Sustainment of Multiple EBP's Fiscally Mandated in Children's MH Services

维持儿童 MH 服务中的多项 EBP 财政授权

• 批准号: 8632885
• 负责人: LAUREN BROOKMAN-FRAZEE
• 金额: $ 78.29万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8632885
• 关键词: Address; Adherence; Adoption; Affect; Attitude; Characteristics; Child; Child Mental Health; Climate; Communities; Community Mental Health Services; Community Services; Consultations; Contracts; County; Data; Development; Early Intervention; Evidence based practice; Health system; Intervention; Investments; Leadership; Los Angeles; Measurement; Measures; Mental Health; Methods; Metric; Modeling; Organizational Policy; Outcome; Penetration; Phase; Policies; Positioning Attribute; Preparation; Prevention; Provider; Public Health; Relative (related person); Research; Role; Services; System; Testing; Time; Time Study; Training; United States; Work; child mental health service; flexibility; improved; innovation; interest; intervention program; multilevel analysis; primary outcome; public health relevance; routine practice; success; tool

DESCRIPTION (provided by applicant): Evidence-based practices (EBPs) are increasingly being implemented in large community mental health systems. Much of the research to date has focused on policy, organizational and practitioner variables that predict adoption and initial implementation of EBPs, yet understanding sustainment is crucial to facilitate a return on costly investments in EBP development. Furthermore, most studies focus on the implementation of a single EBP, limiting opportunities to examine theoretically important predictors of implementation success concerning fit between EBPs and the contexts in which they are utilized. The proposed study will examine the impact of a major policy change mandating use of EBPs and organizational context, organizational accommodation, and practitioner attitudes and adaptations as determinants of EBP sustainment in the largest public mental health system in the United States. Our primary outcomes of interest are two aspects of sustainment: practitioner-level penetration and agency and practitioner structural and intervention fidelity to EBP models. Specific aims are as follows: (1) Characterize sustainment outcomes (Penetration, Fidelity); (2) Use mixed methods to characterize inner context factors and early implementation conditions that potentially predict EBP sustainment; (3) Identify inner context (organizational and practitioner) and early implementation conditions that determine sustainment outcomes. This project will yield new understanding of whether and how multiple EBPs can be sustained in public mental health systems undergoing a policy-driven community implementation effort. We will produce generalizable models for characterizing sustainment, including feasible and flexible measurement of fidelity across multiple EBPs. The findings will inform the development of implementation interventions to promote sustained delivery of EBPs to maximize their public health impact.

描述（由申请人提供）：在大型社区心理卫生系统中越来越多地实施循证实践（EBP）。迄今为止，许多研究都集中在预测EBP的采用和初步实施的政策，组织和从业人员变量上，但是了解维持对于促进EBP开发的昂贵投资回报率至关重要。此外，大多数研究都集中在实施单个EBP上，这限制了研究理论上重要的实施成功预测因素，该预测因素与EBP和使用它们的环境之间的拟合有关。拟议的研究将研究主要政策变更强制使用EBP和组织环境，组织住宿以及从业人员的态度和适应性的影响，作为美国最大公共心理卫生系统中EBP维持的决定因素。我们感兴趣的主要结果是维持的两个方面：从业人员级的渗透以及代理以及从业者的结构和干预忠诚度对EBP模型。具体目的如下：（1）表征维持结果（穿透性，保真度）； （2）使用混合方法来表征内部上下文因素和可能预测EBP维持的早期实施条件； （3）确定内部环境（组织和 从业者）和确定维持结果的早期实施条件。该项目将对在公共心理卫生系统中是否能够维持多个EBP，从事政策驱动的社区实施工作。我们将生成可推广的模型来表征维持的模型，包括对多个EBP的可行和灵活的忠诚度测量。这些发现将为实施干预措施的制定提供信息，以促进EBP的持续交付，以最大程度地发挥其公共卫生影响。