Symposia
Dissemination & Implementation Science
Elizabeth Connors, Ph.D.
Yale University
New Haven, Connecticut
Corianna E. Sichel, Ph.D.
Postdoctoral Research Scientist
Columbia University/New York State Psychiatric Institute
New York, NY
Abstract: Prior studies indicate that measurement-based care (MBC) is effective in improving and accelerating positive mental health outcomes for youth receiving outpatient services. MBC is the routine collection and use of client-reported progress measures to inform shared decision making and collaborative treatment adjustments. It is a relatively feasible and scalable clinical practice to improve care quality in under-resourced community mental health settings. However, MBC uptake is low and close examination of top barriers and facilitators of MBC in community-based youth mental health care is needed to inform how to promote more consistent MBC use across all clinicians. The current mixed methods study used latent class analysis to identify two implementation outcome classes among N=80 clinicians in four community mental health agencies who implemented MBC with youth using a measurement feedback system (MFS). Thematic coding of clinician qualitative feedback about implementation highlighted the importance of four top determinants of practice to promote the uptake of MBC and MFS in youth-serving community mental health settings: 1) clarity, appropriateness and feasibility of the MFS and its measure(s); 2) clinician knowledge and skills; 3) client preferences; and 4) incentives and resources. Examination of determinants by class indicated that “Implementers” endorsed significantly more facilitators than “Non-Implementers”, but the top determinants were the same across classes. Moreover, implementation climate varied more by clinician than agency. Implications for efficient resource allocation and targeted implementation supports for clinicians to promote future MBC and MFS implementation efforts are discussed.