Cargando…

Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol

BACKGROUND: Measurement-based care is an evidence-based practice for depression that efficiently identifies treatment non-responders and those who might otherwise deteriorate [1]. However, measurement-based care is underutilized in community mental health with data suggesting fewer than 20 % of beha...

Descripción completa

Detalles Bibliográficos
Autores principales: Lewis, Cara C., Scott, Kelli, Marti, C. Nathan, Marriott, Brigid R., Kroenke, Kurt, Putz, John W., Mendel, Peter, Rutkowski, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561429/
https://www.ncbi.nlm.nih.gov/pubmed/26345270
http://dx.doi.org/10.1186/s13012-015-0313-2
_version_ 1782389035082186752
author Lewis, Cara C.
Scott, Kelli
Marti, C. Nathan
Marriott, Brigid R.
Kroenke, Kurt
Putz, John W.
Mendel, Peter
Rutkowski, David
author_facet Lewis, Cara C.
Scott, Kelli
Marti, C. Nathan
Marriott, Brigid R.
Kroenke, Kurt
Putz, John W.
Mendel, Peter
Rutkowski, David
author_sort Lewis, Cara C.
collection PubMed
description BACKGROUND: Measurement-based care is an evidence-based practice for depression that efficiently identifies treatment non-responders and those who might otherwise deteriorate [1]. However, measurement-based care is underutilized in community mental health with data suggesting fewer than 20 % of behavioral health providers using this practice to inform treatment. It remains unclear whether standardized or tailored approaches to implementation are needed to optimize measurement-based care fidelity and penetration. Moreover, there is some suggestion that prospectively tailored interventions that are designed to fit the dynamic context may optimize public health impact, though no randomized trials have yet tested this notion [2]. This study will address the following three aims: (1) To compare the effect of standardized versus tailored MBC implementation on clinician-level and client-level outcomes; (2) To identify contextual mediators of MBC fidelity; and (3) To explore the impact of MBC fidelity on client outcomes. METHODS/DESIGN: This study is a dynamic cluster randomized trial of standardized versus tailored measurement-based care implementation in Centerstone, the largest provider of community-based mental health services in the USA. This prospective, mixed methods implementation-effectiveness hybrid design allows for evaluation of the two conditions on both clinician-level (e.g., MBC fidelity) and client-level (depression symptom change) outcomes. Central to this investigation is the focus on identifying contextual factors (e.g., attitudes, resources, process, etc.) that mediate MBC fidelity and optimize client outcomes. DISCUSSION: This study will contribute generalizable and practical strategies for implementing systematic symptom monitoring to inform and enhance behavioral healthcare. TRIAL REGISTRATION: Clinicaltrials.gov NCT02266134. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13012-015-0313-2) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4561429
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-45614292015-09-08 Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol Lewis, Cara C. Scott, Kelli Marti, C. Nathan Marriott, Brigid R. Kroenke, Kurt Putz, John W. Mendel, Peter Rutkowski, David Implement Sci Study Protocol BACKGROUND: Measurement-based care is an evidence-based practice for depression that efficiently identifies treatment non-responders and those who might otherwise deteriorate [1]. However, measurement-based care is underutilized in community mental health with data suggesting fewer than 20 % of behavioral health providers using this practice to inform treatment. It remains unclear whether standardized or tailored approaches to implementation are needed to optimize measurement-based care fidelity and penetration. Moreover, there is some suggestion that prospectively tailored interventions that are designed to fit the dynamic context may optimize public health impact, though no randomized trials have yet tested this notion [2]. This study will address the following three aims: (1) To compare the effect of standardized versus tailored MBC implementation on clinician-level and client-level outcomes; (2) To identify contextual mediators of MBC fidelity; and (3) To explore the impact of MBC fidelity on client outcomes. METHODS/DESIGN: This study is a dynamic cluster randomized trial of standardized versus tailored measurement-based care implementation in Centerstone, the largest provider of community-based mental health services in the USA. This prospective, mixed methods implementation-effectiveness hybrid design allows for evaluation of the two conditions on both clinician-level (e.g., MBC fidelity) and client-level (depression symptom change) outcomes. Central to this investigation is the focus on identifying contextual factors (e.g., attitudes, resources, process, etc.) that mediate MBC fidelity and optimize client outcomes. DISCUSSION: This study will contribute generalizable and practical strategies for implementing systematic symptom monitoring to inform and enhance behavioral healthcare. TRIAL REGISTRATION: Clinicaltrials.gov NCT02266134. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13012-015-0313-2) contains supplementary material, which is available to authorized users. BioMed Central 2015-09-07 /pmc/articles/PMC4561429/ /pubmed/26345270 http://dx.doi.org/10.1186/s13012-015-0313-2 Text en © Lewis et al. 2015 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Lewis, Cara C.
Scott, Kelli
Marti, C. Nathan
Marriott, Brigid R.
Kroenke, Kurt
Putz, John W.
Mendel, Peter
Rutkowski, David
Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol
title Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol
title_full Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol
title_fullStr Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol
title_full_unstemmed Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol
title_short Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol
title_sort implementing measurement-based care (imbc) for depression in community mental health: a dynamic cluster randomized trial study protocol
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561429/
https://www.ncbi.nlm.nih.gov/pubmed/26345270
http://dx.doi.org/10.1186/s13012-015-0313-2
work_keys_str_mv AT lewiscarac implementingmeasurementbasedcareimbcfordepressionincommunitymentalhealthadynamicclusterrandomizedtrialstudyprotocol
AT scottkelli implementingmeasurementbasedcareimbcfordepressionincommunitymentalhealthadynamicclusterrandomizedtrialstudyprotocol
AT marticnathan implementingmeasurementbasedcareimbcfordepressionincommunitymentalhealthadynamicclusterrandomizedtrialstudyprotocol
AT marriottbrigidr implementingmeasurementbasedcareimbcfordepressionincommunitymentalhealthadynamicclusterrandomizedtrialstudyprotocol
AT kroenkekurt implementingmeasurementbasedcareimbcfordepressionincommunitymentalhealthadynamicclusterrandomizedtrialstudyprotocol
AT putzjohnw implementingmeasurementbasedcareimbcfordepressionincommunitymentalhealthadynamicclusterrandomizedtrialstudyprotocol
AT mendelpeter implementingmeasurementbasedcareimbcfordepressionincommunitymentalhealthadynamicclusterrandomizedtrialstudyprotocol
AT rutkowskidavid implementingmeasurementbasedcareimbcfordepressionincommunitymentalhealthadynamicclusterrandomizedtrialstudyprotocol