin;Garland, Ann F.
通讯作者：
Garland, Ann F.
DOI：
10.1023/b:mhsr.0000024351.12294.65
发表时间：
2004-06-01
期刊：
Mental health services research
影响因子：
--
作者：
Aarons, Gregory A
通讯作者：
Aarons, Gregory A
影响因子：
2.8
作者：
Hartveit, M.;Hovlid, E.;Ruud, T.
通讯作者：
Ruud, T.