Powell Byron J, Haley Amber D, Patel Sheila V, Amaya-Jackson Lisa, Glienke Beverly, Blythe Mellicent, Lengnick-Hall Rebecca, McCrary Stacey, Beidas Rinad S, Lewis Cara C, Aarons Gregory A, Wells Kenneth B, Saldana Lisa, McKay Mary M, Weinberger Morris
Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA.
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Implement Sci Commun. 2020;1. doi: 10.1186/s43058-020-00009-5. Epub 2020 Feb 25.
Implementing and sustaining evidence-based programs with fidelity may require multiple implementation strategies tailored to address multi-level, context-specific barriers and facilitators. Ideally, selecting and tailoring implementation strategies should be guided by theory, evidence, and input from relevant stakeholders; however, methods to guide the selection and tailoring of strategies are not well-developed. There is a need for more rigorous methods for assessing and prioritizing implementation determinants (barriers and facilitators) and linking implementation strategies to determinants. The Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS) is an intervention designed to increase the effectiveness of evidence-based practice implementation and sustainment. COAST-IS will enable organizational leaders and clinicians to use Intervention Mapping to select and tailor implementation strategies to address their site-specific needs. Intervention Mapping is a multi-step process that incorporates theory, evidence, and stakeholder perspectives to ensure that implementation strategies effectively address key determinants of change.
COAST-IS will be piloted with community mental health organizations that are working to address the needs of children and youth who experience trauma-related emotional or behavioral difficulties by engaging in a learning collaborative to implement an evidence-based psychosocial intervention (trauma-focused cognitive behavioral therapy). Organizations will be matched and then randomized to participate in the learning collaborative only (control) or to receive additional support through COAST-IS. The primary aims of this study are to (1) assess the acceptability, appropriateness, feasibility, and perceived utility of COAST-IS; (2) evaluate the organizational stakeholders' fidelity to the core elements of COAST-IS; and (3) demonstrate the feasibility of testing COAST-IS in a larger effectiveness trial.
COAST-IS is a systematic method that integrates theory, evidence, and stakeholder perspectives to improve the effectiveness and precision of implementation strategies. If effective, COAST-IS has the potential to improve the implementation and sustainment of a wide range of evidence-based practices in mental health and other sectors.
This study was registered in ClinicalTrials.gov (NCT03799432) on January 10, 2019 (last updated August 5, 2019).
以保真度实施并维持基于证据的项目可能需要多种实施策略，这些策略需针对多层次、特定情境的障碍和促进因素进行调整。理想情况下，选择和调整实施策略应以理论、证据以及相关利益相关者的意见为指导；然而，指导策略选择和调整的方法尚未得到充分发展。需要更严谨的方法来评估实施决定因素（障碍和促进因素）并确定其优先级，以及将实施策略与决定因素相联系。协作组织选择与调整实施策略方法（COAST-IS）是一项旨在提高基于证据的实践实施及维持效果的干预措施。COAST-IS将使组织领导者和临床医生能够运用干预映射来选择和调整实施策略，以满足其特定场所的需求。干预映射是一个多步骤过程，它整合了理论、证据和利益相关者的观点，以确保实施策略能有效解决变革的关键决定因素。
COAST-IS将在社区心理健康组织中进行试点，这些组织正致力于通过参与学习协作以实施基于证据的心理社会干预措施（以创伤为重点的认知行为疗法）来满足遭受创伤相关情绪或行为困难的儿童和青少年的需求。各组织将进行匹配，然后随机分为仅参与学习协作（对照组）或通过COAST-IS获得额外支持。本研究的主要目的是：（1）评估COAST-IS的可接受性、适宜性、可行性和感知效用；（2）评估组织利益相关者对COAST-IS核心要素的保真度；（3）证明在更大规模的有效性试验中测试COAST-IS的可行性。
COAST-IS是一种系统方法，它整合了理论、证据和利益相关者的观点，以提高实施策略的有效性和精准度。如果有效，COAST-IS有可能改善心理健康及其他领域中广泛的基于证据的实践的实施和维持情况。
本研究于2019年1月10日在ClinicalTrials.gov（NCT03799432）注册（最后更新于2019年8月5日）。
