Lee Miranda J, Maranda Michael J, Magura Stephen, Greenman Gregory
The Evaluation Center at Western Michigan University, Kalamazoo, MI.
J Appl Soc Sci (Boulder). 2022 Jun;16(2):442-458. doi: 10.1177/19367244221078278. Epub 2022 Mar 3.
U.S. state governments have the responsibility to regulate and license behavioral healthcare interventions, such as for addiction and mental illness, with increasing emphasis on implementing evidence-based programs (EBPs). A serious obstacle to this is lack of clarity or agreement about what constitutes "evidence-based." The study's purpose was to determine the extent to which and in what contexts web-based Evidence-based Program Registries (EBPRs) are referenced in state government statutes and regulations ("mandates") concerning behavioral healthcare. Examples are: What Works Clearinghouse; National Register of Evidence-based Programs and Practices; Cochrane Database of Systematic Reviews.
The study employed the Westlaw Legal Research Database to search for 30 known EBPR websites relevant to behavioral healthcare within the statutes and regulations of all 50 states.
There was low prevalence of EBPR references in state statutes and regulations pertaining to behavioral healthcare; 20 states had a total of 33 mandates that referenced an EBPR. These mandates usually do not rely on an EBPR as the sole acceptable source for classifying a program or practice as "evidence-based." Instead, EBPRs were named in conjunction with internal state or external sources of information about putative program effectiveness, which may be less valid than EBPRs, to determine what is "evidence-based."
Greater awareness of scientifically - based EBPRs and greater understanding of their advantages need to be fostered among state legislators and regulators charged with making policy to increase or improve the use of evidence-based programs and practices in behavioral healthcare in the U.S.
美国州政府有责任对行为健康护理干预措施进行监管并发放许可，比如针对成瘾和精神疾病的干预措施，且越来越强调实施循证项目（EBPs）。对此的一个严重障碍是对于什么构成“循证”缺乏清晰认识或共识。本研究的目的是确定在州政府关于行为健康护理的法规和条例（“指令”）中，基于网络的循证项目注册库（EBPRs）在多大程度上以及在何种背景下被引用。示例包括：有效方法信息库；循证项目与实践国家注册库；考克兰系统评价数据库。
本研究利用Westlaw法律研究数据库，在所有50个州的法规和条例中搜索与行为健康护理相关的30个已知EBPR网站。
在与行为健康护理相关的州法规和条例中，EBPR被引用的比例较低；20个州共有33条指令引用了EBPR。这些指令通常并不将EBPR作为将一个项目或实践归类为“循证”的唯一可接受来源。相反，EBPR是与关于假定项目有效性的州内或外部信息来源一同被提及的，而这些信息来源可能不如EBPR有效，却被用来确定什么是“循证”。
在美国，负责制定政策以增加或改善行为健康护理中循证项目和实践使用的州立法者和监管者，需要提高对基于科学的EBPR的认识，并更深入地了解其优势。
