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Fernández-Alvarez J, Molinari G, Kilcullen R, Delgadillo J, Drill R, Errázuriz P, Falkenstrom F, Firth N, O'Shea A, Paz C, Youn SJ, Castonguay LG. The Importance of Conducting Practice-oriented Research with Underserved Populations. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:358-375. [PMID: 38157130 DOI: 10.1007/s10488-023-01337-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
There has been a growing emphasis on dissemination of empirically supported treatments. Dissemination, however, should not be restricted to treatment. It can and, in the spirit of the scientific-practitioner model, should also involve research. Because it focuses on the investigation of clinical routine as it takes place in local settings and because it can involve the collaboration of several stakeholders, practice-oriented research (POR) can be viewed as an optimal research method to be disseminated. POR has the potential of addressing particularly relevant gaps of knowledge and action when implemented in regions of the world that have limited resources for or experiences with empirical research, and/or in clinical settings that are serving clinical populations who are not typically receiving optimal mental care services - specifically, individuals in rural and inner cities that have limited economic and social resources. The establishment and maintenance of POR in such regions and/or settings, however, come with specific obstacles and challenges. Integrating the experiences acquired from research conducted in various continents (Africa, Europe, Latin America, and North America), the goal of this paper is to describe some of these challenges, strategies that have been implemented to address them, as well as new possible directions to facilitate the creation and growth of POR. It also describes how these challenges and ways to deal with them can provide helpful lessons for already existing POR infrastructures.
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Affiliation(s)
| | - Guadalupe Molinari
- International University of Valencia, Valencia, Spain
- Aiglé Valencia, Valencia, Spain
| | - Ryan Kilcullen
- Department of Psychology, The Pennsylvania State University, Pennsylvania, USA
| | - Jaime Delgadillo
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Rebecca Drill
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, USA
| | - Paula Errázuriz
- Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
- Millennium Institute for Research on Depression and Personality, Chile, PsiConecta, Chile
| | | | - Nick Firth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Amber O'Shea
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, Pennsylvania, USA
| | - Clara Paz
- Universidad de Las Américas, Ciudad de México, Ecuador
| | - Soo Jeong Youn
- Reliant Medical Group, OptumCare, Harvard Medical School, Worcester, MA, USA
| | - Louis G Castonguay
- Department of Psychology, The Pennsylvania State University, Pennsylvania, USA
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Douglas S, Bovendeerd B, van Sonsbeek M, Manns M, Milling XP, Tyler K, Bala N, Satterthwaite T, Hovland RT, Amble I, Atzil-Slonim D, Barkham M, de Jong K, Kendrick T, Nordberg SS, Lutz W, Rubel JA, Skjulsvik T, Moltu C. A Clinical Leadership Lens on Implementing Progress Feedback in Three Countries: Development of a Multidimensional Qualitative Coding Scheme. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023:10.1007/s10488-023-01314-6. [PMID: 37917313 DOI: 10.1007/s10488-023-01314-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Progress feedback, also known as measurement-based care (MBC), is the routine collection of patient-reported measures to monitor treatment progress and inform clinical decision-making. Although a key ingredient to improving mental health care, sustained use of progress feedback is poor. Integration into everyday workflow is challenging, impacted by a complex interrelated set of factors across patient, clinician, organizational, and health system levels. This study describes the development of a qualitative coding scheme for progress feedback implementation that accounts for the dynamic nature of barriers and facilitators across multiple levels of use in mental health settings. Such a coding scheme may help promote a common language for researchers and implementers to better identify barriers that need to be addressed, as well as facilitators that could be supported in different settings and contexts. METHODS Clinical staff, managers, and leaders from two Dutch, three Norwegian, and four mental health organizations in the USA participated in semi-structured interviews on how intra- and extra-organizational characteristics interact to influence the use of progress feedback in clinical practice, supervision, and program improvement. Interviews were conducted in the local language, then translated to English prior to qualitative coding. RESULTS A team-based consensus coding approach was used to refine an a priori expert-informed and literature-based qualitative scheme to incorporate new understandings and constructs as they emerged. First, this hermeneutic approach resulted in a multi-level coding scheme with nine superordinate categories and 30 subcategories. Second-order axial coding established contextually sensitive categories for barriers and facilitators. CONCLUSIONS The primary outcome is an empirically derived multi-level qualitative coding scheme that can be used in progress feedback implementation research and development. It can be applied across contexts and settings, with expectations for ongoing refinement. Suggestions for future research and application in practice settings are provided. Supplementary materials include the coding scheme and a detailed playbook.
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Affiliation(s)
- Susan Douglas
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA.
| | - Bram Bovendeerd
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
- Dimence, Center for Mental Health Care, Deventer, the Netherlands
| | | | - Mya Manns
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA
| | - Xavier Patrick Milling
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA
| | - Ke'Sean Tyler
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA
| | | | - Tim Satterthwaite
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA
| | - Runar Tengel Hovland
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Department of Research and Innovation, Førde Hospital Trust, Førde, Norway
| | - Ingunn Amble
- Villa Sana - Centre for Work Health, Modum Bad, Norway
| | | | - Michael Barkham
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Kim de Jong
- Clinical Psychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Tony Kendrick
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Samuel S Nordberg
- Department of Behavioral Health, Reliant Medical Group, Worcester, MA, USA
| | - Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany
| | - Julian A Rubel
- Department of Psychology, Psychotherapy Research Lab, Justus Liebig University Giessen, Giessen, Germany
| | | | - Christian Moltu
- District General Hospital of Førde, Førde, Norway
- Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway
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