The Stages of Implementation Completion for Evidence-Based Practice

描述(由申请人提供)：在过去的十年里，人们越来越努力地将循证实践(EBPS)应用到现实世界的社区环境中。因此，研究人员试图了解执行过程中的哪些步骤对于有效地将循证政策输送到不同的环境至关重要，以及如何最好地衡量这些步骤是否发生得很好。这项提案映射到NIH PAR-10-038，目标是“为传播和实施方法制定结果衡量标准和适当的方法，以准确评估将证据付诸实践的方法的成功。”实施完成阶段(SIC)是为评估多维治疗寄养护理(MTFC)模式的实施情况而制定的一项8阶段措施。每个阶段都对应于实施的三个阶段：实施前、实施和可持续性。SIC在每个实施阶段采用现场的实施绩效，如活动完成情况和持续时间所示。已证明，早期执行情况(即执行前)可以预测中期方案筹资委员会的成功执行结果。在拟议的项目中，通过与每个EBP开发者的合作，SIC将被调整和扩展到三个新的EBPS，即多系统疗法、多维家庭疗法和计算机辅助版本的应对猫，这些EBP服务于有心理健康问题的儿童和家庭。回顾数据(来自以前的站点实施工作)和预期数据(来自新采用的站点)都将被分析。将审查执行前业绩对执行结果的影响(Aim1)。此外，混合方法程序将侧重于增加对导致实施成功或失败的基本过程的了解，以确定SIC是否能够及早发现地点成功的可能性(目标2)。研究活动还将包括SIC阶段的成本图 以及审查执行费用与业绩之间的关系(目标3)。因此，该项目填补了实施科学领域的一个空白，解决了实施过程和相关费用的衡量差距。与由儿童心理健康执行科学专家和最终用户组成的咨询委员会合作，研究结果，包括执行的关键要素和相关费用，将分发给参加的循证医学计划和更广泛的领域，以供决策者参考。开发一种通过评估执行情况来预测执行结果的工具，将有助于查明需要干预的领域(例如，通过额外的支助/协商)。此外，能够可靠地衡量执行进程将有助于今后对执行战略的评价。该项目的总体目标是提供工具，帮助增加社区对EBPS的接受，从而 增加向青年提供服务的机会，减少因执行工作失败而浪费的资源。

DESCRIPTION (provided by applicant): Over the last decade, there has been an increased effort to implement evidence-based practices (EBPs) into real-world community settings. Accordingly, researchers have sought to understand what steps in the implementation process are essential to effectively transport EBPs to a diverse range of settings, and how to best measure if these steps have occurred well. This proposal maps onto NIH PAR-10-038 by targeting the "development of outcome measures and suitable methodologies for dissemination and implementation approaches that accurately assess the success of an approach to move evidence into practice." The Stages of Implementation Completion (SIC) is an 8-stage measure that was developed to evaluate the implementation of the Multidimensional Treatment Foster Care (MTFC) model. Each of the stages maps onto the three phases of implementation: pre-implementation, implementation, and sustainability. The SIC measures adopting sites' implementation performance, as indicated by activity completion and duration, in each of the implementation stages. Early stage implementation performance (i.e., pre-implementation) has been shown to predict successful implementation outcomes for MTFC. In the proposed project, the SIC will be adapted and extended to three new EBPs serving children and families with mental health problems, Multisystemic Therapy, Multidimensional Family Therapy, and a computer-assisted version of Coping Cat, through collaborations with each of the EBP developers. Both retrospective data (from previous site implementation efforts) and prospective data (from newly adopting sites) will be analyzed. The influence of pre-implementation performance on implementation outcomes will be examined (Aim1). In addition, mixed method procedures will focus on increasing understanding of the underlying processes that lead to implementation success or failure in order to determine if the SIC can provide early detection of sites' likelihood of success (Aim 2). Study activities also will include cost mapping of SIC stages and an examination of the relationship between implementation costs and performance (Aim 3). This project, therefore, fills a void in the field of implementation science by addressing the measurement gap in both the implementation process and the associated costs. In collaboration with an Advisory Board comprised of child mental health implementation science experts and end users, study outcomes, including the key elements of implementation and associated costs, will be disseminated to the participating EBPs and to the broader field to inform decision makers. The development of a tool that predicts implementation outcomes by assessing implementation performance will help identify areas in need of intervention (e.g., through additional support/consultation). Further, the ability to reliably measure implementation processes will facilitate future evaluations of implementation strategies. The overarching goal of this project is to provide tools that will help increase the uptake of EBPs in communities, thereby increasing the availability of services to youth and decreasing wasted resources from failed implementation efforts.