Whitmyre Emma D, Esposito-Smythers Christianne, López Roberto, Goldberg Debora G, Liu Freda, Defayette Annamarie B
Psychology Department, Children's National Hospital, 111 Michigan Avenue NW, Washington, D.C., 20010, USA.
Psychology Department, George Mason University, Fairfax, VA, 22030, USA.
Clin Child Fam Psychol Rev. 2024 Dec;27(4):909-942. doi: 10.1007/s10567-024-00498-z. Epub 2024 Oct 30.
Measurement-Based Care (MBC) is the systematic use of patient-reported data to inform care decisions and monitor treatment progress. MBC has been shown to improve patient outcomes across medical and mental health treatment settings for adults and youth. While many studies have examined the use of MBC in specific care settings, few have focused on the implementation of MBC among youth populations or across care settings. While a review has shown that use of MBC benefits youth, no published reviews exist that summarize the successful strategies and barriers to implementation models across studies in youth service settings. To address these gaps, the present systematic review (N = 25 studies) focuses on the implementation of MBC across four youth service settings, including outpatient mental health centers, medical centers/pediatric clinics, schools, and clinical psychology training clinics. Results suggest that few studies employ consistent implementation models or strategies to guide efforts. Further, there is significant overlap in the successful strategies employed as well as the barriers to implementation of MBC across youth service settings, at the client, clinician, and organizational levels. Broadly, the authors recommend on the basis of findings that future implementation work in youth service settings: incorporate comprehensive training in the use of MBC for clinicians; incorporate stakeholder feedback into the implementation process for initial and sustained use; employ digital measurement feedback systems to deliver MBC that allow for real-time feedback and continuous technical support; and employ a health equity lens in implementation efforts to help address disparities in access to and use of MBC so that all youth and families may benefit from this evidence-based practice.
基于测量的照护（MBC）是系统地运用患者报告的数据来为照护决策提供信息并监测治疗进展。研究表明，MBC能改善成人和青少年在医疗及心理健康治疗环境中的治疗效果。虽然许多研究探讨了MBC在特定照护环境中的应用，但很少有研究关注MBC在青少年群体中的实施情况或跨照护环境的实施情况。虽然有一项综述表明MBC的使用对青少年有益，但尚无已发表的综述总结青少年服务环境中跨研究的实施模型的成功策略和障碍。为了填补这些空白，本系统综述（共纳入25项研究）聚焦于MBC在四种青少年服务环境中的实施情况，包括门诊心理健康中心、医疗中心/儿科诊所、学校和临床心理学培训诊所。结果表明，很少有研究采用一致的实施模型或策略来指导相关工作。此外，在青少年服务环境中，在客户、临床医生和组织层面，MBC实施所采用的成功策略以及实施障碍存在显著重叠。总体而言，作者根据研究结果建议，未来在青少年服务环境中的实施工作应：为临床医生提供关于MBC使用的全面培训；将利益相关者的反馈纳入初始和持续使用的实施过程；采用数字测量反馈系统来提供MBC，以实现实时反馈和持续的技术支持；在实施工作中采用健康公平视角，以帮助解决MBC获取和使用方面的差异，使所有青少年及其家庭都能从这种循证实践中受益。
