ABSTRACT
BACKGROUND:
Efficacious psychiatric
treatments are not consistently deployed in
community practice, and clinical outcomes are attenuated compared with those achieved in clinical trials. A major focus for
mental health services research is to develop effective and
cost-effective
strategies that increase the use of evidence-based assessment, prevention, and
treatment approaches in
community settings.
OBJECTIVE:
The
goal of this program of
research is to apply insights from
behavioral economics and participatory design to advance the
science and practice of implementing
evidence-based practice (EBP) for individuals with
psychiatric disorders across the
life span.
METHODS:
Project 1 (Assisting Depressed
Adults in
Primary care Treatment [ADAPT]) is
patient-focused and leverages
decision-making
heuristics to compare ways to incentivize adherence to
antidepressant medications in the first 6 weeks of
treatment among
adults newly diagnosed with
depression. Project 2 (App for Strengthening Services In Specialized
Therapeutic Support [ASSISTS]) is provider-focused and utilizes normative
pressure and
social status to increase
data collection among
community mental health workers treating
children with
autism. Project 3 (Motivating
Outpatient Therapists to Implement Valuing a Team Effort [MOTIVATE]) explores how participatory design can be used to design organizational-level implementation
strategies to increase clinician use of EBPs. The
projects are supported by a
Methods Core that provides expertise in
implementation science,
behavioral economics, participatory design, measurement, and associated statistical approaches.
RESULTS:
Enrollment for project ADAPT started in 2018; results are expected in 2020. Enrollment for project ASSISTS
will begin in 2019; results are expected in 2021. Enrollment for project MOTIVATE started in 2018; results are expected in 2019.
Data collection had begun for ADAPT and MOTIVATE when this protocol was submitted.
CONCLUSIONS:
This
research will advance the
science of implementation through efforts to improve implementation strategy design, measurement, and statistical
methods. First, we
will test and refine approaches to collaboratively design implementation
strategies with stakeholders (eg, discrete choice experiments and innovation tournaments). Second, we
will refine the measurement of mechanisms related to
heuristics used in
decision making. Third, we
will develop new ways to test mechanisms in multilevel implementation trials. This trifecta, coupled with findings from our 3 exploratory
projects,
will lead to improvements in our
knowledge of what causes successful implementation, what variables moderate and mediate the effects of those causal factors, and how best to leverage this
knowledge to increase the
quality of care for people with
psychiatric disorders. TRIAL REGISTRATION ClinicalTrials.gov NCT03441399; https//www.clinicaltrials.gov/ct2/show/NCT03441399 (Archived by WebCite at http//www.webcitation.org/74dRbonBD). INTERNATIONAL
REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/12121.