Measuring the Multilevel Outcomes of Children's Mental Health Services Implementation

项目摘要 实施科学旨在缩小科学与实践之间的差距，并在以下方面取得了进展： 就执行战略和成果达成共识。实施研究主要侧重于直接 执行战略的成果，尽管有证据表明， 因为儿童的心理健康服务会导致一系列多层次的结果。多层面成果包括 不是主要焦点的结构;它们是间接的、计划外的或对其他利益相关者更突出的 比研究员。一项对儿童心理健康实施策略的系统性回顾发现， 这项研究系统地调查了计划外的结果。这项研究的长期目标是改善 通过开发分类和决策工具， 纳入多层次的结果衡量标准，并制定一项与消费者相关的务实衡量标准。 包括多层次的结果可以识别重要的和意外的结果，为质量改进提供信息， 可用性和干预措施的有效性以及了解负面下游。许多 实施研究项目缺乏对多层次成果的认识或资源， 我们认为是由于目前缺乏选择最合适的多层次的现有指导方针造成的 共同执行战略的成果。通过使用理论、专家共识和利益相关者 参与，我们将确定与实施战略相关的多层次结果的分类 与四个利益相关者角色（消费者/家庭、供应商、政策制定者和 研究人员）。这项工作将通过三轮调查进行，由一批专家参加， 这些角色中的每一个都将对实施战略和相关成果进行评级， 利益攸关方的作用。结果将用于创建一个决策工具，以确定和衡量全部余额 儿童心理健康服务实施战略的成果，这将有几个 效益它将提供一个更完整和民主的图片级联和偶尔令人惊讶的 实施工作的影响，并有助于理论修正。这将有助于执行者和政策 决策者提高干预措施的可用性和有效性，做出更好的成本效益选择， 预防不良结果的机会，使创新者能够突出积极的多层次 成果，并提高预测执行情况的准确性。

PROJECT SUMMARY Implementation science aims to close the science-to-practice gap, and progress has been made toward consensus on implementation strategies and outcomes. Implementation studies are primarily focused on direct outcomes of implementation strategies, despite evidence that implementation efforts in complex settings such as children’s mental health services lead to a host of multilevel outcomes. Multilevel outcomes include constructs that are not the primary focus; they are indirect, unplanned, or more salient to other stakeholders than the researcher. A systematic review of children’s mental health implementation strategies found only one study systematically investigated unplanned outcomes. The long-term goal of this study is to improve implementation science in children’s mental health services by developing a taxonomy and decision tool for incorporating multilevel outcome measures, and develop one pragmatic measure as relevant to consumers. Including multilevel outcomes may identify important and unexpected results to inform quality improvement, usability, and the effectiveness of interventions as well as learning about negative downstream. Many implementation research projects lack the awareness of or resources to measure multilevel outcomes, which we believe is caused by the current absence of existing guidelines for selecting the most appropriate multilevel outcomes for common implementation strategies. Through use of theory, expert consensus, and stakeholder participation, we will identify a taxonomy of multilevel outcomes that are linked to implementation strategies and are most relevant to four stakeholder roles (consumers/families, providers, policy makers, and researchers). This will be done through three rounds of surveys with a pool of expert participants representing each of these roles, who will rate implementation strategies and associated outcomes as relevant to their stakeholder role. Results will be used to create a decision making tool to identify and measure the full balance of outcomes of implementation strategies in children’s mental health services, which would have several benefits. It would provide a more complete and democratic picture of the cascading and occasionally surprising impacts of implementation efforts, and contribute to theory modification. It would help implementers and policy makers increase the usability and effectiveness of interventions, make better cost-benefit choices, provide opportunities for the prevention of undesirable outcomes, enable innovators to highlight positive multilevel outcomes, and improve precision in predicting implementation.