Understanding the impact of organizational implementation strategies on EBT use

了解组织实施策略对 EBT 使用的影响

• 批准号: 8722035
• 负责人: Nathaniel J. Williams
• 金额: $ 3.07万
• 依托单位: UNIVERSITY OF TENNESSEE KNOXVILLE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-13 至 2015-08-07
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8722035
• 关键词: Address; Adoption; Advanced Development; American; Area; Behavioral Research; Biomedical Research; Child; Child Mental Health; Childhood; Client; Clinical; Collaborations; Complex; Consultations; Development; Diffusion of Innovation; Educational workshop; Effectiveness; Evidence based treatment; Failure; Family; Funding; Goals; Health system; Intervention; Investments; Knowledge; Learning; Link; Literature; Mental Health; Mental Health Services; Mental disorders; Mentors; National Institute of Mental Health; Organizational Change; Organizational Culture; Outcome; Personal Satisfaction; Personnel Turnover; Process; Public Health; Publications; Quality of life; Randomized Controlled Trials; Reading; Research; Research Personnel; Research Project Grants; Research Training; Role; Science; Scientist; Services; Site; Social Environment; Stress; System; Testing; Training; Training Activity; Treatment Cost; Visit; Work; base; career; community setting; cost; experience; implementation research; implementation science; improved; innovation; organizational climate; programs; research study; skills; success; symposium; theories; treatment as usual

DESCRIPTION (provided by applicant): Approximately 15 million American children suffer from psychiatric disorders at an estimated treatment cost of $8.9 billion annually. During the last 30 years several effective evidence-based treatments (EBTs) have been developed to treat these conditions. However, EBTs are rarely implemented successfully in usual care practice settings. Given the typically poor outcomes of usual care services, the National Institute of Mental Health recently prioritized research that develops and tests implementation strategies to effectively integrate EBTs within community settings. Implementation researchers have tested a range of implementation strategies in mental health settings but two key knowledge gaps limit the field. First, researchers have yet to identify the specific change processes (i.e., the require "active ingredients" of implementation interventions), or the specific change mechanisms (i.e., the intermediate changes that occur during the course of the intervention and serve as the basis for the effect) that explain how and why implementation strategies generate desired changes. Identification of change processes and mechanisms is critical to developing the most effective and efficient implementation strategies for targeted settings. Second, although most mental health services are provided within complex organizations and decades of research suggest organizational social context is vital to successful innovation implementation, few implementation strategies target social context. The next steps in advancing the development of effective implementation strategies involve understanding how successful implementation strategies generate their effects, and specifically addressing the role of social context in the cross-level organizational change that characterizes successful EBT implementation. The proposed research training plan enables the PI to develop an independent program of research focused on identifying the organizational change processes and mechanisms that contribute to effective integration of EBTs into routine clinical settings. The research training plan includes advanced training activities that develop the PI's competency across three core areas: implementation science, organizational interventions, and organizational change mechanisms. The plan includes specialized didactic learning activities (elective coursework, workshops, and conferences), collaboration with three expert implementation scientists who are each directing NIMH-funded R01 implementation studies, and completion of an independent research project. The research project is the first to directly test organizational change processes and change mechanisms in the context of a randomized controlled trial of an organizational implementation strategy. The training plan prepares the PI for an independent research career focused on improving the implementation of effective mental health treatments in usual care settings. The likely benefits of this research include enhanced quality of life for children with psychiatric disorders and their families and reduced costs of mental health treatment through greater efficiency and effectiveness of service systems.

描述（由申请人提供）：大约1500万美国儿童患有精神疾病，估计每年的治疗费用为89亿美元。在最后