Improving the implementation and sustainment of evidence-based practices in community mental health organizations: a study protocol for a matched-pair cluster randomized pilot study of the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS).
Improving the implementation and sustainment of evidence-based practices in community mental health organizations: a study protocol for a matched-pair cluster randomized pilot study of the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS).
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DOI：
10.1186/s43058-020-00009-5
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发表时间：
2020-01-01
影响因子：
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通讯作者：
Weinberger, Morris
中科院分区：
文献类型：
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作者：
Powell, Byron J;Haley, Amber D;Weinberger, Morris
背景：忠实地实施和维持以证据为基础的项目可能需要多种实施策略，以解决多层次、具体背景的障碍和促进因素。理想情况下，选择和调整实施战略应以理论、证据和相关利益攸关方的投入为指导；然而，指导战略选择和裁剪的方法还不完善。需要更严格的方法来评估和确定实施决定因素（障碍和促进因素）的优先次序，并将实施战略与决定因素联系起来。选择和调整实施战略的协作组织方法（COAST-IS）是一种干预措施，旨在提高基于证据的实践实施和维持的有效性。COAST-IS将使组织领导人和临床医生能够使用干预测绘来选择和定制实施战略，以满足其特定地点的需求。干预绘图是一个多步骤的过程，它结合了理论、证据和利益相关者的观点，以确保实施战略有效地解决变化的关键决定因素。方法：COAST-IS将在社区精神卫生组织中进行试点，这些组织正在努力解决经历创伤相关情感或行为困难的儿童和青少年的需求，通过参与学习协作来实施基于证据的社会心理干预（以创伤为重点的认知行为疗法）。组织将被匹配，然后随机选择只参与学习协作（对照）或通过COAST-IS获得额外支持。本研究的主要目的是：(1)评估COAST-IS的可接受性、适当性、可行性和感知效用；(2)评估组织利益相关者对COAST-IS核心要素的忠诚度；(3)证明在更大规模的有效性试验中测试COAST-IS的可行性。讨论：COAST-IS是一种系统的方法，它整合了理论、证据和利益相关者的观点，以提高实施战略的有效性和准确性。如果有效，海岸信息系统有可能改善精神卫生和其他部门广泛的循证做法的执行和维持。试验注册：该研究于2019年1月10日在ClinicalTrials.gov （NCT03799432）注册（最后更新于2019年8月5日）。
BACKGROUND: Implementing and sustaining evidence-based programs with fidelity may require multiple implementation strategies tailored to address multi-level, context-specific barriers and facilitators. Ideally, selecting and tailoring implementation strategies should be guided by theory, evidence, and input from relevant stakeholders; however, methods to guide the selection and tailoring of strategies are not well-developed. There is a need for more rigorous methods for assessing and prioritizing implementation determinants (barriers and facilitators) and linking implementation strategies to determinants. The Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS) is an intervention designed to increase the effectiveness of evidence-based practice implementation and sustainment. COAST-IS will enable organizational leaders and clinicians to use Intervention Mapping to select and tailor implementation strategies to address their site-specific needs. Intervention Mapping is a multi-step process that incorporates theory, evidence, and stakeholder perspectives to ensure that implementation strategies effectively address key determinants of change.METHODS: COAST-IS will be piloted with community mental health organizations that are working to address the needs of children and youth who experience trauma-related emotional or behavioral difficulties by engaging in a learning collaborative to implement an evidence-based psychosocial intervention (trauma-focused cognitive behavioral therapy). Organizations will be matched and then randomized to participate in the learning collaborative only (control) or to receive additional support through COAST-IS. The primary aims of this study are to (1) assess the acceptability, appropriateness, feasibility, and perceived utility of COAST-IS; (2) evaluate the organizational stakeholders' fidelity to the core elements of COAST-IS; and (3) demonstrate the feasibility of testing COAST-IS in a larger effectiveness trial.DISCUSSION: COAST-IS is a systematic method that integrates theory, evidence, and stakeholder perspectives to improve the effectiveness and precision of implementation strategies. If effective, COAST-IS has the potential to improve the implementation and sustainment of a wide range of evidence-based practices in mental health and other sectors.TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov (NCT03799432) on January 10, 2019 (last updated August 5, 2019).