Kilbourne Amy M, Goodrich David E, Lai Zongshan, Almirall Daniel, Nord Kristina M, Bowersox Nicholas W, Abraham Kristen M
With the exception of Dr. Almirall, the authors are with the Veterans Affairs (VA) Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, and the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail:
Psychiatr Serv. 2015 Jan 1;66(1):90-3. doi: 10.1176/appi.ps.201300497. Epub 2014 Nov 17.
This study compared effectiveness of an enhanced versus standard implementation strategy (Replicating Effective Programs [REP]) on site-level uptake of Re-Engage, a national program for veterans with serious mental illness.
Mental health providers at 158 Veterans Affairs (VA) facilities were given REP-based manuals and training in Re-Engage, which involved identifying veterans who had not been seen in VA care for at least one year, documenting their clinical status, and coordinating further health care. After six months, facilities not responding to REP (N=88) were randomized to receive six months of facilitation (enhanced REP) or continued standard REP. Site-level uptake was defined as percentage of patients (N=1,531) with updated documentation or with whom contact was attempted.
Rate of Re-Engage uptake was greater for enhanced REP sites compared with standard REP sites (41% versus 31%, p=.01). Total REP facilitation time was 7.3 hours per site for six months.
Added facilitation improved short-term uptake of a national mental health program.
本研究比较了强化实施策略与标准实施策略（复制有效项目[REP]）对“重新参与”项目（一项针对患有严重精神疾病退伍军人的全国性项目）在机构层面采用情况的有效性。
为158家退伍军人事务部（VA）机构的心理健康服务提供者提供基于REP的手册，并对他们进行“重新参与”项目培训，该项目包括识别至少一年未接受VA护理的退伍军人、记录他们的临床状况以及协调进一步的医疗保健。六个月后，对未对REP做出反应的机构（N = 88）进行随机分组，一组接受为期六个月的促进措施（强化REP），另一组继续接受标准REP。机构层面的采用情况定义为有更新记录或尝试与其联系的患者（N = 1531）的百分比。
强化REP机构的“重新参与”项目采用率高于标准REP机构（41%对31%，p = 0.01）。六个月内每个机构的REP促进总时间为7.3小时。
额外的促进措施提高了一项全国性心理健康项目的短期采用率。
