Investigating the Payer Role in the Implementation of EBP in the Public Sector

描述（由申请人提供）：Ruth L. Kirschstein国家研究服务奖的目标是支持申请人发展独立研究项目所必需的关键技能，通过付款人政策和融资来促进社区心理健康中基于证据的实践（ebp）的实施。本F32申请提出研究，以解决NIMH战略计划的目标4：加强NIMH支持的研究对公共卫生的影响，特别是提高各利益相关者对有效的基于研究的干预措施的吸收和实施，并改善获得有效的心理健康干预措施的机会。在执行科学专家David S. Mandell博士的指导下，要实现的具体培训目标是：1)在社区心理健康和更广泛的领域中发展实施科学和付款人激励方面的专业知识；2)在设计、方法和分析方面获得适合拟议项目和未来实施科学和社区心理健康研究的相关经验；3)建立合作和跨学科关系网络，以协助当前和未来的研究工作。本F32的研究部分将调查支付方在EBP实施中的作用这一重要问题。尽管支付方可以通过各种策略在激励使用EBP方面发挥关键作用，但关于公共精神卫生系统中使用哪些激励措施的研究却非常少。拟议研究的目的是检查公共资助的社区精神卫生保健支付者使用不同激励措施的程度，他们如何实施这些激励措施，以及这些激励措施使用的促进因素和障碍。具体来说，申请人建议在初步结果的基础上，对县和州一级的支付者进行全国性调查，以便：1)系统地识别、记录和描述支付者在公共精神卫生系统中采用的激励措施，以增加社区精神卫生提供者中基于证据的实践的使用；2)检查文献中提出的激励措施实施的潜在障碍和促进因素。申请人还将使用定性方法并对付款人进行半结构化访谈，根据他们实施不同激励措施以增加EBP使用的程度进行分层，以确定使用不同策略的障碍和促进因素。在本项目的过程中，申请人将获得政府机构和支付方在实施和维持EBP方面的专业知识，并将获得实施科学、支付方和激励融资、调查设计和开发等方面的关键知识和技能，以及经验丰富和成熟的导师团队的专业知识。

DESCRIPTION (provided by applicant): The goal of this Ruth L. Kirschstein National Research Service Award is to support the applicant in developing the critical skills necessary for an independent research program in promoting the implementation of evidence- based practices (EBPs) in community mental health through payer policy and financing. This F32 application proposes research to address Objective 4 of the NIMH Strategic Plan: Strengthen the Public Health Impact of NIMH-Supported Research, specifically improving the uptake and implementation of effective research-based interventions by various stakeholders and improving access to effective mental health interventions. Specific training goals to be achieved under the mentorship of David S. Mandell, ScD, an expert in implementation science are to: 1) develop expertise in implementation science and payer incentives in community mental health and broader fields, 2) gain relevant experience in the design, methods, and analyses appropriate for the proposed project and future research in implementation science and community mental health, and 3) establish a network of collaborative and cross-disciplinary relationships to assist in current and future research endeavors. The research component of this F32 will investigate the important question of the payer's role in the implementation of EBP. Despite the critical role payers can play in incentivizing the use of EBP through various strategies, there is remarkably little research examining which incentives are used in public mental health systems. The goal of the proposed study is to examine the extent to which payers for publicly-funded community mental health care use different incentives, how they implement them, and the facilitators and barriers to their use. Specifically, the applicant proposes to build on preliminary results by developing and fielding a national survey of county and state-level payers to: 1) systematically identify, document, and describe incentives employed by payers in the public mental health system to increase the use of evidence- based practices among community mental health providers and 2) examine potential barriers and facilitators to the implementation of incentives proposed in the literature. The applicant will also use qualitative methods and conduct semi-structured interviews with payers, stratified by the extent to which they implement different incentives to increase use of EBP, to determine barriers and facilitators to the use of different strategies. Over the course of this project the applicant will develop expertise in the role of governmental entities and payers in the implementation and sustainment of EBP, and will gain critical knowledge and skills in implementation science, payer and incentive financing, and survey design and development with the expertise of an experienced and established team of mentors.