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

Impact Center总体摘要： 优化循证实践实施对临床的影响 影响中心的目标是加速循证实践(EBP)对青年的影响 在资源匮乏的社区环境中接受精神保健。这些设置包括通信- 机构精神健康中心和学校，为大多数低收入、种族多元化的年轻人提供精神保健 接受服务的人。在这些情况下，EBPS没有得到广泛实施或忠诚度不高，年轻人的 未得到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应对四种最常见的青少年心理健康问题：抑郁症-- 锡安，包括创伤后应激在内的焦虑，以及行为状况。为患者提供高质量的治疗 青年、社区环境需要支持，以优化EBP的实施。实施科学领域 试图解决这一研究与实践之间的差距；然而，最近的一篇社论呼吁更多的“实际实施” 与实践社区合作生成解决方案，从而开发出他们可以使用的工具-- 悬而未决的是EBP的实施。在Impact中，我们将与利益相关者合作开发、提炼、使用- 推广和传播便于用户使用的方法和工具，以加速EBPS对青年的影响。 影响目标3执行方面的挑战：(1)确定执行EBP的决定因素并确定其优先次序； (2)将实施战略与确定优先顺序的决定因素相匹配；以及(3)测试和优化战略 实践合作伙伴目标(例如，可及性、偏好、影响力、效率、可负担性)。我们的方法核心是一种跨 来自临床、社区和组织心理学、信息、计算机和实施的学科团队- 心理科学；人类学；医学；公共卫生；以用户为中心的设计。我们将制定方法 和工具包，与实践合作伙伴共同设计和改进，以确保可接受性、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。 影响中心，凯撒永久华盛顿健康研究所-华盛顿大学 合作伙伴，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学习效率，促进核心、探索性项目和试点之间的协同和集成 格兰特计划。这一核心将引导传播到实践和科学界、培训和评估- 影响的起因。方法核心将合作开发新方法，支持调查人员，并培训- EES，并积极参与外联活动。勘探项目将采用和改进Impact的方法 三个挑战，制定和测试实际执行战略，以提高治疗质量和 通过EBP实施的客户结果。项目1优化了以测量为基础的护理，这是一个基础框架- 负责指导EBP的交付。项目2优化并测试以同行为主导、以一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扩大覆盖范围和影响 为学校的临床医生使用以创伤为重点的CBT提供有效的、多组成部分的参与战略。

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.