Ferrari Manuela, Saulnier Marianne-Sarah, Iyer Srividya N, Roy Marc-André, Abdel-Baki Amal
McGill University, 845 Sherbrooke St W, Montreal, QC, H3A 0G4, Canada.
Douglas Research Centre, 6875 Boulevard LaSalle, Verdun, QC, H4H 1R3, Canada.
Health Res Policy Syst. 2025 Mar 14;23(1):34. doi: 10.1186/s12961-024-01281-w.
Heterogeneity in implementing essential evidence-based early intervention for psychosis services (EIS) components persists despite existing fidelity standards/guidelines in many countries. Rapid-learning health systems (RLHS) may remedy these challenges, improving service delivery through systematic data collection, analysis, feedback and capacity-building activities. SARPEP (Système Apprenant Rapide pour les Programmes de Premiers Épisodes Psychotiques) is the first Canadian RLHS for EIS. This paper presents qualitative findings from the mixed-method study that evaluated the feasibility and acceptability of SARPEP.
We conducted six focus groups on the implementation of SARPEP with 25 participants from all SARPEP stakeholder groups; most were involved from project inception and throughout the 3-year implementation. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework (Glasgow, et al., 2019) and Lessard's dimensions for learning health systems guided data collection and deductive analysis.
Reach: focus group participants reflected SARPEP reach and included all stakeholders involved (six service users, two family members, four psychiatrists, six managers, seven team leaders) who shared their experiences.
participants confirmed that SARPEP improved program capacity for data collection on core indicators and promoted evidence-based practices. Adoption: participants supported the selection of specific indicators and need to improve data-gathering technologies in the RLHS, even while challenges persisted regarding the integration of digital platform use by service users into routine care. Implementation and maintenance: all participants credited the RLHS with enabling mutual learning, self-reflection of programs and shared improvement of practices.
SARPEP contributes to promote evidence-based care and a sense of belonging within the Quebec EIS network.
尽管许多国家都有现有的保真度标准/指南，但在实施针对精神病服务（EIS）组件的基本循证早期干预措施方面，异质性依然存在。快速学习卫生系统（RLHS）或许可以解决这些挑战，通过系统的数据收集、分析、反馈和能力建设活动来改善服务提供。SARPEP（Système Apprenant Rapide pour les Programmes de Premiers Épisodes Psychotiques，即精神病首次发作项目快速学习系统）是加拿大首个用于EIS的RLHS。本文呈现了一项混合方法研究的定性结果，该研究评估了SARPEP的可行性和可接受性。
我们针对SARPEP的实施开展了6个焦点小组，共有来自SARPEP所有利益相关者群体的25名参与者；大多数人从项目启动就参与其中，并贯穿了3年的实施过程。覆盖范围、有效性、采用情况、实施情况、维持情况（RE-AIM）框架（格拉斯哥等人，2019年）以及莱萨尔关于学习卫生系统的维度指导了数据收集和演绎分析。
覆盖范围：焦点小组参与者反映了SARPEP的覆盖范围，涵盖了所有参与的利益相关者（6名服务使用者、2名家庭成员、4名精神科医生、6名管理人员、7名团队负责人），他们分享了自己的经历。
参与者确认，SARPEP提高了项目收集核心指标数据的能力，并促进了循证实践。采用情况：参与者支持选择特定指标，并且需要改进RLHS中的数据收集技术，尽管在将服务使用者使用数字平台纳入常规护理方面仍存在挑战。实施和维持：所有参与者都认为RLHS促进了相互学习、项目的自我反思以及实践的共同改进。
SARPEP有助于促进魁北克EIS网络内的循证护理和归属感。
