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与初级保健中儿科综合护理准备情况相关的实施前组织环境

Pre-Implementation Organizational Environment Associated with Pediatric Integrated Care Readiness in Primary Care.

作者信息

Stadnick Nicole A, Penalosa Martina G, Martinez Kassandra, Brookman-Frazee Lauren, Gizzo Daniel P, Sahms Timothy, Kuelbs Cynthia L, Aarons Gregory A

机构信息

University of California San Diego, Department of Psychiatry, San Diego, CA.

Child and Adolescent Services Research Center, San Diego, CA.

出版信息

Evid Based Pract Child Adolesc Ment Health. 2022;7(1):5-11. doi: 10.1080/23794925.2021.1875344. Epub 2021 Feb 5.

Abstract

OBJECTIVE

To characterize pre-implementation organizational factors associated with Access To Tailored Autism Integrated Care (ATTAIN), an integrated care model for children with autism and identified or suspected co-occurring mental health needs.

METHODS

Pediatric primary care providers (n=36) completed surveys as part of a pilot study testing ATTAIN feasibility. Measures assessed: background characteristics; implementation climate; organizational readiness; evidence-based practice (EBP) attitudes; knowledge, confidence and comfort caring for children with autism.

RESULTS

Compared to providers from a network of primary care practices and an integrated healthcare system, providers from a Federally Qualified Health Center (FQHC) reported less positive perceptions of climate supportive of EBP implementation and, specifically, selection for openness and rewards for EBPs. Implementation climate was associated with autism knowledge, comfort with mental health referral and follow up, and organizational change efficacy.

CONCLUSIONS

Findings advance understanding of pre-implementation organizational context factors important to assess for EBP implementation in diverse pediatric care settings.

摘要

目的

描述与“获得定制自闭症综合护理(ATTAIN)”相关的实施前组织因素,ATTAIN是一种针对患有自闭症且已确定或疑似有并发心理健康需求儿童的综合护理模式。

方法

作为测试ATTAIN可行性的一项试点研究的一部分,儿科初级保健提供者(n = 36)完成了调查。评估的指标包括:背景特征;实施氛围;组织准备情况;循证实践(EBP)态度;照顾自闭症儿童的知识、信心和舒适度。

结果

与来自初级保健机构网络和综合医疗系统的提供者相比,来自联邦合格健康中心(FQHC)的提供者对支持EBP实施的氛围,特别是对EBP的开放性选择和奖励的积极看法较少。实施氛围与自闭症知识、心理健康转诊和随访的舒适度以及组织变革效能相关。

结论

研究结果有助于进一步理解在不同儿科护理环境中评估EBP实施时重要的实施前组织背景因素。

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