What educational strategies and mechanisms facilitate EBP use? A mixed methods examination of therapist perceptions within a system-driven implementation of multiple EBPs.
What educational strategies and mechanisms facilitate EBP use? A mixed methods examination of therapist perceptions within a system-driven implementation of multiple EBPs.
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DOI：
10.1177/2633489520982903
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发表时间：
2021-01
影响因子：
--
通讯作者：
Brookman-Frazee, Lauren
中科院分区：
文献类型：
--
作者：
Motamedi, Mojdeh;Lau, Anna S.;Lind, Teresa;Lui, Joyce H. L.;Rodriguez, Adriana;Smith, Ashley;Brookman-Frazee, Lauren
关键词：
外部顾问（如治疗开发人员和培训师）和内部项目负责人可以使用许多策略来支持循证实践（EBP）的实施。本研究的目的是确定治疗师认为哪些教育实施策略最有帮助，通过哪些机制，以及这些策略是否与EBP的使用有关。半结构化访谈进行了60名治疗师，和826治疗师完成了调查，他们的看法教育实施策略和报告的EBP交付系统驱动的，多EBP的实施工作。使用顺序QUAL → QUAN混合方法，我们首先确定定性主题。接下来，我们进行了多层次逻辑回归，以研究如何定量调查项目对应的定性主题预测EBP的使用。初步定性专题分析显示，四个实施战略被认为是必不可少的EBP交付：连接到一个社区的训练有素的治疗师，持续的咨询/监督，提供内部主管培训的EBP，并获得EBP材料和资源。定量结果显示了与训练有素的治疗师社区联系相关的策略（即，在一个机构中有EBP培训和提供经验的其他治疗师的百分比，而不是那些只接受过EBP培训的人），正在进行的咨询/监督，以及有一个接受过EBP培训的内部主管（接受EBP特定的内部监督）与EBP使用显著相关，而接受EBP助推器则没有。最接近的量化指标对应的EBP资源，EBP网络培训，与EBP的使用。治疗师报告说，这些策略通过接触其他治疗师的病例、指导/反馈、情感支持和消除EBP使用的逻辑障碍来支持EBP的提供。这些研究结果表明，如何考虑治疗师的观点，并通过主管，顾问和社区的治疗师在EBP经验丰富的EBP支持创建一个网络可能是特别重要的EBP交付。公共精神卫生系统越来越多地实施多种循证实践（EBP）。外部顾问（如治疗开发人员和培训师）和内部项目负责人可以使用许多策略来支持EBP的实施。本研究的目的是确定哪些内部和外部的实施策略被认为是最有帮助的治疗师，以及这些策略是如何与继续使用循证医学。首先，对治疗师的定性访谈显示，以下策略是支持他们提供EBP的关键：（1）与训练有素的治疗师社区的联系，（2）持续的咨询/监督，（3）在他们的项目中有一个受过EBP培训的内部主管，（4）获得EBP材料和后勤资源。接下来，调查数据的定量分析研究了治疗师确定为最有帮助的策略是否可以预测治疗师在初始培训后继续提供EBP。结果证实，策略涉及与社区的治疗师培训和经验丰富的EBP，正在进行的咨询/监督，并有一个内部主管培训的EBP使用显着相关。治疗师报告说，这些策略通过接触其他治疗师的病例、指导/反馈、情感支持和消除EBP使用的逻辑障碍来支持EBP的提供。这些发现可以帮助系统和方案优先考虑实施战略，以支持EBP的持续交付。
Many strategies may be used by external consultants (such as treatment developers and trainers) and internal program leaders to support evidence-based practice (EBP) implementation. The goal of this study was to identify which educational implementation strategies are considered by therapists to be most helpful, through which mechanisms, and whether these strategies are linked to EBP use. Semi-structured interviews were conducted with 60 therapists, and 826 therapists completed surveys regarding their perceptions of educational implementation strategies and reported delivery of EBPs within a system-driven, multiple-EBP implementation effort. Using sequential QUAL → QUAN mixed methods, we first identified qualitative themes. Next, we conducted a multilevel logistic regression to examine how quantitative survey items corresponding with qualitative themes predicted EBP use. Initial qualitative thematic analyses revealed four implementation strategies perceived as essential for EBP delivery: connection to a community of trained therapists, ongoing consultation/supervision, availability of internal supervisors trained in the EBP, and access to EBP materials and resources. Quantitative results showed strategies related to connections with a community of trained therapists (i.e., percentage of other therapists at an agency with EBP training and delivery experience as opposed to those who are only trained in the EBP), ongoing consultation/supervision, and having an internal supervisor trained in the EBP (receiving EBP-specific in-house supervision) were significantly associated with EBP use while receiving EBP boosters was not. The closest quantitative indicator corresponding to access to EBP resources, EBP web-based training, was not associated with EBP use. Therapist reported these strategies supported EBP delivery through exposure to other therapists’ cases, guidance/feedback, emotional support, and removing logistic barriers to EBP use. These findings demonstrate how considering therapist perspectives and creating a network of EBP support via supervisors, consultants, and a community of therapists experienced in the EBP may be particularly critical to EBP delivery. Public mental health systems are increasingly implementing multiple evidence-based practices (EBPs). There are many strategies that may be used by external consultants (such as treatment developers and trainers) and internal program leaders to support EBP implementation. The goal of this study was to identify which of these internal and external implementation strategies are considered by therapists to be most helpful and how these strategies are linked with continued use of EBPs. First, qualitative interviews with therapists revealed the following strategies are key for supporting their delivery of EBPs: (1) connections to a community of trained therapists, (2) ongoing consultation/supervision, (3) having an internal supervisor at their program who was trained in the EBP, and (4) access to EBP materials and logistic resources. Next, quantitative analyses of survey data examined whether any of the strategies therapists identified as most helpful predicted the continued delivery of EBPs by therapists after initial training. Results confirmed that strategies involving connections with a community of therapists trained in and experienced with the EBP, ongoing consultation/supervision, and having an internal supervisor trained in the EBP were each significantly associated with EBP use. Therapist reported these strategies supported EBP delivery through exposure to other therapists’ cases, guidance/feedback, emotional support, and removing logistic barriers to EBP use. These findings can assist systems and programs in prioritizing implementation strategies to support the sustained delivery of EBPs.
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发表时间：
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影响因子：
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