Optimizing Evidence-Based Practice Implementation for Clinical Impact: the IMPACT Center

影响中心总体总结： 优化循证医学实践的实施以提高临床效果 IMPACT中心的目标是加速循证实践对青年的影响 在资源匮乏的社区环境中接受精神卫生保健。这些设置，其中包括通信- 国家心理健康中心和学校，为大多数低收入，种族多样化的年轻人提供心理保健 谁接受服务。在这些环境中，EBP没有得到广泛或忠实的实施，年轻人对EBP的需求很高。 未满足的心理健康需求，导致不良后果。在IMPACT中，我们专注于优化EBP实施， 在资源匮乏的社区环境中，四种最常见的青少年心理健康状况：抑郁症， 包括创伤后压力和行为状况。提供高质量的治疗， 青年、社区环境需要支持，以优化EBP的实施。执行科学领域 曾试图解决这一研究与实践的差距，然而，最近的一篇社论呼吁更多的“实际实施 科学”，与实践界合作产生解决方案，从而产生他们可以使用的工具， 对于EBP的实施。在IMPACT中，我们将与利益相关者合作开发、完善、使用- 使用和传播方便用户的方法和工具，以加速电子商务对青年的影响。 （I）确定环境业务方案实施的决定因素并确定其优先次序; (II)将实施战略与优先考虑的决定因素相匹配;以及（III）根据 实践合作伙伴目标（例如，范围、偏好、影响、效率、可负担性）。我们的方法核心是一个跨- 来自临床，社区和组织心理学的学科团队;信息，计算机和简单的 心理学、人类学、医学、公共卫生和以用户为中心的设计。我们将开发方法 以及针对每项挑战的工具包，与实践伙伴共同设计和完善，以提高可接受性、可行性和 适当性我们与西澳EBP倡议的合作伙伴关系是开发新方法的理想实验室。 IMPACT中心，华盛顿大学凯撒医疗机构华盛顿健康研究所 由刘易斯和多尔西共同执导。行政核心将支持利益攸关方的参与， 最大限度地提高中心的学习能力，促进核心、探索性项目和试点项目之间的协同和整合 资助计划。这一核心将导致传播到实践和科学界，培训和评估， 的影响。方法核心将合作开发新方法，支持研究人员和培训- 积极参与，积极参与。探索性项目将采用并改进IMPACT的方法， 三大挑战，制定和测试切实可行的实施战略，以提高治疗质量， 通过EBP实施的客户成果。项目1优化了基于测量的护理，这是一个基础框架， 工作指导EBP交付。项目2优化和测试了一个同行领导，前线领导者为重点的战略，以优化 认知行为疗法（CBT）治疗四种最常见的青少年疾病。项目3扩大覆盖面和影响力 一个有效的，多成分的参与策略，为临床医生在学校使用创伤为重点的CBT。

IMPACT CENTER OVERALL SUMMARY: Optimizing Evidence-Based Practice Implementation for Clinical Impact The goal of the IMPACT Center is to accelerate the impact of evidence-based practices (EBPs) for youth receiving mental healthcare in low-resourced community-based settings. These settings, which include commu- nity mental health centers and schools, provide mental healthcare to most low-income, ethnically diverse youth who receive services. In these settings, EBPs are not implemented widely or with fidelity, and youth have high unmet mental health needs, leading to adverse outcomes. In IMPACT, we focus on optimizing EBP implemen- tation in low-resourced community settings for four of the most common youth mental health conditions: depres- sion, anxiety including posttraumatic stress, and behavioral conditions. To provide high-quality treatment for youth, community settings need support to optimize EBP implementation. The field of implementation science has tried to address this research-practice gap; however, a recent editorial call for more “practical implementation science” that generates solutions in partnership with the practice community leading to tools they can use inde- pendently for EBP implementation. In IMPACT, we will partner with stakeholders in developing, refining, employ- ing, and disseminating user-friendly methods and tools to accelerate the impact of EBPs for youth. IMPACT targets 3 implementation challenges: (I) Identify and prioritize determinants to EBP implementation; (II) Match implementation strategies to prioritized determinants; and (III) Test and optimize strategies according to practice partner goals (e.g., reach, preference, impact, efficiency, affordability). Our Methods Core is a trans- disciplinary team from clinical, community, and organizational psychology; information, computer, and imple- mentation sciences; anthropology; medicine; public health; and user-centered design. We will develop methods and toolkits for each challenge, co-designed and refined with practice partners for acceptability, feasibility, and appropriateness. Our partnership with the WA EBP Initiative is an ideal laboratory for developing new methods. The IMPACT Center, a Kaiser Permanente Washington Health Research Institute-University of Washington partnership, is codirected by Lewis and Dorsey. The Administrative Core will support stakeholder engagement, maximize Center learning, and foster synergy and integration across the Cores, exploratory projects, and pilot grant program. This Core will lead dissemination to the practice and scientific communities, training, and evalu- ation of IMPACT. The Methods Core will collaboratively develop new methods, support investigators and train- ees, and actively participate in outreach. The exploratory projects will employ and refine methods from IMPACT's three challenges, developing and testing practical implementation strategies to improve treatment quality and client outcomes via EBP implementation. Project 1 optimizes measurement-based care, a foundational frame- work to guide EBP delivery. Project 2 optimizes and tests a peer-led, frontline leader-focused strategy to optimize cognitive behavioral therapy (CBT) for four most common youth conditions. Project 3 increases reach and impact of an effective, multicomponent engagement strategy for clinicians in schools to use trauma-focused CBT.