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全县培训计划中的心理健康服务提供者的覆盖范围和参与度。

Mental Health Provider Reach and Engagement in a Countywide Training Initiative.

机构信息

Indiana University School of Medicine, Indianapolis, IN, USA.

Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.

出版信息

Adm Policy Ment Health. 2024 Jul;51(4):530-542. doi: 10.1007/s10488-024-01345-7. Epub 2024 Feb 13.

Abstract

Many training initiatives are underway to increase implementation of evidence-based practice (EBPs) in mental healthcare. However, little is known about what types of trainings and supports yield the highest reach and engagement. Supported by a tax-funded, countywide initiative to improve access to quality care for youths, the current mixed methods study evaluates mental health (MH) provider reach, or registering for the training initiative, and engagement, or participation in training activities, for several EBP training and implementation supports. MH providers were offered free 1) formal EBP workshops, 2) a biweekly learning community, 3) individual case consultation, and 4) confidential online clinical feedback system. To register, interested providers (N = 698) completed a web-based assessment measuring clinical practice information, organizational implementation climate, and EBP knowledge, attitudes, and practices. Thirteen providers, selected via purposeful sampling stratified by level of participation, completed semi-structured qualitative interviews. While the training initiative achieved high reach (66% of county agencies had a provider register), far fewer providers engaged substantially in training. Quantitative results indicated that providers whose professional discipline was not psychology, had higher baseline EBP knowledge, more extensive use of common evidence-based strategies, and less extensive use of other therapy strategies, engaged in more training. Rapid qualitative analysis of interviews expanded upon these findings and illuminated provider, organizational, system, practical, and training activity-specific barriers and facilitators to engagement. Findings suggest the importance of identifying strategies for improving provider engagement in training activities beyond workshops. Implications for future research and training initiatives are discussed.

摘要

许多培训计划正在开展,以增加在精神卫生保健中实施循证实践(EBP)的力度。然而,对于哪种类型的培训和支持能够产生最大的效果和参与度,我们知之甚少。本混合方法研究由一项基于税收的、全县范围的计划提供支持,旨在改善青少年获得优质护理的机会,该计划评估了几种 EBP 培训和实施支持的精神健康(MH)服务提供者的覆盖范围(即注册培训计划)和参与度(即参与培训活动)。MH 服务提供者可免费获得以下培训和支持:1)正式的 EBP 研讨会;2)两周一次的学习社区;3)个体案例咨询;4)保密的在线临床反馈系统。为了注册,有兴趣的提供者(N=698)完成了一项基于网络的评估,该评估衡量了临床实践信息、组织实施氛围以及 EBP 知识、态度和实践。通过有目的的抽样,按参与度分层,选择了 13 名提供者进行半结构化的定性访谈。虽然培训计划的覆盖面很广(全县机构中有 66%的机构有提供者注册),但实际上只有少数提供者会大量参与培训。定量结果表明,专业非心理学的提供者具有更高的 EBP 知识基础、更广泛地使用常见的循证策略、以及较少使用其他治疗策略,因此他们会更积极地参与培训。对访谈的快速定性分析扩展了这些发现,并阐明了参与培训活动的提供者、组织、系统、实际和培训活动特定的障碍和促进因素。研究结果表明,除了研讨会之外,确定提高提供者参与培训活动的策略非常重要。讨论了对未来研究和培训计划的影响。

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