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

Lewis CC, Scott K, Marti CN, Marriott BR, Kroenke K, Putz JW, Mendel P, Rutkowski D - Implement Sci (2015)

Bottom Line: It remains unclear whether standardized or tailored approaches to implementation are needed to optimize measurement-based care fidelity and penetration.Central to this investigation is the focus on identifying contextual factors (e.g., attitudes, resources, process, etc.) that mediate MBC fidelity and optimize client outcomes.This study will contribute generalizable and practical strategies for implementing systematic symptom monitoring to inform and enhance behavioral healthcare.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St, Bloomington, IN, 47405, USA. lewiscc@indiana.edu.

ABSTRACT

Background: Measurement-based care is an evidence-based practice for depression that efficiently identifies treatment non-responders and those who might otherwise deteriorate [1]. However, measurement-based care is underutilized in community mental health with data suggesting fewer than 20 % of behavioral health providers using this practice to inform treatment. It remains unclear whether standardized or tailored approaches to implementation are needed to optimize measurement-based care fidelity and penetration. Moreover, there is some suggestion that prospectively tailored interventions that are designed to fit the dynamic context may optimize public health impact, though no randomized trials have yet tested this notion [2]. This study will address the following three aims: (1) To compare the effect of standardized versus tailored MBC implementation on clinician-level and client-level outcomes; (2) To identify contextual mediators of MBC fidelity; and (3) To explore the impact of MBC fidelity on client outcomes.

Methods/design: This study is a dynamic cluster randomized trial of standardized versus tailored measurement-based care implementation in Centerstone, the largest provider of community-based mental health services in the USA. This prospective, mixed methods implementation-effectiveness hybrid design allows for evaluation of the two conditions on both clinician-level (e.g., MBC fidelity) and client-level (depression symptom change) outcomes. Central to this investigation is the focus on identifying contextual factors (e.g., attitudes, resources, process, etc.) that mediate MBC fidelity and optimize client outcomes.

Discussion: This study will contribute generalizable and practical strategies for implementing systematic symptom monitoring to inform and enhance behavioral healthcare.

Trial registration: Clinicaltrials.gov NCT02266134 .

No MeSH data available.


Related in: MedlinePlus

Framework of dissemination
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Related In: Results  -  Collection

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Fig1: Framework of dissemination

Mentions: The Framework for Dissemination [34] is the study’s guiding conceptual model as it is derived from the best available implementation research and includes a three-phase evaluation process for use with academic-community partnerships (see Fig. 1). The context of diffusion within this model highlights six domains theorized to determine successful implementation (see Fig. 1, Box 1): (1) norms and attitudes, (2) structure and process, (3) resources, (4) policies and incentives, (5) networks and linkages, and (6) media and change agents.Fig. 1


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

Lewis CC, Scott K, Marti CN, Marriott BR, Kroenke K, Putz JW, Mendel P, Rutkowski D - Implement Sci (2015)

Framework of dissemination
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4561429&req=5

Fig1: Framework of dissemination
Mentions: The Framework for Dissemination [34] is the study’s guiding conceptual model as it is derived from the best available implementation research and includes a three-phase evaluation process for use with academic-community partnerships (see Fig. 1). The context of diffusion within this model highlights six domains theorized to determine successful implementation (see Fig. 1, Box 1): (1) norms and attitudes, (2) structure and process, (3) resources, (4) policies and incentives, (5) networks and linkages, and (6) media and change agents.Fig. 1

Bottom Line: It remains unclear whether standardized or tailored approaches to implementation are needed to optimize measurement-based care fidelity and penetration.Central to this investigation is the focus on identifying contextual factors (e.g., attitudes, resources, process, etc.) that mediate MBC fidelity and optimize client outcomes.This study will contribute generalizable and practical strategies for implementing systematic symptom monitoring to inform and enhance behavioral healthcare.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St, Bloomington, IN, 47405, USA. lewiscc@indiana.edu.

ABSTRACT

Background: Measurement-based care is an evidence-based practice for depression that efficiently identifies treatment non-responders and those who might otherwise deteriorate [1]. However, measurement-based care is underutilized in community mental health with data suggesting fewer than 20 % of behavioral health providers using this practice to inform treatment. It remains unclear whether standardized or tailored approaches to implementation are needed to optimize measurement-based care fidelity and penetration. Moreover, there is some suggestion that prospectively tailored interventions that are designed to fit the dynamic context may optimize public health impact, though no randomized trials have yet tested this notion [2]. This study will address the following three aims: (1) To compare the effect of standardized versus tailored MBC implementation on clinician-level and client-level outcomes; (2) To identify contextual mediators of MBC fidelity; and (3) To explore the impact of MBC fidelity on client outcomes.

Methods/design: This study is a dynamic cluster randomized trial of standardized versus tailored measurement-based care implementation in Centerstone, the largest provider of community-based mental health services in the USA. This prospective, mixed methods implementation-effectiveness hybrid design allows for evaluation of the two conditions on both clinician-level (e.g., MBC fidelity) and client-level (depression symptom change) outcomes. Central to this investigation is the focus on identifying contextual factors (e.g., attitudes, resources, process, etc.) that mediate MBC fidelity and optimize client outcomes.

Discussion: This study will contribute generalizable and practical strategies for implementing systematic symptom monitoring to inform and enhance behavioral healthcare.

Trial registration: Clinicaltrials.gov NCT02266134 .

No MeSH data available.


Related in: MedlinePlus