Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive (0812), La Jolla, CA, USA 92093-0812.
Implement Sci. 2011 Sep 7;6:104. doi: 10.1186/1748-5908-6-104.
The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States.
Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data.
A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups.
EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.
本研究旨在评估行政人员/政策制定者与直接参与实践的人员在以下方面的潜在差异：他们认为哪些因素可能会阻碍或促进美国大型公共心理健康服务系统实施循证实践（EBP）。
参与者包括心理健康系统县官员、机构主管、项目经理、临床工作人员、行政人员和消费者。作为概念映射程序的一部分，对每个目标群体进行头脑风暴小组讨论，以确定在大型公共心理健康系统中实施 EBP 的具体障碍或促进因素。根据相似性对陈述进行分类，并由每个参与者根据其感知的重要性和可变性对其进行评分。多维标度、聚类分析、描述性统计和 t 检验用于分析数据。
使用概念映射程序将总共 105 条陈述提炼为 14 个聚类。两组人员对影响 EBP 实施的因素的重要性看法存在差异，直接参与实践的人员对临床认知和 EBP 实施对临床实践的影响的重要性评价更高。与之前的研究一致，财务问题（成本、资金）被两组人员评为最重要和最不可能改变的因素之一。
EBP 的实施是一个复杂的过程，不同的利益相关者可能对 EBP 实施的影响的相对重要性持有不同的看法。实施工作必须包括来自多个层面的利益相关者的投入，以揭示不同的和趋同的观点。
