Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA
Abstract Background Despite an established taxonomy of implementation strategies, minimal guidance exists for how to select and tailor strategies to specific practices and contexts. We employed a replicable method to obtain stakeholder perceptions of the most feasible and important implementation st...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-022-00319-w |
| _version_ | 1818249888863879168 |
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| author | Elizabeth H. Connors Aaron R. Lyon Kaylyn Garcia Corianna E. Sichel Sharon Hoover Mark D. Weist Jacob K. Tebes |
| author_facet | Elizabeth H. Connors Aaron R. Lyon Kaylyn Garcia Corianna E. Sichel Sharon Hoover Mark D. Weist Jacob K. Tebes |
| author_sort | Elizabeth H. Connors |
| collection | DOAJ |
| description | Abstract Background Despite an established taxonomy of implementation strategies, minimal guidance exists for how to select and tailor strategies to specific practices and contexts. We employed a replicable method to obtain stakeholder perceptions of the most feasible and important implementation strategies to increase mental health providers’ use of measurement-based care (MBC) in schools. MBC is the routine use of patient-reported progress measures throughout treatment to inform patient-centered, data-driven treatment adjustments. Methods A national sample of 52 school mental health providers and researchers completed two rounds of modified Delphi surveys to rate the relevance, importance, and feasibility of 33 implementation strategies identified for school settings. Strategies were reduced and definitions refined using a multimethod approach. Final importance and feasibility ratings were plotted on “go-zone” graphs and compared across providers and researchers to identify top-rated strategies. Results The initial 33 strategies were rated as “relevant” or “relevant with changes” to MBC in schools. Importance and feasibility ratings were high overall for both survey rounds; on a scale of 1 to 5, importance ratings (3.61–4.48) were higher than feasibility ratings (2.55–4.06) on average. Survey 1 responses resulted in a reduced, refined set of 21 strategies, and six were rated most important and feasible on Survey 2: (1) assess for readiness and identify barriers and facilitators; (2) identify and prepare champions; (3) develop a usable implementation plan; (4) offer a provider-informed menu of free, brief measures; (5) develop and provide access to training materials; and (6) make implementation easier by removing burdensome documentation tasks. Provider and researcher ratings were not significantly different, with a few exceptions: providers reported higher feasibility and importance of removing burdensome paperwork than researchers, providers reported higher feasibility of train-the trainer approaches than researchers, and researchers reported higher importance of monitoring fidelity than providers. Conclusions The education sector is the most common setting for child and adolescent mental health service delivery in the USA. Effective MBC implementation in schools has the potential to elevate the quality of care received by many children, adolescents, and their families. This empirically derived, targeted list of six implementation strategies offers potential efficiencies for future testing of MBC implementation in schools. |
| first_indexed | 2024-12-12T15:43:39Z |
| format | Article |
| id | doaj.art-3e18d4f0eca3402e883f56573fdcd2f0 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-12-12T15:43:39Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-3e18d4f0eca3402e883f56573fdcd2f02022-12-22T00:19:49ZengBMCImplementation Science Communications2662-22112022-06-013111710.1186/s43058-022-00319-wImplementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USAElizabeth H. Connors0Aaron R. Lyon1Kaylyn Garcia2Corianna E. Sichel3Sharon Hoover4Mark D. Weist5Jacob K. Tebes6Department of Psychiatry, Yale UniversityDepartment of Psychiatry and Behavioral Sciences, University of WashingtonDepartment of Psychiatry, Yale UniversityDepartment of Psychiatry, Yale UniversityDepartment of Psychiatry, University of MarylandDepartment of Psychology, University of South CarolinaDepartment of Psychiatry, Yale UniversityAbstract Background Despite an established taxonomy of implementation strategies, minimal guidance exists for how to select and tailor strategies to specific practices and contexts. We employed a replicable method to obtain stakeholder perceptions of the most feasible and important implementation strategies to increase mental health providers’ use of measurement-based care (MBC) in schools. MBC is the routine use of patient-reported progress measures throughout treatment to inform patient-centered, data-driven treatment adjustments. Methods A national sample of 52 school mental health providers and researchers completed two rounds of modified Delphi surveys to rate the relevance, importance, and feasibility of 33 implementation strategies identified for school settings. Strategies were reduced and definitions refined using a multimethod approach. Final importance and feasibility ratings were plotted on “go-zone” graphs and compared across providers and researchers to identify top-rated strategies. Results The initial 33 strategies were rated as “relevant” or “relevant with changes” to MBC in schools. Importance and feasibility ratings were high overall for both survey rounds; on a scale of 1 to 5, importance ratings (3.61–4.48) were higher than feasibility ratings (2.55–4.06) on average. Survey 1 responses resulted in a reduced, refined set of 21 strategies, and six were rated most important and feasible on Survey 2: (1) assess for readiness and identify barriers and facilitators; (2) identify and prepare champions; (3) develop a usable implementation plan; (4) offer a provider-informed menu of free, brief measures; (5) develop and provide access to training materials; and (6) make implementation easier by removing burdensome documentation tasks. Provider and researcher ratings were not significantly different, with a few exceptions: providers reported higher feasibility and importance of removing burdensome paperwork than researchers, providers reported higher feasibility of train-the trainer approaches than researchers, and researchers reported higher importance of monitoring fidelity than providers. Conclusions The education sector is the most common setting for child and adolescent mental health service delivery in the USA. Effective MBC implementation in schools has the potential to elevate the quality of care received by many children, adolescents, and their families. This empirically derived, targeted list of six implementation strategies offers potential efficiencies for future testing of MBC implementation in schools.https://doi.org/10.1186/s43058-022-00319-wImplementation strategy selectionMeasurement-based careSchool mental health treatment |
| spellingShingle | Elizabeth H. Connors Aaron R. Lyon Kaylyn Garcia Corianna E. Sichel Sharon Hoover Mark D. Weist Jacob K. Tebes Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA Implementation Science Communications Implementation strategy selection Measurement-based care School mental health treatment |
| title | Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA |
| title_full | Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA |
| title_fullStr | Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA |
| title_full_unstemmed | Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA |
| title_short | Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA |
| title_sort | implementation strategies to promote measurement based care in schools evidence from mental health experts across the usa |
| topic | Implementation strategy selection Measurement-based care School mental health treatment |
| url | https://doi.org/10.1186/s43058-022-00319-w |
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