The Role of Economic Evaluation in Dissemination and Implementation Research

Raghavan, Ramesh

doi:10.1093/acprof:oso/9780199751877.003.0005

Cited by 34 publications

(27 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, the current manuscript does not include a comprehensive cost-effectiveness analysis that would aid in determining whether the statistically significant, yet modest clinical reductions in alcohol consumption observed in the investigation are associated with substantial cost savings from the individual, trauma center or societal perspective. Of note, intervention training costs that included workshop with feedback and coaching in the current investigation were approximately $4,500 (61); these costs do not appear to be substantially different from the costs associated with the American College of Surgeons’ post-alcohol mandate sponsored stand-alone workshop training sessions (6, 7, 61, 62). …”

Section: Discussionmentioning

confidence: 76%

Disseminating alcohol screening and brief intervention at trauma centers: a policy-relevant cluster randomized effectiveness trial

et al. 2014

View full text Add to dashboard Cite

Background and aims In 2005 the American College of Surgeons passed a mandate requiring that Level I trauma centers have mechanisms to identify and intervene with problem drinkers. The aim of this investigation was to determine if a multilevel trauma center intervention targeting both providers and patients would lead to higher quality alcohol screening and brief intervention (SBI) when compared with trauma center mandate compliance without implementation enhancements. Design Cluster randomized trial in which intervention site (site n =10, patient n =409) providers received 1-day workshop training on evidence-based motivational interviewing (MI) alcohol interventions and four 30-minute feedback and coaching sessions; control sites (site n =10, patient n =469) implemented the mandate without study team training enhancements. Setting Trauma centers in the United States of America. Participants 878 blood alcohol positive inpatients with and without traumatic brain injury (TBI). Measurements MI skills of providers were assessed with fidelity coded standardized patient interviews. All patients were interviewed at baseline, and 6- and 12-months post-injury with the Alcohol Use Disorders Identification Test (AUDIT). Findings Intervention site providers consistently demonstrated enhanced MI skills compared with control providers. Intervention patients demonstrated an 8% reduction in AUDIT hazardous drinking relative to controls over the course of the year after injury (RR =0.88, 95%, CI =0.79, 0.98). Intervention patients were more likely to demonstrate improvements in alcohol use problems in the absence of TBI (p =0.002). Conclusion Trauma center providers can be trained to deliver higher quality alcohol screening and brief intervention than untrained providers, which is associated with modest reductions in alcohol use problems, particularly among patients without traumatic brain injury.

show abstract

Section: Discussionmentioning

confidence: 76%

Disseminating alcohol screening and brief intervention at trauma centers: a policy-relevant cluster randomized effectiveness trial

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Finally, it will be essential to assess the cost-effectiveness of these approaches. 89,90 Several ongoing studies will contribute to the evidence-base for selecting and tailoring implementation strategies to context-specific factors, including the Tailored Implementation for Chronic Disease research program 34 and a study recently funded by the National Institute of Mental Health that will test tailored versus standard approaches to implementing measurement-based care 91 for depression (R01MH103310; Lewis, PI).…”

Section: Discussionmentioning

confidence: 99%

Methods to Improve the Selection and Tailoring of Implementation Strategies

Powell

Beidas

Lewis

et al. 2015

J Behav Health Serv Res

603

599

View full text Add to dashboard Cite

Implementing behavioral health interventions is a complicated process. It has been suggested that implementation strategies should be selected and tailored to address the contextual needs of a given change effort; however, there is limited guidance as to how to do this. This article proposes four methods (concept mapping, group model building, conjoint analysis, and intervention mapping) that could be used to match implementation strategies to identified barriers and facilitators for a particular evidence-based practice or process change being implemented in a given setting. Each method is reviewed, examples of their use are provided, and their strengths and weaknesses are discussed. The discussion includes suggestions for future research pertaining to implementation strategies and highlights these methods' relevance to behavioral health services and research.

show abstract

“…DBHIDS has used a number of strategies to support provider organizations and assist in covering the marginal costs of implementation (Raghavan, 2012; Raghavan et al, 2008), allowing organizations to invest more fully in the adoption, implementation, and sustainment of EBPs. Specifically, DBHIDS has supported organizations by: forming a coordinating body to oversee the implementation of EBPs and provide ongoing support to organizational leaders and clinicians, dedicating EBP coordinators to support implementation, providing financial support for training and consultation in EBPs (including lost staff time), providing continuing education units (CEUs) and other educational opportunities within the system, piloting the use of enhanced rates for EBPs and the use of claims modifiers to track the adoption of EBPs, monitoring fidelity to EBPs, and providing support for general organizational health and functioning.…”

Section: Philadelphia’s Behavioral Health Transformation Effortmentioning

confidence: 99%

Applying the Policy Ecology Framework to Philadelphia’s Behavioral Health Transformation Efforts

Powell

Beidas

Rubin³

et al. 2016

Adm Policy Ment Health

View full text Add to dashboard Cite

Raghavan et al. (2008) proposed that effective implementation of evidence-based practices requires implementation strategies deployed at multiple levels of the “policy ecology,” including the organizational, regulatory or purchaser agency, political, and social levels. However, much of implementation research and practice targets providers without accounting for contextual factors that may influence provider behavior. This paper examines Philadelphia’s efforts to work toward an evidence-based and recovery-oriented behavioral health system, and uses the policy ecology framework to illustrate how multifaceted, multilevel implementation strategies can facilitate the widespread implementation of evidence-based practices. Ongoing challenges and implications for research and practice are discussed.

show abstract

The Role of Economic Evaluation in Dissemination and Implementation Research

Cited by 34 publications

References 0 publications

Disseminating alcohol screening and brief intervention at trauma centers: a policy-relevant cluster randomized effectiveness trial

Disseminating alcohol screening and brief intervention at trauma centers: a policy-relevant cluster randomized effectiveness trial

Methods to Improve the Selection and Tailoring of Implementation Strategies

Applying the Policy Ecology Framework to Philadelphia’s Behavioral Health Transformation Efforts

Contact Info

Product

Resources

About