P2i

Principal Investigator: Rinad Beidas, PhD

5K23MH099179-04

 

Evidence-based treatments (EBTs), treatments that have been evaluated scientifically and show evidence of efficacy, are not widely available in community settings. It takes up to 17 years after proof of efficacy for these treatments to make their way into community settings. In response to the call for implementation of EBTs, states and counties have mandated behavioral health reform. Evaluations of the impact of these policies and other initiatives on implementation are rare.

A new center to support the implementation of EBTs, the Evidence Based Practices Innovation Center (EPIC), has been created in Philadelphia as part of the Department of Behavioral Health. We have operationalized the activities of EPIC as a policy mandate. EPIC will encourage and incentivize clinics to implement EBTs for youth by providing an infrastructure to support these services (e.g., training, consultation) and potentially through an enhanced payment rate for provision of EBTs.

The formation of EPIC offers a rare and important opportunity to prospectively study implementation in response to a policy mandate. This mixed-methods study is prospective, longitudinal, and observational. We will investigate the response of 30 community mental health clinics to EPIC and the resulting policy from the Department of Behavioral Health encouraging and incentivizing clinics to implement EBTs for youth. Study participants will be approximately 210 therapists and 30 executive directors. Data will be collected prior to the policy, and then 2 and 4 years following the implementation of the policy. Quantitative data will include clinician-level measures of intervention implementation and potential moderators of implementation (organizational and leader-level variables). Clinician-level measures include self-reported therapist fidelity to EBT techniques as measured by the Therapist Procedures Checklist-Revised, observed therapist fidelity as measured by the Therapist Process Observational Coding System- Strategies Scale, organization variables as measured by the Organizational Social Context Measurement System and the Implementation Climate Assessment, leader variables as measured by the Multifactor Leadership Questionnaire, attitudes towards EBTs as measured by the Evidence-Based Practice Attitude Scale, and knowledge of EBTs as measured by the Knowledge of Evidence- Based Services Questionnaire. Qualitative data will include semi-structured interviews with a subset of the sample. Findings from the proposed research will inform both future policy mandates around implementation and the support required for the success of these policies, increase the number of youth in the public sector who can access quality psychosocial treatment, and reduce the research-practice gap.