How Engaged are Stakeholders in Evidence-Based Treatment Implementation Projects? Results From a Scoping Review of Children’s Mental Health Treatment Projects

2021 ◽  
Author(s):  
Noah S Triplett
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Stakeholder Engagement ◽  
Child Mental Health ◽  
The United States ◽  
Successful Implementation ◽  
Evidence Based ◽  
Implementation Phase ◽  
Evidence Based Treatment ◽  
Treatment Implementation

Engaging stakeholders in child mental health evidence-based treatment (EBT) implementation projects may increase the likelihood of successful implementation; However, little is known about the extent of stakeholder engagement to inform the implementation of EBTs. We conducted a scoping review to characterize stakeholder engagement in child mental health EBT implementation projects. We performed data extraction and synthesis to describe key study and stakeholder characteristics, stakeholder engagement methods and rationales, reported impacts of stakeholder engagement, and quality of reporting on stakeholder engagement. We identified a total of 103 unique child mental health EBT implementation projects. The largest number of projects were in the United States and conducted in community mental health settings. Most projects engaged EBT providers during the active implementation phase and with limited depth, often gathering information from stakeholders about barriers and facilitators without sharing decision-making power. Across projects, impacts of stakeholder engagement spanned all implementation outcomes. Given that stakeholder engagement is often shallow and follows initial implementation efforts, additional effort should be made to increase engagement to preempt challenges to EBT implementation and ensure implementation success. Such efforts may ensure the just distribution of power in EBT implementation efforts and could be essential in addressing mental health disparities.

The compatibility of clinical child mental health treatment and evidence-based treatment protocols.

2020 ◽  
Vol 17 (1) ◽  
pp. 25-32
Author(s):  
Stephen P. H. Whiteside ◽  
Jarrod M. Leffler ◽  
Melissa K. Hord ◽  
Leslie A. Sim ◽  
Michele M. Schmidt ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Child Mental Health ◽  
Evidence Based ◽  
Health Treatment ◽  
Treatment Protocols ◽  
Evidence Based Treatment

scholarly journals Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics

2021 ◽  
Vol 18 (15) ◽  
pp. 7739
Author(s):  
Miriam Blume ◽  
Petra Rattay ◽  
Stephanie Hoffmann ◽  
Jacob Spallek ◽  
Lydia Sander ◽  
...  
Keyword(s):  
Mental Health ◽  
Children And Adolescents ◽  
Health Inequalities ◽  
Scoping Review ◽  
The United States ◽  
Family Characteristics ◽  
Future Research ◽  
Childhood And Adolescence ◽  
Moderating Effects ◽  
Scoping Reviews

This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6–18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.

scholarly journals Implementation of NAVIGATE Coordinated Specialty Care for First Episode Psychosis: the Michigan Experience

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 177-178
Author(s):  
Eric D. Achtyes ◽  
Kari Kempema ◽  
Zhehui Luo ◽  
Katharine N. Thakkar ◽  
Catherine Adams ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Symptoms ◽  
The United States ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Control Group ◽  
Evidence Based ◽  
Block Grant ◽  
Episode Psychosis

AbstractStudy ObjectivesCoordinated specialty care (CSC) is widely accepted as an evidence-based treatment for first episode psychosis (FEP). The NAVIGATE intervention from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study is a CSC intervention which offers a suite of evidence-based treatments shown to improve engagement and clinical outcomes, especially in those with shorter duration of untreated psychosis (DUP). Coincident with the publication of this study, legislation was passed by the United States Congress in 2014–15 to fund CSC for FEP via a Substance Abuse and Mental Health Services Administration (SAMHSA) block grant set-aside for each state. In Michigan (MI) the management of this grant was delegated to Network180, the community mental health authority in Kent County, with the goal of making CSC more widely available to the 10 million people in MI. Limited research describes the outcomes of implementation of CSC into community practices with no published accounts evaluating the use of the NAVIGATE intervention in a naturalistic setting. We describe the outcomes of NAVIGATE implementation in the state of MI.MethodsIn 2014, 3 centers in MI were selected and trained to provide NAVIGATE CSC for FEP. In 2016 a 4th center was added, and 2 existing centers were expanded to provide additional access to NAVIGATE. Inclusion: age 18–31, served in 1 of 4 FEP centers in MI. Data collection began in 2015 for basic demographics, global illness (CGI q3 mo), hospital/ED use and work/school (SURF q3 mo) and was expanded in 2016 to include further demographics, diagnosis, DUP, vital signs; and in 2018 for clinical symptoms with the modified Colorado Symptom Inventory (mCSI q6 mo), reported via an online portal. This analysis used data until 12/31/19. Mixed effects models adjusted by age, sex and race were used to account for correlated data within patients.ResultsN=283 had useable demographic information and were included in the analysis. Age at enrollment was 21.6 ± 3.0 yrs; 74.2% male; 53.4% Caucasian, 34.6% African American; 12.9 ± 1.7 yrs of education (N=195). 18 mo retention was 67% with no difference by sex or race. CGI scores decreased 20% from baseline (BL) to 18 mo (BL=3.5, N=134; 15–18 mo=2.8, N=60). Service utilization via the SURF was measured at BL (N=172) and 18 mo (N=72): psychiatric hospitalizations occurred in 37% at BL and 6% at 18 mo (p<0.01); ER visits occurred in 40% at BL and 13% at 18 mo (p<0.01). 44% were working or in school at BL and 68% at 18 mo (p<0.01). 21% were on antipsychotics (AP) at BL (N=178) and 85% at 18 mo (N=13) with 8% and 54% on long acting injectable-AP at BL and 18 mo, respectively. Limitations include missing data and lack of a control group.ConclusionThe implementation of the NAVIGATE CSC program for FEP in MI resulted in meaningful clinical improvement for enrollees. Further support could make this evidence-based intervention available to more people with FEP.FundingSupported by funds from the SAMHSA Medicaid State Block Grant set-aside awarded to Network180 (Achtyes, Kempema). The funders had no role in the design of the study, the analysis or the decision to publish the results.

scholarly journals Evidence for implementation of interventions to promote mental health in the workplace: a systematic scoping review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Charlotte Paterson ◽  
Caleb Leduc ◽  
Margaret Maxwell ◽  
Birgit Aust ◽  
Benedikt L. Amann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Scoping Review ◽  
Mental Health Problems ◽  
Evaluation Studies ◽  
Grey Literature ◽  
Mental Health Promotion ◽  
Successful Implementation ◽  
Health Promotion Interventions ◽  
Promote Mental Health

Abstract Background Mental health problems are common in the working population and represent a growing concern internationally, with potential impacts on workers, organisations, workplace health and compensation authorities, labour markets and social policies. Workplace interventions that create workplaces supportive of mental health, promote mental health awareness, destigmatise mental illness and support those with mental disorders are likely to improve health and economical outcomes for employees and organisations. Identifying factors associated with successful implementation of these interventions can improve intervention quality and evaluation, and facilitate the uptake and expansion. Therefore, we aim to review research reporting on the implementation of mental health promotion interventions delivered in workplace settings, in order to increase understanding of factors influencing successful delivery. Methods and analysis A scoping review will be conducted incorporating a stepwise methodology to identify relevant literature reviews, primary research and grey literature. This review is registered with Research Registry (reviewregistry897). One reviewer will conduct the search to identify English language studies in the following electronic databases from 2008 through to July 1, 2020: Scopus, PROSPERO, Health Technology Assessments, PubMed, Campbell Collaboration, Joanna Briggs Library, PsycINFO, Web of Science Core Collection, CINAHL and Institute of Occupational Safety and Health (IOSH). Reference searching, Google Scholar, Grey Matters, IOSH and expert contacts will be used to identify grey literature. Two reviewers will screen title and abstracts, aiming for 95% agreement, and then independently screen full texts for inclusion. Two reviewers will assess methodological quality of included studies using the Mixed Methods Appraisal Tool and extract and synthesize data in line with the RE-AIM framework, Nielson and Randall’s model of organisational-level interventions and Moore’s sustainability criteria, if the data allows. We will recruit and consult with international experts in the field to ensure engagement, reach and relevance of the main findings. Discussion This will be the first systematic scoping review to identify and synthesise evidence of barriers and facilitators to implementing mental health promotion interventions in workplace settings. Our results will inform future evaluation studies and randomised controlled trials and highlight gaps in the evidence base. Systematic review registration Research Registry (reviewregistry897)

scholarly journals Provider self-efficacy in delivering evidence-based psychosocial interventions: A scoping review

2021 ◽  
Vol 2 ◽  
pp. 263348952098825
Author(s):  
Cheri J Shapiro ◽  
Kathleen Watson MacDonell ◽  
Mariah Moran
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Implementation Research ◽  
Self Efficacy ◽  
Psychosocial Interventions ◽  
Health Interventions ◽  
Evidence Based ◽  
Health Providers ◽  
Plain Language ◽  
Mental Health Interventions

Background: Among the many variables that affect implementation of evidence-based interventions in real-world settings, self-efficacy is one of the most important factors at the provider level of the social ecology. Yet, research on the construct of provider self-efficacy remains limited. Objectives: This scoping review was conducted to enhance understanding of the construct of provider self-efficacy and to examine how the construct is defined and measured in the context of implementation of evidence-based mental health interventions. Design: Online databases were used to identify 190 papers published from 1999 to June of 2018 that included search terms for providers, evidence-based, and self-efficacy. To be eligible for the scoping review, papers needed to focus on the self-efficacy of mental health providers to deliver evidence-based psychosocial interventions. A total of 15 publications were included in the review. Results: The construct of provider self-efficacy is not clearly defined but is typically described as confidence to deliver a specific intervention or practice. A range of measures are used to assess provider self-efficacy across both provider and intervention types. Conclusions: Standardized definition and measurement of provider self-efficacy is needed to advance practice and implementation research. Plain language abstract: Provider self-efficacy is known to influence implementation of evidence-based mental health interventions. However, the ways in which provider self-efficacy is defined and measured in implementation research literature is not well understood; furthermore, it is not clear what types of providers and interventions are represented in this literature. This scoping review adds to current research by revealing that there is no agreed upon definition or measure of provider self-efficacy in the context of implementation of evidence-based interventions, and that the research includes multiple types of providers (e.g., social workers, counselors, psychologists) and interventions. Self-efficacy appears to change as a function of training and support. To further research in this area, a common definition and agreed upon measures of this construct are needed.

scholarly journals Dialectical Behavioural Therapy Skills for Employment

2018 ◽  
pp. 734-768
Author(s):  
Janet D. Feigenbaum
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Social Functioning ◽  
Feasibility Studies ◽  
Behavioural Therapy ◽  
Evidence Based ◽  
Complex Relationship ◽  
Evidence Based Treatment ◽  
Direct Association ◽  
Dialectical Tension

The complex relationship between mental health and employment is transactional and unique to each individual. Thus the decision to commence (or return) to employment for this population requires an individualized formulation emphasizing the dialectical tension between the benefits of employment and stressors in the workplace. In addition, unemployment is associated with a number of social exclusion risks which may impact upon an individual’s mental health. Vocational functioning in those with personality disorder (PD) is more compromised than social functioning and does not improve in direct association with change in mental health symptoms. Obtaining and retaining employment requires the ability to manage workplace emotions, behaviour, and relationships. Dialectical behavioural therapy (DBT) is an evidence-based treatment that addresses these key areas of dysfunction—adaptations for employment include DBT-W, DBT-ACES, and DBT-SE, each with their own focus. Feasibility studies have shown these adaptations are acceptable to and may be effective for participants.

A quality improvement project to reduce restrictive interventions in a mental health service

2021 ◽  
pp. 1-12
Author(s):  
Darren Savarimuthu ◽  
Katja Jung
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Positive Impact ◽  
Essential Elements ◽  
Quality Improvement Project ◽  
Psychiatric Ward ◽  
Quality Improvement Initiative ◽  
Successful Implementation ◽  
Evidence Based ◽  
Improvement Project

Background/aims This article describes a quality improvement project that aimed to reduce restrictive interventions on an acute psychiatric ward. In light of a service level agreement and based on a trust-wide target, the purpose of the project was to reduce restrictive interventions by 20% within a period of 6 months. It was also anticipated that a least restrictive environment could have a positive impact on patient experience. Methods Three evidence-based interventions were introduced to the ward during the quality improvement project. These included positive behaviour support, the Safewards model and the productive ward initiative. Results There was a 63% reduction in restrictive interventions over a 6-month period through the successful implementation of a series of evidence-based interventions to manage behaviours that challenge on the mental health ward. Conclusions The project identified collaborative team working, staff training and adequate resources as essential elements in the success of the quality improvement initiative. However, co-production was found to be crucially significant in bringing sustainable changes in ward environment and in addressing restrictive practices.

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