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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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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 |
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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 |
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