Lewis Cara C, Puspitasari Ajeng, Boyd Meredith R, Scott Kelli, Marriott Brigid R, Hoffman Mira, Navarro Elena, Kassab Hannah
Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA.
Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th St, Bloomington, IN, 47401, USA.
BMC Res Notes. 2018 Jan 27;11(1):76. doi: 10.1186/s13104-018-3193-0.
Although tailored implementation methods are touted as superior to standardized, few researchers have directly compared the two and little guidance regarding the specific details of each method exist. Our study compares these methods in a dynamic cluster randomized trial seeking to optimize implementation of measurement based care (MBC) for depression in community behavioral health. This specific manuscript provides a detailed, replicable account of the components of each multi-faceted implementation method.
The standardized best practice method includes training, consultation, a clinical guideline, and electronic health record enhancements with the goal to optimize the delivery of MBC with fidelity. Conversely, the tailored, customized and collaborative method is informed by recent implementation science advancements and begins with a needs assessment, followed by tailored training that feeds back barriers data to clinicians, the formation of an implementation team, a clinician-driven clinic-specific guideline, and the use of fidelity data to inform implementation team activities; the goal of the tailored condition is to ensure the intervention and implementation strategies address unique factors of the context. The description of these methods will inform others seeking to implement MBC, as well as those planning to use standardized or tailored implementation methods for interventions beyond behavioral health.
尽管定制化实施方法被认为优于标准化方法，但很少有研究人员直接对二者进行比较，且关于每种方法具体细节的指导也很少。我们的研究在一项动态整群随机试验中对这些方法进行了比较，该试验旨在优化社区行为健康中基于测量的抑郁症护理（MBC）的实施。这篇特定的手稿详细、可重复地阐述了每种多方面实施方法的组成部分。
标准化最佳实践方法包括培训、咨询、临床指南以及电子健康记录增强功能，目标是以保真度优化MBC的提供。相反，定制化、个性化和协作性方法借鉴了近期实施科学的进展，首先进行需求评估，然后进行定制化培训，将障碍数据反馈给临床医生，组建实施团队，制定临床医生主导的针对特定诊所的指南，并利用保真度数据为实施团队的活动提供信息；定制化条件的目标是确保干预措施和实施策略解决背景中的独特因素。这些方法的描述将为其他寻求实施MBC的人提供信息，也为那些计划在行为健康之外的干预措施中使用标准化或定制化实施方法的人提供信息。
