Building System Capacity to Implement EBPs within A Community Based QI Model

描述（由申请人提供）：本研究优化了一个自然发生的实验室，以研究EBP的采用和实施（EBP A&I）在总社区方法（TCA）倡议-一个国家资助的项目（自2008财年以来每年约300万美元）在新墨西哥州的六个农村地区实施，药物滥用率高。TCA是一种以社区为基础的协作方法，强调所有利益相关者参与各级药物滥用方案的规划，实施，评估和可持续性。对TCA倡议进行评估的一个重要发现是，各地点的EBP A&I差异很大。本研究的目的是检查可能导致EBP A&I可变性的因素，探索州，当地供应商和消费者制定计划以支持TCA和全州范围内的EBP A&I的协作过程，并检查此过程对提高EBP A&I能力的影响。这项研究的公共卫生影响是改善现有TCA计划中EBP实施的能力，支持TCA模型在全州范围内的成功扩展，并提供一个改进EBP A&I的模型，该模型可以在面临类似重大挑战的其他州实施EBP A & I。 本研究将探讨以下问题：（1）什么因素会影响TCA倡议中的EBP A&I？(2)合作制定的EBP A&I改进计划（AIIP）是否提高了在TCA倡议和全州范围内采用和实施EBP的能力？回答这些问题的具体目的是（1）完善EBP能力调查（EBPICS），并为系统更改计划做好准备。这项比较设计研究将通过与州、地方供应商和消费者一起使用概念图来进行，以制定和优先考虑EBP A&I支持，用于制定全州和地方的EBP A&I改进计划;随后进行专家审查，以最终确定EBPIC调查（2）检查哪个国家机构，通过对各州的EBPIC调查，个人提供者和消费者层面的因素被认为是最影响物质滥用相关EBP A&I和当地TCA计划中EBP A&I能力的因素，本地供应商和消费者，并进行深入访谈;（3）。通过对合作过程对制定计划的影响进行定性研究，记录和检查合作制定的全州和地方TCA EBP采用和实施改进计划（AIIIP）的过程;以及（4）通过T2 EBPIC调查，访谈和年度TCA站点提案的审查，检查TCA EBP AIIP实施的成功和EBP A&I能力的改进。 公共卫生相关性：新墨西哥州已承诺为三氯乙酸倡议提供大量资金（自2008财政年度以来每年约300万美元），正是因为其潜在的公共卫生效益，即减少所有新墨西哥人高药物滥用率的影响。这项研究努力扩大这一好处，不仅改善EBP的实施在现有的TCA倡议，而且还支持TCA模型在全州范围内的成功扩展。此外，该提案通过提供一种改进EBP A&I的模式，将可能的公共卫生利益扩展到新墨西哥州以外，这种模式可以在面临类似EBP A&I挑战的其他州复制。

DESCRIPTION (provided by applicant): This study optimizes a naturally occurring laboratory to study EBP adoption and implementation (EBP A&I) within the Total Community Approach (TCA) initiative-- a state-funded project (approximately 3 million dollars per year since FY08) implemented in six rural areas of New Mexico with high rates of substance abuse. TCA is a community-based, collaborative approach emphasizing the involvement of a full range of stakeholders at all levels of substance abuse program planning, implementation, evaluation, and sustainability. A significant finding from the evaluation of the TCA initiative has been that there is great variation in EBP A&I across sites. This purpose of this study is to examine the factors that may account for the variability in EBP A&I, explore the collaborative process by which state, local providers and consumers develop plans to support EBP A&I in TCA and statewide, and examine the impact of this process on improving EBP A&I capacity. This public health impact of this study is the ability to improve EBP implementation in the existing TCA initiative, support the successful expansion statewide of the TCA model, and provide a model for improving EBP A&I that can be implemented in other states facing similar significant challenges to EBP A&I. The proposed research will explore the following questions: (1) What factors impact EBP A&I in the TCA initiative? (2) Do the collaboratively developed EBP A&I Improvement Plans (AIIPs) enhance the capacity to adopt and implement EBPs in the TCA initiative and statewide? The Specific Aims to answer these questions are (1) Refine EBP Capacities Survey (EBPICS) and prepare for system change planning. This comparative design study will be conducted through use of Concept Mapping with state, local providers and consumers to develop and prioritize EBP A&I supports to be used to develop EBP A&I improvement plans (AIIPs) statewide and locally; followed by expert review to finalized the EBPIC survey (2) Examine what state agency, individual provider and consumer level factors are perceived to most impact substance abuse-related EBP A&I and the current level of EBP A&I capacity in local TCA programs through EBPIC survey with state, local provider and consumers, and in-depth interviews; (3). Document and examine the process of collaboratively developed statewide and local TCA EBP Adoption and Implementation Improvement Plans (AIIIPs) through a qualitative study of the impact of the collaborative process on plans developed; and (4) Examine success in the implementation of the TCA EBP AIIPs and improvements in EBP A&I capacity through T2 EBPIC survey, interviews, and reviews of annual TCA site proposals. PUBLIC HEALTH RELEVANCE: The state of New Mexico has committed extensive funding (approximately 3 million dollars per year since FY08) to the TCA initiative precisely because of its potential public health benefit of reducing the impact of high rates of substance abuse for all New Mexicans. This study strives to extend this benefit by not only improving EBP implementation within the existing TCA initiative, but also to support successful expansion of the TCA model statewide. Additionally, this proposal extends the possible public health benefit beyond New Mexico by providing a model for improving EBP A&I that can be replicated in other states facing similar challenges to EBP A&I.