Dissemination and Implementation of Evidence-Based Practices for Child and Adolescent Mental Health: A Systematic Review

Abstract

Objective While there has been a dramatic increase in the number of evidence-based practices (EBPs) to improve child and adolescent mental health, the poor uptake of these EBPs has led to investigations of factors related to their successful dissemination and implementation. The purpose of this systematic review was to identify key findings from empirical studies examining the dissemination and implementation of EBPs for child and adolescent mental health. Method Out of 14,247 citations initially identified, 73 articles drawn from 44 studies met inclusion criteria. The articles were classified by implementation phase (exploration, preparation, implementation, and sustainment) and specific implementation factors examined. These factors were divided into outer (i.e., system level) and inner (i.e., organizational level) contexts. Results Few studies utilized true experimental designs; most were observational. Of the many inner context factors that were examined in these studies (e.g., provider characteristics, organizational resources, leadership), fidelity monitoring and supervision had the strongest empirical evidence. While the focus of fewer studies, implementation interventions focused on improving organizational climate and culture were associated with better intervention sustainment as well as child and adolescent outcomes. Outer contextual factors such as training and use of specific technologies to support intervention use were also important in facilitating the implementation process. Conclusions The further development and testing of dissemination and implementation strategies is needed in order to more efficiently move EBPs into usual care.

The Survey of School Promotion of Emotional and Social Health (SSPESH): A Brief Measure of the Implementation of Whole-School Mental Health Promotion

“…Similar results have been reported elsewhere (e.g. Simonsen et al, 2012;Payton et al, 2008;Sklad, Diekstra, Ritter, Ben, & Gravesteijn, 2012;Durlak et al 2011;Kidger, Araya, Donovan, & Gunnell, 2012;Wells, Barlow, & Stewart-Brown, 2003;Basch, 2011;Novins, Green, Legha, & Aarons, 2013;Weissberg, Goren, Domitrovich, & Dusenbury, 2013). However, despite the large number of school-based programs that foster positive mental health, there continues to be little evidence available concerning how schools measure the implementation of such programs and the impact that they may have (Adelman & Taylor, 2000;Domitrovich et al, 2008;Durlak and DuPre, 2008).…”

Preventing Child and Adolescent Anxiety Disorders: Overview of Systematic Reviews

“…Because relevant primary studies, systematic reviews, and meta-analyses are spread across numerous peer-reviewed journals, the gray (unpublished) literature, and research repositories, the use of prevention interventions by clinicians and health service policymakers may have been hampered by lack of access to what is known about effective interventions. [22][23][24] Therefore, we conducted this overview of systematic reviews (OSRs) of prevention interventions for child and adolescent anxiety. Three questions were addressed: (1) Does the intervention prevent anxiety diagnosis and/or reduce anxiety symptoms compared to passive controls?…”

A comparison of parent reported outcome with experience of services

“…Children seen in clinical practice often have more complex and severe disorders, greater levels of comorbidity as well as more adverse psycho-social backgrounds compared to participants in intervention trials who may be selected to avoid comorbidity and are often recruited from non-clinical environments (Weisz et al, 2013). This leads to heated debates about the extent to which evidence-based interventions can be applied to routine service provision (Kazdin, 2008;Novins et al, 2013;Weisz et al, 2013). Deighton et al (2015), using naturalistic service collected data reported no significant difference in outcome between evidence based practice and non-evidence based practice in children with conduct disorders, but a significantly greater improvement according to child self-report among children with emotional disorders.…”