The Stages of Implementation Completion for Evidence-Based Practice

描述（由申请人提供）：在过去的十年中，在现实世界的社区环境中实施循证实践（ebp）的努力越来越多。因此，研究人员试图了解在实施过程中哪些步骤对于有效地将ebp输送到各种环境中至关重要，以及如何最好地衡量这些步骤是否进行得很好。该提案以NIH PAR-10-038为目标，旨在“制定结果衡量标准和适当的方法，用于传播和实施方法，以准确评估将证据转化为实践的方法的成功程度”。实施完成阶段（SIC）是一个8阶段的测量，用于评估多维治疗寄养（MTFC）模型的实施情况。每个阶段都映射到实施的三个阶段：实施前、实施和可持续性。SIC在每个实施阶段采用网站的实施绩效来衡量，以活动完成情况和持续时间来表示。早期阶段的实施绩效（即实施前）已被证明可以预测MTFC的成功实施结果。在拟议的计划中，我们会与每一个心理健康计划的开发者合作，将“心理健康中心”扩展至三个为有心理健康问题的儿童和家庭服务的新心理健康计划，即“多系统治疗”、“多维家庭治疗”，以及“应对猫”的电脑辅助版本。回顾性数据（来自以前的站点实施工作）和前瞻性数据（来自新采用的站点）都将进行分析。将审查实施前绩效对实施结果的影响（目标1）。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潜在过程的理解，以确定SIC是否可以提供早期检测站点成功的可能性（目标2）。研究活动还将包括SIC阶段的成本图

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.