Deinse Tonya Van, Waters Allison, Barton Kasey, Bloodworth Sherri, Powell Nicholas
School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA.
Georgia Department of Community Supervision, 2 M.L.K. Jr Dr SE, Atlanta, GA, 30334, USA.
BMC Glob Public Health. 2025 Jun 24;3(1):54. doi: 10.1186/s44263-025-00174-6.
Although implementation science methods have been widely used across all sectors of healthcare, they are less commonly used to promote health interventions within criminal legal system settings. This gap in the research is problematic given the need for effective treatments to address comparatively worse health and mental health outcomes among people involved in the criminal legal system. Additionally, there have been relatively few published studies documenting methods at the pre-implementation phase. This article reports on a pre-implementation assessment conducted as part of a grant-funded initiative with a statewide community supervision agency to address key limitations in the state's Specialized Mental Health Supervision program by piloting two implementation strategies: clinical case consultation and enhancing mental health officers' relationships with behavioral health service providers.
The purpose of this study was to provide agency leaders with practical and timely information to make decisions regarding their plan for rolling out the initiative. Within a 30-day timeframe, the research team conducted 22 brief, semi-structured interviews with members of the implementation team and community supervision officers and their supervisors. The team then used rapid qualitative analysis methods to identify potential challenges and facilitators of the implementation strategies and make recommendations to improve implementation.
Although participants indicated that considering mental health symptoms was a top factor in caseload assignment and step-down, they believed other stabilizing factors (e.g., housing, employment) and risk for re-offense should also be considered. Participants described the need for more training on mental health topics and the local service system. Lastly, the agency learned about factors that could impact the consultation process (e.g., trusting the consultant, maintaining a growth mindset) and relationships with behavioral health service providers (e.g., having a common language between community supervision and behavioral health), officer workload, and leadership engagement.
Pre-implementation assessments, including those conducted using rapid analysis methods, should be routine practices when launching an intervention or an implementation strategy under real-world conditions. These assessments provide agencies and their research partners with actionable and tailored information that can enhance the pace and effectiveness of their implementation efforts.
尽管实施科学方法已在医疗保健的各个领域广泛应用，但在刑事法律系统环境中促进健康干预措施方面的应用却较少。鉴于需要有效的治疗方法来解决刑事法律系统中相关人员相对较差的健康和心理健康结果，这一研究空白存在问题。此外，记录实施前阶段方法的已发表研究相对较少。本文报告了一项实施前评估，该评估是一项由全州社区监督机构资助的倡议的一部分，旨在通过试点两种实施策略来解决该州专门心理健康监督计划中的关键限制：临床病例咨询和加强心理健康官员与行为健康服务提供者的关系。
本研究的目的是为机构领导提供实用且及时的信息，以便他们就推出该倡议的计划做出决策。在30天的时间内，研究团队对实施团队成员、社区监督官员及其主管进行了22次简短的半结构化访谈。然后，研究团队使用快速定性分析方法来确定实施策略的潜在挑战和促进因素，并提出改进实施的建议。
尽管参与者表示，在案件量分配和逐步减少时考虑心理健康症状是一个首要因素，但他们认为还应考虑其他稳定因素（如住房、就业）和再犯罪风险。参与者描述了对更多心理健康主题和当地服务系统培训的需求。最后，该机构了解到可能影响咨询过程的因素（如信任顾问、保持成长心态）以及与行为健康服务提供者的关系（如社区监督和行为健康之间有共同语言）、官员工作量和领导参与度。
实施前评估，包括那些使用快速分析方法进行的评估，在现实世界条件下启动干预或实施策略时应成为常规做法。这些评估为机构及其研究伙伴提供了可操作且量身定制的信息，可加快其实施工作的速度并提高有效性。
