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首页> 外文期刊>The American psychologist >An Intervention Mapping Process to Increase Evidence-Based Psychotherapy Within a Complex Healthcare System
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An Intervention Mapping Process to Increase Evidence-Based Psychotherapy Within a Complex Healthcare System

机译：在复杂的医疗保健系统中增加循证心理治疗的干预映射过程

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In response to recommendations from the Special Committee on posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs, Veterans Health Administration (VHA) chartered a workgroup to identify strategies for improving the reach and fidelity of evidence-based psychotherapies (EBPs) implemented by VHA through clinician training initiatives. The workgroup, which comprised stakeholders in a variety of roles within the VHA, used an Intervention Mapping process, a practical approach to designing change strategies based on theory, evidence, and stakeholder input. High-level recommendations centered around implementation of recent VHA/Department of Defense (VA/DoD) treatment guidelines. In addition to recommended first-line and suggested second-line treatments, the guidelines include measurement-based care and shared decision making around EBPs and their alternatives to ensure that care is goal-oriented and patient-centered. To support increased reach and fidelity, the workgroup made four broad recommendations: (a) enhancing leadership support; (b) alignment of policies, programs, and processes that influence reach of EBPs as recommended in clinical practice guidelines, including implementation support to accompany EBP trainings; (c) use of clinical data to inform decision making at multiple levels, and to provide fidelity support when outcomes are lower than expected or desired; and (d) increasing veteran and stakeholder education and awareness of guideline recommendations and availability of EBPs. These recommendations accompanied a more detailed set of recommended steps for implementation. This article describes the Intervention Mapping process and a summary of resulting workgroup recommendations.
机译：根据创伤后应激障碍（PTSD）特别委员会的建议，美国退伍军人事务部、退伍军人健康管理局（VHA）特许成立了一个工作组，以确定通过临床医生培训计划提高VHA实施的循证心理治疗（EBP）的覆盖范围和可信度的策略。该工作组由在VHA中扮演各种角色的利益相关者组成，使用了干预映射过程，这是一种基于理论、证据和利益相关者输入设计变革策略的实用方法。高级别建议围绕最近VHA/国防部（VA/DoD）治疗指南的实施。除了推荐的一线和二线治疗外，指南还包括基于测量的护理和围绕循证医学及其替代方案的共享决策，以确保护理以目标为导向，以患者为中心。为了支持扩大影响力和忠诚度，工作组提出了四项广泛的建议：（a）加强领导支持；（b） 按照临床实践指南的建议，调整影响EBP覆盖范围的政策、计划和流程，包括伴随EBP培训的实施支持；（c） 使用临床数据在多个层面为决策提供信息，并在结果低于预期或期望时提供忠诚支持；（d）加强退伍军人和利益相关者的教育，提高对指南建议和EBP可用性的认识。这些建议伴随着一套更详细的建议实施步骤。本文描述了干预映射过程，并总结了工作组的建议。

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