Center for Behavioral Intervention Technologies, Northwestern University.
Brown School, Washington University in St. Louis.
Am Psychol. 2020 Nov;75(8):1080-1092. doi: 10.1037/amp0000686.
U.S. health care systems are tasked with alleviating the burden of mental health, but are frequently underprepared and lack workforce and resource capacity to deliver services to all in need. Digital mental health interventions (DMHIs) can increase access to evidence-based mental health care. However, DMHIs commonly do not fit into the day-to-day activities of the people who engage with them, resulting in a research-to-practice gap for DMHI implementation. For health care settings, differences between digital and traditional mental health services make alignment and integration challenging. Specialized attention is needed to improve the implementation of DMHIs in health care settings so that these services yield high uptake, engagement, and sustainment. The purpose of this article is to enhance efforts to integrate DMHIs in health care settings by proposing implementation strategies, selected and operationalized based on the discrete strategies established in the Expert Recommendations for Implementing Change project, that align to DMHI-specific barriers in these settings. Guidance is offered in how these strategies can be applied to DMHI implementation across four phases commonly distinguished in implementation science using the Exploration, Preparation, Implementation, Sustainment Framework. Next steps to advance research in this area and improve the research-to-practice gap for implementing DMHIs are recommended. Applying implementation strategies to DMHI implementation will enable psychologists to systematically evaluate this process, which can yield an enhanced understanding of the factors that facilitate implementation success and improve the translation of DMHIs from controlled trials to real-world settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
美国的医疗保健系统承担着缓解精神卫生负担的任务,但常常准备不足,缺乏提供服务的劳动力和资源能力,无法满足所有有需要的人。数字心理健康干预措施(DMHIs)可以增加获得循证精神卫生保健的机会。然而,DMHIs 通常不符合与他们互动的人的日常活动,导致 DMHI 实施的研究与实践之间存在差距。对于医疗保健环境,数字和传统心理健康服务之间的差异使得协调和整合具有挑战性。需要特别关注以改善 DMHIs 在医疗保健环境中的实施,以便这些服务能够获得高采用率、参与度和维持度。本文的目的是通过提出实施策略来加强在医疗保健环境中整合 DMHIs 的努力,这些策略是根据专家建议实施变革项目中确定的离散策略选择和实施的,这些策略与这些环境中 DMHI 特定的障碍相吻合。提供了如何在实施科学中通常区分的四个阶段(探索、准备、实施和维持阶段)中应用这些策略来实施 DMHI 的指导。建议了推进该领域研究和缩小实施 DMHI 的研究与实践差距的下一步措施。将实施策略应用于 DMHI 的实施将使心理学家能够系统地评估这一过程,从而更深入地了解促进实施成功的因素,并改善 DMHI 从对照试验到实际环境的转化。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。