Development and Testing of an Evidence Based Intervention Sustainment Measure

摘要 移动循证实践(EBP)和特定心理健康证据的重要性 从研究到实践的干预(EBI)得到了广泛的认可。实现科学领域有 迅速发展以弥补这一差距，并正在越来越多地建立关于影响因素和 EBP和EBIS的实施战略。不幸的是，成功的实施并不能保证 持续的维持。如果没有可持续发展，任何EBI承诺的公共卫生利益都将无法实现 浪费了开发、评估和实施的累积成本。因此，实现 可持续发展对于加强研究对公众健康的影响至关重要。虽然这是一个持续的阶段 几十年来，关于维持和支持机制的研究已经得到了承认 它受到缺乏务实、可靠和有效的衡量标准的限制。特别需要一种可持续的 评估是否继续使用有效干预措施、是否保持能力和 坚持出效益。目前的措施似乎冗长、复杂、因地制宜，不适合 由一线服务提供商完成。因此，没有在所有研究中一致使用的衡量标准， 从而限制了复制和比较。我们建议审查和扩大目前关于维持的工作 制定可推广的EBI维持措施的定义、框架和工具。拟议中的工作 在开发一种可在不同健康环境中推广的措施方面具有创新性 组织背景和广泛的心理社会EBI。这项措施将对提供者进行管理 在精神卫生机构、学校、物质使用障碍治疗中心和儿童福利机构 心理社会EBI通常会被提供。此外，拟议的工作在使用RASCH方面具有创新性 测量模型，项目反应理论家族的一员，共同进行量表分析 用传统的经典检验理论统计方法。我们的具体目标是：目标1：目录 现有的维持测量构造，生成项目库，并评估项目的面貌和内容 效度；目标2：收集数据，使用经典测试理论进行信度和结构效度分析；目标 3：进行RASCH分析以评估项目功能；检查潜在的人口统计、背景和嵌套 结构影响(例如，机构、服务系统、经验、种族和族裔)对项目功能的影响；以及 确定量表分数的分界点；目标4：通过评估以下各项之间的关系来检查收敛效度 可持续发展措施和可持续发展气候、可持续发展领导力，以及对特定目标的态度 虾。

Abstract The importance of moving Evidence Based Practice (EBP) and specific mental health Evidence Based Interventions (EBIs) from research to practice is widely recognized. The field of implementation science has rapidly evolved to bridge this gap and is increasingly building evidence about influencing factors and implementation strategies for EBP and EBIs. Unfortunately, successful implementation does not guarantee ongoing sustainment. Without sustainment the public health benefits promised by any EBI will not be achieved and the accumulated costs from development, evaluation and implementation are wasted. Therefore, achieving sustainment is essential to strengthen the public health impact of research. Although a sustainment phase of implementation has been acknowledged for decades, research on sustainment and the mechanisms supporting it is limited by a lack of a pragmatic, reliable, and valid measure. There is particular need for a sustainment measure that assesses whether effective interventions continue to be used, have maintained capacity and persist in producing benefits. Current measures appear to be long, complex, context specific and unsuitable for completion by front-line service providers. As such, there is no measure that is consistently used across studies, thereby limiting replication and comparisons. We propose to review and extend the current work on sustainment definitions, frameworks and tools to develop a generalizable measure of EBI sustainment. The proposed work is innovative in developing a measure that will be generalizable across different health settings and organizational contexts and a wide-range of psychosocial EBIs. The measure will be administered to providers in mental health agencies, schools, substance use disorder treatment centers, and child welfare agencies where psychosocial EBIs are commonly delivered. In addition, the proposed work is innovative in its use of the Rasch Measurement Model, a member of the Item Response Theory family, to conduct the scale analyses together with the traditional Classical Test Theory statistical approaches. Specifically our aims are: Aim 1: Catalogue existing sustainment measurement constructs, generate an item pool, and assess items' face and content validity; Aim 2: Collect data and conduct reliability and construct validity analyses using classical test theory; Aim 3: Conduct Rasch analyses to assess item functioning; examine potential demographic, contextual and nested structure influences (e.g. agency, service system, experience, race and ethnicity) on item functioning; and determine cut-off points for scale scores; Aim 4: Examine convergent validity by assessing relationships between the sustainment measure and sustainment climate, sustainment leadership, and attitudes towards the specific EBI.