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A mixed methods multiple case study of implementation as usual in children’s social service organizations: study protocol

机译：儿童社会服务组织照常实施的混合方法多案例研究：研究方案

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Background Improving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care. It is likely that efforts to identify, develop, and refine implementation strategies will be more successful if they are informed by relevant stakeholders and are responsive to the strengths and limitations of the contexts and implementation processes identified in usual care settings. This study will describe: the types of implementation strategies used; how organizational leaders make decisions about what to implement and how to approach the implementation process; organizational stakeholders’ perceptions of different implementation strategies; and the potential influence of organizational culture and climate on implementation strategy selection, implementation decision-making, and stakeholders’ perceptions of implementation strategies. Methods/design This study is a mixed methods multiple case study of seven children’s social service organizations in one Midwestern city in the United States that compose the control group of a larger randomized controlled trial. Qualitative data will include semi-structured interviews with organizational leaders (e.g., CEOs/directors, clinical directors, program managers) and a review of documents (e.g., implementation and quality improvement plans, program manuals, etc.) that will shed light on implementation decision-making and specific implementation strategies that are used to implement new programs and practices. Additionally, focus groups with clinicians will explore their perceptions of a range of implementation strategies. This qualitative work will inform the development of a Web-based survey that will assess the perceived effectiveness, relative importance, acceptability, feasibility, and appropriateness of implementation strategies from the perspective of both clinicians and organizational leaders. Finally, the Organizational Social Context measure will be used to assess organizational culture and climate. Qualitative, quantitative, and mixed methods data will be analyzed and interpreted at the case level as well as across cases in order to highlight meaningful similarities, differences, and site-specific experiences. Discussion This study is designed to inform efforts to develop more effective implementation strategies by fully describing the implementation experiences of a sample of community-based organizations that provide mental health services to youth in one Midwestern city.
机译：背景技术提高儿童心理健康和社会服务环境的质量将需要能够将有效治疗和其他创新（例如评估工具）转移到常规护理中的实施策略。如果相关利益攸关方告知他们并响应常规护理环境中确定的环境和实施过程的优势和局限性，确定，制定和完善实施策略的努力可能会更加成功。这项研究将描述：使用的实施策略的类型;组织负责人如何决定实施什么以及如何实施实施过程;组织利益相关者对不同实施策略的看法;以及组织文化和氛围对实施策略选择，实施决策以及利益相关者对实施策略的理解的潜在影响。方法/设计本研究是一项混合方法多案例研究，研究对象是美国中西部一个城市的七个儿童社会服务组织，该组织组成了较大的随机对照试验的对照组。定性数据将包括与组织负责人（例如，首席执行官/董事，临床主管，计划经理）进行的半结构化访谈，以及对文件的审查（例如，实施和质量改进计划，计划手册等），以阐明实施情况用于实施新计划和实践的决策和特定实施策略。此外，与临床医生的焦点小组将探讨他们对一系列实施策略的看法。这项定性工作将为基于Web的调查的发展提供信息，该调查将从临床医生和组织负责人的角度评估实施策略的感知有效性，相对重要性，可接受性，可行性和适当性。最后，组织社会背景测量将用于评估组织文化和气候。定性，定量和混合方法的数据将在案例级别以及跨案例进行分析和解释，以突出有意义的相似性，差异和特定地点的经验。讨论本研究旨在通过全面描述一个中西部城市为青年提供心理健康服务的社区组织样本的实施经验，来为制定更有效的实施策略提供参考。

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