Choice and Partnership Approach to community mental health and addiction services: a realist-informed scoping review
Objectives The Choice and Partnership Approach (CAPA) was developed to create an accessible, child-centred and family-centred model of child and adolescent mental health service delivery that is adaptable to different settings. We sought to describe the state of evidence regarding the extent, outcom...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-10-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/10/e064436.full |
| _version_ | 1811338489156861952 |
|---|---|
| author | Adrian MacKenzie Leslie Anne Campbell Sharon E Clark Jill Chorney Debbie Emberly Julie MacDonald Lori Wozney Grace Warner |
| author_facet | Adrian MacKenzie Leslie Anne Campbell Sharon E Clark Jill Chorney Debbie Emberly Julie MacDonald Lori Wozney Grace Warner |
| author_sort | Adrian MacKenzie |
| collection | DOAJ |
| description | Objectives The Choice and Partnership Approach (CAPA) was developed to create an accessible, child-centred and family-centred model of child and adolescent mental health service delivery that is adaptable to different settings. We sought to describe the state of evidence regarding the extent, outcomes and contextual considerations of CAPA implementation in community mental health services.Design Scoping review.Data sources Published and grey literature were searched using MEDLINE, Embase, CINAHL, PsycINFO, Scopus and Google to 13 and 20 July 2022, respectively.Eligibility criteria We included reports focused on the implementation, outcomes (clinical, programme or system) or a discussion of contextual factors that may impact CAPA implementation in either child and adolescent or adult mental health services.Data extraction and synthesis Data were extracted using a codebook that reflected the five domains of the Consolidated Framework for Implementation Research (CFIR) and reviewed for agreement and accuracy. Data were synthesised according to the five CFIR domains.Results Forty-eight reports describing 36 unique evaluations were included. Evaluations were observational in nature; 10 employed pre–post designs. CAPA implementation, regardless of setting, was largely motivated by long wait times. Characteristics of individuals (eg, staff buy-in or skills) were not reported. Processes of implementation included facilitative leadership, data-informed planning and monitoring and CAPA training. Fidelity to CAPA was infrequently measured (n=9/36) despite available tools. Health system outcomes were most frequently reported (n=28/36); few evaluations (n=7/36) reported clinical outcomes, with only three reporting pre/post CAPA changes.Conclusions Gaps in evidence preclude a systematic review and meta-analysis of CAPA implementation. Measurement of clinical outcomes represents an area for significant improvement in evaluation. Consistent measurement of model fidelity is essential for ensuring the accuracy of outcomes attributed to its implementation. An understanding of the change processes necessary to support implementation would be strengthened by more comprehensive consideration of contextual factors. |
| first_indexed | 2024-04-13T18:11:36Z |
| format | Article |
| id | doaj.art-d32864eddb0143b7b23221b52ffece12 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-13T18:11:36Z |
| publishDate | 2022-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-d32864eddb0143b7b23221b52ffece122022-12-22T02:35:53ZengBMJ Publishing GroupBMJ Open2044-60552022-10-01121010.1136/bmjopen-2022-064436Choice and Partnership Approach to community mental health and addiction services: a realist-informed scoping reviewAdrian MacKenzie0Leslie Anne Campbell1Sharon E Clark2Jill Chorney3Debbie Emberly4Julie MacDonald5Lori Wozney6Grace Warner7Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, CanadaDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, CanadaMental Health and Addictions, IWK Health, Halifax, Nova Scotia, CanadaDepartment of Psychiatry, Dalhousie University, Halifax, Nova Scotia, CanadaMental Health and Addictions, IWK Health, Halifax, Nova Scotia, CanadaMental Health and Addictions, Nova Scotia Health, Halifax, Nova Scotia, CanadaDepartment of Psychiatry, Dalhousie University, Halifax, Nova Scotia, CanadaSchool of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, CanadaObjectives The Choice and Partnership Approach (CAPA) was developed to create an accessible, child-centred and family-centred model of child and adolescent mental health service delivery that is adaptable to different settings. We sought to describe the state of evidence regarding the extent, outcomes and contextual considerations of CAPA implementation in community mental health services.Design Scoping review.Data sources Published and grey literature were searched using MEDLINE, Embase, CINAHL, PsycINFO, Scopus and Google to 13 and 20 July 2022, respectively.Eligibility criteria We included reports focused on the implementation, outcomes (clinical, programme or system) or a discussion of contextual factors that may impact CAPA implementation in either child and adolescent or adult mental health services.Data extraction and synthesis Data were extracted using a codebook that reflected the five domains of the Consolidated Framework for Implementation Research (CFIR) and reviewed for agreement and accuracy. Data were synthesised according to the five CFIR domains.Results Forty-eight reports describing 36 unique evaluations were included. Evaluations were observational in nature; 10 employed pre–post designs. CAPA implementation, regardless of setting, was largely motivated by long wait times. Characteristics of individuals (eg, staff buy-in or skills) were not reported. Processes of implementation included facilitative leadership, data-informed planning and monitoring and CAPA training. Fidelity to CAPA was infrequently measured (n=9/36) despite available tools. Health system outcomes were most frequently reported (n=28/36); few evaluations (n=7/36) reported clinical outcomes, with only three reporting pre/post CAPA changes.Conclusions Gaps in evidence preclude a systematic review and meta-analysis of CAPA implementation. Measurement of clinical outcomes represents an area for significant improvement in evaluation. Consistent measurement of model fidelity is essential for ensuring the accuracy of outcomes attributed to its implementation. An understanding of the change processes necessary to support implementation would be strengthened by more comprehensive consideration of contextual factors.https://bmjopen.bmj.com/content/12/10/e064436.full |
| spellingShingle | Adrian MacKenzie Leslie Anne Campbell Sharon E Clark Jill Chorney Debbie Emberly Julie MacDonald Lori Wozney Grace Warner Choice and Partnership Approach to community mental health and addiction services: a realist-informed scoping review BMJ Open |
| title | Choice and Partnership Approach to community mental health and addiction services: a realist-informed scoping review |
| title_full | Choice and Partnership Approach to community mental health and addiction services: a realist-informed scoping review |
| title_fullStr | Choice and Partnership Approach to community mental health and addiction services: a realist-informed scoping review |
| title_full_unstemmed | Choice and Partnership Approach to community mental health and addiction services: a realist-informed scoping review |
| title_short | Choice and Partnership Approach to community mental health and addiction services: a realist-informed scoping review |
| title_sort | choice and partnership approach to community mental health and addiction services a realist informed scoping review |
| url | https://bmjopen.bmj.com/content/12/10/e064436.full |
| work_keys_str_mv | AT adrianmackenzie choiceandpartnershipapproachtocommunitymentalhealthandaddictionservicesarealistinformedscopingreview AT leslieannecampbell choiceandpartnershipapproachtocommunitymentalhealthandaddictionservicesarealistinformedscopingreview AT sharoneclark choiceandpartnershipapproachtocommunitymentalhealthandaddictionservicesarealistinformedscopingreview AT jillchorney choiceandpartnershipapproachtocommunitymentalhealthandaddictionservicesarealistinformedscopingreview AT debbieemberly choiceandpartnershipapproachtocommunitymentalhealthandaddictionservicesarealistinformedscopingreview AT juliemacdonald choiceandpartnershipapproachtocommunitymentalhealthandaddictionservicesarealistinformedscopingreview AT loriwozney choiceandpartnershipapproachtocommunitymentalhealthandaddictionservicesarealistinformedscopingreview AT gracewarner choiceandpartnershipapproachtocommunitymentalhealthandaddictionservicesarealistinformedscopingreview |