Snider Mira D H, Boyd Meredith R, Walker Madison R, Powell Byron J, Lewis Cara C
Department of Psychology, West Virginia University, 53 Campus Drive Morgantown, Morgantown, WV, 26505, USA.
Department of Psychology, University of California Los Angeles, Los Angeles, USA.
Implement Sci Commun. 2023 Aug 14;4(1):94. doi: 10.1186/s43058-023-00474-8.
Audit and feedback (A&F) is an implementation strategy that can facilitate implementation tailoring by identifying gaps between desired and actual clinical care. While there are several theory-based propositions on which A&F components lead to better implementation outcomes, many have not been empirically investigated, and there is limited guidance for stakeholders when applying A&F in practice. The current study aims to illustrate A&F procedures in six community mental health clinics, with an emphasis on reporting A&F components that are relevant to theories of how feedback elicits behavior change.
Six clinics from a larger trial using a tailored approach to implement measurement-based care (MBC) were analyzed for feedback content, delivery mechanisms, barriers to feedback, and outcomes of feedback using archival data. Pattern analysis was conducted to examine relations between A&F components and changes in MBC use.
Several sites utilized both aggregate and individualized data summaries, and data accuracy concerns were common. Feedback cycles featuring individual-level clinician data, data relevant to MBC barriers, and information requested by data recipients were related to patterns of increased MBC use.
These findings support extant theory, such as Feedback Intervention Theory. Mental health professionals wishing to apply A&F should consider establishing reciprocal feedback mechanisms on the quality and amount of data being received and adopting specific roles communicating and addressing data quality concerns.
ClinicalTrials.gov Identifier: NCT02266134.
审核与反馈（A&F）是一种实施策略，可通过识别期望的临床护理与实际临床护理之间的差距来促进实施的针对性调整。虽然有几个基于理论的命题表明哪些A&F组件会带来更好的实施效果，但许多命题尚未经过实证研究，而且利益相关者在实践中应用A&F时的指导有限。本研究旨在阐述六个社区心理健康诊所的A&F程序，重点报告与反馈如何引发行为改变的理论相关的A&F组件。
使用存档数据，对来自一项采用针对性方法实施基于测量的护理（MBC）的大型试验中的六个诊所的反馈内容、传递机制、反馈障碍和反馈结果进行分析。进行模式分析以检查A&F组件与MBC使用变化之间的关系。
几个地点同时使用了汇总数据和个性化数据摘要，数据准确性问题很常见。以个体层面的临床医生数据、与MBC障碍相关的数据以及数据接收者要求的信息为特征的反馈周期与MBC使用增加的模式相关。
这些发现支持了现有的理论，如反馈干预理论。希望应用A&F的心理健康专业人员应考虑就所接收数据的质量和数量建立相互反馈机制，并采用特定角色来沟通和解决数据质量问题。
ClinicalTrials.gov标识符：NCT02266134。
