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，在全面社区方法（TCA）倡议中研究EBP的采用和实施（EBP A&I）——这是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高药物滥用率的农村地区实施。TCA是一种以社区为基础的协作方法，强调在药物滥用方案的规划、实施、评估和可持续性的各个层面上，所有利益相关者都参与其中。TCA计划评估的一个重要发现是，不同地点的EBP A&I存在很大差异。本研究的目的是研究可能导致EBP A&I变化的因素，探索州、地方供应商和消费者制定支持TCA和全州EBP A&I计划的合作过程，并研究这一过程对提高EBP A&I能力的影响。这项研究对公共卫生的影响是能够改善现有TCA计划中EBP的实施，支持TCA模式在全州范围内的成功扩展，并提供一个改善EBP A&I的模型，该模型可以在面临与EBP A&I类似重大挑战的其他州实施。本研究将探讨以下问题：(1)在TCA倡议中，哪些因素影响EBP的A&I ？(2)协同开发的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标是：(1)完善EBP能力调查（EBPICS）并为系统变更计划做好准备。这项比较设计研究将通过与州、地方供应商和消费者的概念映射来进行，以开发和优先考虑EBP A&I支持，用于制定全州和地方的EBP A&I改进计划（aiip）；(2)通过对州、地方供应商和消费者的EBPIC调查以及深度访谈，检查哪些州机构、个人供应商和消费者层面的因素被认为对药物滥用相关的EBP A&I和当地TCA计划中EBP A&I能力的当前水平影响最大；(3)。通过对合作过程对制定的计划的影响的定性研究，记录和检查合作制定的州和地方TCA EBP采用和实施改进计划（aiips）的过程；(4)通过第2次EBP调查、访谈和对年度TCA选址建议的审查，检查TCA EBP aiip的成功实施和EBP A&I能力的改善。

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.