The Stages of Implementation Completion for Evidence-Based Practice

描述（由申请人提供）：在过去的十年中，越来越多的努力将循证实践（EBP）应用到现实世界的社区环境中。因此，研究人员试图了解实施过程中的哪些步骤对于有效地将EBP运输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发生得很好。该提案映射到NIH PAR-10-038，目标是“制定结果测量和适当的传播方法，并实施准确评估将证据付诸实践的方法是否成功的方法。“实施完成阶段（SIC）是一项8阶段措施，旨在评估多维治疗寄养（MTFC）模式的实施情况。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衡量各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。早期实施绩效（即，实施前）已被证明可以预测中期财务框架的成功实施结果。在拟议的项目中，SIC将通过与每个EBP开发人员的合作，调整和扩展到三个新的EBP，为有精神健康问题的儿童和家庭提供服务，多系统治疗，多维家庭治疗和计算机辅助版本的应对猫。将分析回顾性数据（来自之前的临床试验机构实施工作）和前瞻性数据（来自新采用的临床试验机构）。将审查执行前业绩对执行结果的影响（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基本过程的理解，以确定SIC是否能够及早发现研究中心的成功可能性（目标2）。研究活动还将包括SIC各阶段的成本绘图 以及审查执行费用与业绩之间的关系（目标3）。因此，该项目填补了执行科学领域的空白，解决了执行过程和相关费用方面的衡量差距。与由儿童心理健康实施科学专家和最终用户组成的咨询委员会合作，将向参与的EBP和更广泛的领域传播研究成果，包括实施的关键要素和相关费用，以告知决策者。开发一种通过评估执行业绩来预测执行成果的工具将有助于确定需要干预的领域（例如，通过更多的支持/咨询）。此外，可靠衡量执行进程的能力将有助于今后对执行战略进行评价。该项目的总体目标是提供有助于增加社区对循证生物制品的吸收的工具， 增加向青年提供的服务，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.