National integration of mental health screening and treatment into specialized care for cystic fibrosis: What predicts success?

Abstract

Objectives: The CF Foundation sponsored competitive awards for Mental Health Coordinators (MHCs) from 2016 to 2018 to implement the international guidelines for mental health screening and treatment in US CF centers. Longitudinal surveys evaluated success in implementing these guidelines using the Consolidated Framework for Implementation Research (CFIR).Methods: MHCs completed annual surveys assessing implementation from preparation/basic implementation (e.g., using recommended screeners) to full implementation/sustainability (e.g., providing evidence-based treatments). Points were assigned to questions through consensus, with higher scores assigned to more complex tasks. Linear regression and mixed effects models were used to: (1) examine differences in centers and MHC characteristics, (2) identify predictors of success,(3) model the longitudinal trajectory of implementation scores.Results: A total of 122 MHCs (88.4% responded): Cohort 1, N = 80; Cohort 2, N = 30; and Cohort 3, N = 12. No differences in center characteristics were found.Significant improvements in implementation were observed across centers over time. Years of experience on a CF team was the only significant predictor of success;

Highly effective cystic fibrosis transmembrane conductance (regulator) modulator therapy: shifting the curve for most while leaving some further behind

“…The neuropsychiatric effects have improved shortly after modulator therapy was reduced or stopped, suggesting a direct relationship to HEMT [25]. The importance of mental health in CF has been reflected by a nearly universal implementation of mental screening in US CF care centers [26].…”