Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol

Lewis, Cara C.; Scott, Kelli; Marti, C. Nathan; Marriott, Brigid R.; Kroenke, Kurt; Putz, John W.; Mendel, Peter; Rutkowski, David

doi:10.1186/s13012-015-0313-2

Cited by 58 publications

(59 citation statements)

References 67 publications

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“…Such measures, rather than diluting the interventions, may ultimately improve them and increase the likelihood of sustainability. Some researchers have begun to integrate this framework into their research to examine whether strategies to address the dynamic contexts into which interventions are implemented can lead to successful implementation and sustainment (73,133).…”

Section: Capacity Buildingmentioning

confidence: 99%

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

Shelton

Cooper

Stirman

2024

Annual Review of Public Health

477

627

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intensity for the sustained achievement of desirable program goals and population outcomes. This understudied area has been identified as one of the most significant translational research problems. Adding to this challenge is uncertainty regarding the extent to which intervention adaptation and evolution are necessary to address the needs of populations that differ from those in which interventions were originally tested or implemented. This review critically examines and discusses conceptual and methodological issues in studying sustainability, summarizes the multilevel factors that have been found to influence the sustainability of interventions in a range of public health and health care settings, and highlights key areas for future research. AbstractThere is strong interest in implementation science to address the gap between research and practice in public health. Research on the sustainability of evidence-based interventions has been growing rapidly. Sustainability has been defined as the continued use of program components at sufficient (17,97,109). Although numerous evidence-based public health interventions and clinical preventive strategies and treatments are available, it can be challenging to implement and sustain them outside of controlled settings, particularly if they were originally tested in narrow populations or unrepresentative circumstances (49). As a rapidly growing field, implementation science has focused on understanding factors and strategies that influence the initial adoption and integration of evidence-based interventions (EBIs) in real-world settings (103). Whereas significant advancements have been made in understanding the adoption and implementation of EBIs across a range of community and health care settings, less is known about their sustainability. Recently, experts have prioritized sustainability as an understudied area (45), identifying it as "one of the most significant translational research problems of our time" (103, p. 2) and as a persistent challenge across a range of settings and service delivery sectors, and across health behaviors and outcomes.Maximizing the public health impact of EBIs will require investing in sustainability research. This research will enable us to better understand what factors and processes influence the sustainability of interventions and how to plan proactively for the continuation of EBIs. Moreover, there has been growing consideration of the policy and ethical implications of developing effective health programs without investing in sustainability (118). Researchers, health leaders, advocates, policy makers, practitioners, and funders alike have concerns about the long-term impact and value of their investment in discontinued interventions. In addition to lost investments, time, and resources, there are other reasons for which advancing our understanding of the sustainability of EBIs has value (99, 122). Maintaining effective programs and practices is critical for achieving health benefits, particularly if there is a latency period betwee...

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Section: Capacity Buildingmentioning

confidence: 99%

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

Shelton

Cooper

Stirman

2024

Annual Review of Public Health

477

627

View full text Add to dashboard Cite

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“…Notes: Severity of depression 26 was defined using PHQ-9 as minimal (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), moderately severe (15)(16)(17)(18)(19), and severe (20)(21)(22)(23)(24)(25)(26)(27). Alcohol 32 and drug use 33 during the past year were screened with self-report measures.…”

Section: Patients In Primary Care Settings That Screened Positive Formentioning

confidence: 99%

“…Use of MBC is associated with rates of remission twice as high when compared with standard of care 14 and has now been adopted in treatment guidelines for depression. 15 As clinicians rarely administer serial measurements in their practice, [16][17][18] the MBC approach relies on patient self-report assessments for both screening and management of depression.…”

mentioning

confidence: 99%

A Structured Approach to Detecting and Treating Depression in Primary Care: VitalSign6 Project

Jha¹,

Grannemann²,

Trombello³

et al. 2019

Ann Fam Med

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PURPOSE This report describes outcomes of an ongoing quality-improvement project (VitalSign6) in a large US metropolitan area to improve recognition, treatment, and outcomes of depressed patients in 16 primary care clinics (6 charity clinics, 6 federally qualified health care centers, 2 private clinics serving lowincome populations, and 2 private clinics serving patients with either Medicare or private insurance). METHODS Inclusion in this retrospective analysis was restricted to the first 25,000 patients (aged ≥12 years) screened with the 2-item Patient Health Questionnaire (PHQ-2) in the aforementioned quality-improvement project. Further evaluations with self-reports and clinician assessments were recorded for those with positive screen (PHQ-2 >2). Data collected from August 2014 though November 2016 were available at 3 levels: (1) initial PHQ-2 (n = 25,000), (2) positive screen (n = 4,325), and (3) clinician-diagnosed depressive disorder with 18 or more weeks of enrollment (n = 2,160). RESULTS Overall, 17.3% (4,325/25,000) of patients screened positive for depression. Of positive screens, 56.1% (2,426/4,325) had clinician-diagnosed depressive disorder. Of those enrolled for 18 or more weeks, 64.8% were started on measurement-based pharmacotherapy and 8.9% referred externally. Of the 1,400 patients started on pharmacotherapy, 45.5%, 30.2%, 12.6%, and 11.6% had 0, 1, 2, and 3 or more follow-up visits, respectively. Remission rates were 20.3% (86/423), 31.6% (56/177), and 41.7% (68/163) for those with 1, 2, and 3 or more follow-up visits, respectively. Baseline characteristics associated with higher attrition were: non-white, positive drug-abuse screen, lower depression/anxiety symptom severity, and younger age. CONCLUSION Although remission rates are high in those with 3 or more followup visits after routine screening and treatment of depression, attrition from care is a significant issue adversely affecting outcomes.

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“…The site visits will involve a structured brainstorming process [77,78] with organizational leaders and clinicians that will yield data on relevant implementation outcomes, performance objectives, and determinants. Qualitative data provide nuanced and site-specific information about organizational needs and strengths, and is particularly important in assessing outer setting factors given the absence of quantitative measures [79].…”

Section: Intervention Mappingmentioning

confidence: 99%

Improving the implementation and sustainment of evidence-based practices in community mental health organizations: a study protocol for a matched-pair cluster randomized pilot study of the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS)

Powell

Haley

Patel

et al. 2020

Implement Sci Commun

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Background: Implementing and sustaining evidence-based programs with fidelity may require multiple implementation strategies tailored to address multi-level, context-specific barriers and facilitators. Ideally, selecting and tailoring implementation strategies should be guided by theory, evidence, and input from relevant stakeholders; however, methods to guide the selection and tailoring of strategies are not well-developed. There is a need for more rigorous methods for assessing and prioritizing implementation determinants (barriers and facilitators) and linking implementation strategies to determinants. The Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS) is an intervention designed to increase the effectiveness of evidence-based practice implementation and sustainment. COAST-IS will enable organizational leaders and clinicians to use Intervention Mapping to select and tailor implementation strategies to address their site-specific needs. Intervention Mapping is a multi-step process that incorporates theory, evidence, and stakeholder perspectives to ensure that implementation strategies effectively address key determinants of change. Methods: COAST-IS will be piloted with community mental health organizations that are working to address the needs of children and youth who experience trauma-related emotional or behavioral difficulties by engaging in a learning collaborative to implement an evidence-based psychosocial intervention (trauma-focused cognitive behavioral therapy). Organizations will be matched and then randomized to participate in the learning collaborative only (control) or to receive additional support through COAST-IS. The primary aims of this study are to (1) assess the acceptability, appropriateness, feasibility, and perceived utility of COAST-IS; (2) evaluate the organizational stakeholders' fidelity to the core elements of COAST-IS; and (3) demonstrate the feasibility of testing COAST-IS in a larger effectiveness trial.

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Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol

Cited by 58 publications

References 67 publications

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

A Structured Approach to Detecting and Treating Depression in Primary Care: VitalSign6 Project

Improving the implementation and sustainment of evidence-based practices in community mental health organizations: a study protocol for a matched-pair cluster randomized pilot study of the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS)

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