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Policy to implementation: evidence-based practice in community mental health – study protocol

机译：实施政策：社区心理健康中基于证据的实践–研究方案

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Background Evidence-based treatments (EBTs) are not widely available in community mental health settings. In response to the call for implementation of evidence-based treatments in the United States, states and counties have mandated behavioral health reform through policies and other initiatives. Evaluations of the impact of these policies on implementation are rare. A systems transformation about to occur in Philadelphia, Pennsylvania, offers an important opportunity to prospectively study implementation in response to a policy mandate. Methods/design Using a prospective sequential mixed-methods design, with observations at multiple points in time, we will investigate the responses of staff from 30 community mental health clinics to a policy from the Department of Behavioral Health encouraging and incentivizing providers to implement evidence-based treatments to treat youth with mental health problems. Study participants will be 30 executive directors, 30 clinical directors, and 240 therapists. Data will be collected prior to the policy implementation, and then at two and four years following policy implementation. Quantitative data will include measures of intervention implementation and potential moderators of implementation (i.e., organizational- and leader-level variables) and will be collected from executive directors, clinical directors, and therapists. Measures include self-reported therapist fidelity to evidence-based treatment techniques as measured by the Therapist Procedures Checklist-Revised, organizational variables as measured by the Organizational Social Context Measurement System and the Implementation Climate Assessment, leader variables as measured by the Multifactor Leadership Questionnaire, attitudes towards EBTs as measured by the Evidence-Based Practice Attitude Scale, and knowledge of EBTs as measured by the Knowledge of Evidence- Based Services Questionnaire. Qualitative data will include semi-structured interviews with a subset of the sample to assess the implementation experience of high-, average-, and low-performing agencies. Mixed methods will be integrated through comparing and contrasting results from the two methods for each of the primary hypotheses in this study. Discussion Findings from the proposed research will inform both future policy mandates around implementation and the support required for the success of these policies, with the ultimate goal of improving the quality of treatment provided to youth in the public sector.
机译：背景社区精神卫生环境中，基于证据的治疗（EBT）并不广泛。为响应在美国实施基于证据的治疗的呼吁，各州和县通过政策和其他措施强制要求进行行为健康改革。很少评估这些政策对实施的影响。即将在宾夕法尼亚州费城进行的系统改造为响应政策要求而进行前瞻性研究实施提供了重要的机会。方法/设计使用前瞻性顺序混合方法设计，并在多个时间点进行观察，我们将调查30家社区精神卫生诊所员工对行为卫生部政策的反应，以鼓励和激励提供者实施证据，以治疗患有精神健康问题的青少年为基础的治疗方法。研究参与者将是30位执行董事，30位临床主任和240位治疗师。数据将在政策实施之前收集，然后在政策实施之后的两年和四年中收集。定量数据将包括干预措施的实施措施和潜在的措施实施者（即组织和领导层变量），并将从执行董事，临床主任和治疗师那里收集。措施包括自我报告的治疗师对基于治疗师程序清单修订的循证治疗技术的忠诚度，组织社会环境评估系统和实施环境评估所度量的组织变量，多因素领导力问卷调查所度量的领导者变量，通过循证实践态度量表衡量的对EBT的态度，以及通过循证服务知识调查表衡量的EBT知识。定性数据将包括半结构化访谈以及一部分样本，以评估高，中，低绩效机构的实施经验。对于本研究中的每个主要假设，将通过比较和对比两种方法的结果来整合混合方法。讨论拟议研究的发现将为未来的政策执行任务提供指导，并为成功实施这些政策提供支持，其最终目标是提高向公共部门青年提供的治疗质量。

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