Gehring Nicole D, McGrath Patrick, Wozney Lori, Soleimani Amir, Bennett Kathryn, Hartling Lisa, Huguet Anna, Dyson Michele P, Newton Amanda S
Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada.
IWK Health Centre, 5850-5980 University Avenue, Halifax, NS, Canada.
Implement Sci. 2017 Jun 21;12(1):76. doi: 10.1186/s13012-017-0608-6.
Researchers, healthcare planners, and policymakers convey a sense of urgency in using eMental healthcare technologies to improve pediatric mental healthcare availability and access. Yet, different stakeholders may focus on different aspects of implementation. We conducted a systematic review to identify implementation foci in research studies and government/organizational documents for eMental healthcare technologies for pediatric mental healthcare.
A search of eleven electronic databases and grey literature was conducted. We included research studies and documents from organization and government websites if the focus included eMental healthcare technology for children/adolescents (0-18 years), and implementation was studied and reported (research studies) or goals/recommendations regarding implementation were made (documents). We assessed study quality using the Mixed Methods Appraisal Tool and document quality using the Appraisal of Guidelines for Research & Evaluation II. Implementation information was grouped according to Proctor and colleagues' implementation outcomes-acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability-and grouped separately for studies and documents.
Twenty research studies and nine government/organizational documents met eligibility criteria. These articles represented implementation of eMental healthcare technologies in the USA (14 studies), United Kingdom (2 documents, 3 studies), Canada (2 documents, 1 study), Australia (4 documents, 1 study), New Zealand (1 study), and the Netherlands (1 document). The quality of research studies was excellent (n = 11), good (n = 6), and poor (n = 1). These eMental health studies focused on the acceptability (70%, n = 14) and appropriateness (50%, n = 10) of eMental healthcare technologies to users and mental healthcare professionals. The quality of government and organizational documents was high (n = 2), medium (n = 6), and low (n = 1). These documents focused on cost (100%, n = 9), penetration (89%, n = 8), feasibility (78%, n = 7), and sustainability (67%, n = 6) of implementing eMental healthcare technology.
To date, research studies have largely focused on acceptability and appropriateness, while government/organizational documents state goals and recommendations regarding costs, feasibility, and sustainability of eMental healthcare technologies. These differences suggest that the research evidence available for pediatric eMental healthcare technologies does not reflect the focus of governments and organizations. Partnerships between researchers, healthcare planners, and policymakers may help to align implementation research with policy development, decision-making, and funding foci.
研究人员、医疗保健规划者和政策制定者迫切希望利用电子心理健康保健技术来提高儿科心理健康保健的可及性和可获得性。然而，不同的利益相关者可能关注实施的不同方面。我们进行了一项系统综述，以确定针对儿科心理健康保健的电子心理健康保健技术的研究以及政府/组织文件中的实施重点。
对11个电子数据库和灰色文献进行了检索。如果重点包括针对儿童/青少年（0至18岁）的电子心理健康保健技术，并且对实施进行了研究和报告（研究）或提出了有关实施的目标/建议（文件），我们纳入来自组织和政府网站的研究及文件。我们使用混合方法评估工具评估研究质量，使用研究与评估指南II评估文件质量。实施信息根据普罗克特及其同事的实施结果——可接受性、采用率、适宜性、成本、可行性、保真度、渗透率和可持续性——进行分组，并分别针对研究和文件进行分组。
20项研究和9份政府/组织文件符合纳入标准。这些文章代表了电子心理健康保健技术在美国（14项研究）、英国（2份文件，3项研究）、加拿大（2份文件，1项研究）、澳大利亚（4份文件，1项研究）、新西兰（1项研究）和荷兰（1份文件）的实施情况。研究的质量为优秀（n = 11）、良好（n = 6）和较差（n = 1）。这些电子心理健康研究关注电子心理健康保健技术对用户和心理健康专业人员的可接受性（70%，n = 14）和适宜性（50%，n = 10）。政府和组织文件的质量为高（n = 2）、中（n = 6）和低（n = 1）。这些文件关注实施电子心理健康保健技术的成本（100%，n = 9）、渗透率（89%，n = 8）、可行性（78%，n = 7）和可持续性（67%，n = 6）。
迄今为止，研究主要集中在可接受性和适宜性方面，而政府/组织文件则阐述了有关电子心理健康保健技术的成本、可行性和可持续性的目标及建议。这些差异表明，现有的儿科电子心理健康保健技术研究证据未能反映政府和组织的重点。研究人员、医疗保健规划者和政策制定者之间的合作可能有助于使实施研究与政策制定、决策和资金重点保持一致。
