141 lines
4.5 KiB
YAML
141 lines
4.5 KiB
YAML
|
abstract: 'ObjectiveStudy a quality improvement approach for implementing
|
||
|
|
|
||
|
|
evidence-based employment services at specialty mental health clinics.
|
||
|
|
|
||
|
|
Data Sources/Study SettingSemistructured interviews with clinicians and
|
||
|
|
|
||
|
|
administrators before, during, and after implementation. Qualitative
|
||
|
|
|
||
|
|
field notes, structured baseline and follow-up interviews with patients,
|
||
|
|
|
||
|
|
semistructured interviews with patients after implementation, and
|
||
|
|
|
||
|
|
administrative data.
|
||
|
|
|
||
|
|
Study DesignSite-level controlled trial at four implementation and four
|
||
|
|
|
||
|
|
control sites. Hybrid implementation-effectiveness study with mixed
|
||
|
|
|
||
|
|
methods intervention evaluation design.
|
||
|
|
|
||
|
|
Data Collection/Extraction MethodsSite visits, in-person and telephone
|
||
|
|
|
||
|
|
interviews, patient surveys, patient self-assessment. A total of 801
|
||
|
|
|
||
|
|
patients completed baseline surveys and 53 clinicians and other clinical
|
||
|
|
|
||
|
|
key stakeholders completed longitudinal qualitative interviews.
|
||
|
|
|
||
|
|
Principal FindingsAt baseline, sites varied in the availability,
|
||
|
|
|
||
|
|
utilization, and quality of supported employment. Each site needed
|
||
|
|
|
||
|
|
quality improvement for this service, though for differing reasons, with
|
||
|
|
|
||
|
|
some needing development of the service itself and others needing
|
||
|
|
|
||
|
|
increased service capacity. Improvements in knowledge, attitudes,
|
||
|
|
|
||
|
|
beliefs, and referral behaviors were evident in mid- and
|
||
|
|
|
||
|
|
postimplementation interviews, though some barriers persisted. Half of
|
||
|
|
|
||
|
|
patients expressed an interest in working at baseline. Patients at
|
||
|
|
|
||
|
|
implementation sites were 2.3 times more likely to receive employment
|
||
|
|
|
||
|
|
services during the study year. Those who had a service visit were more
|
||
|
|
|
||
|
|
likely to be employed at follow-up than those who did not.
|
||
|
|
|
||
|
|
ConclusionsStudies of implementation and effectiveness require mixed
|
||
|
|
|
||
|
|
methods to both enhance implementation in real time and provide context
|
||
|
|
|
||
|
|
for interpretation of complex results. In this study, a quality
|
||
|
|
|
||
|
|
improvement approach resulted in superior patient-level outcomes and
|
||
|
|
|
||
|
|
improved clinician knowledge, attitudes, and behaviors, in the context
|
||
|
|
|
||
|
|
of substantial variation among sites.'
|
||
|
|
affiliation: 'Hamilton, AB (Corresponding Author), Univ Calif Los Angeles, Dept Psychiat
|
||
|
|
\& Biobehav Sci, 11301 Wilshire Blvd 210A, Los Angeles, CA 90073 USA.
|
||
|
|
|
||
|
|
Hamilton, Alison B.; Cohen, Amy N.; Young, Alexander S., Univ Calif Los Angeles,
|
||
|
|
Dept Psychiat \& Biobehav Sci, Los Angeles, CA 90073 USA.
|
||
|
|
|
||
|
|
Hamilton, Alison B.; Cohen, Amy N.; Glover, Dawn L.; Young, Alexander S., Greater
|
||
|
|
Los Angeles VA Healthcare Ctr, Los Angeles, CA 90073 USA.
|
||
|
|
|
||
|
|
Whelan, Fiona, Univ Calif Los Angeles, Dept Psychiat \& Biobehav Sci, Semel Inst
|
||
|
|
Biostat Core SIStat, Los Angeles, CA 90073 USA.
|
||
|
|
|
||
|
|
Chemerinski, Eran, James J Peters VA Med Ctr, Bronx, NY USA.
|
||
|
|
|
||
|
|
McNagny, Kirk P.; Reist, Christopher, Long Beach VA Healthcare Syst, Long Beach,
|
||
|
|
CA USA.
|
||
|
|
|
||
|
|
Mullins, Deborah, Michael E DeBakey VA Med Ctr, Houston, TX USA.
|
||
|
|
|
||
|
|
Schubert, Max, Cent Texas Vet Healthcare Syst, Waco, TX USA.'
|
||
|
|
author: Hamilton, Alison B. and Cohen, Amy N. and Glover, Dawn L. and Whelan, Fiona
|
||
|
|
and Chemerinski, Eran and McNagny, Kirk P. and Mullins, Deborah and Reist, Christopher
|
||
|
|
and Schubert, Max and Young, Alexander S.
|
||
|
|
author-email: alisonh@ucla.edu
|
||
|
|
author_list:
|
||
|
|
- family: Hamilton
|
||
|
|
given: Alison B.
|
||
|
|
- family: Cohen
|
||
|
|
given: Amy N.
|
||
|
|
- family: Glover
|
||
|
|
given: Dawn L.
|
||
|
|
- family: Whelan
|
||
|
|
given: Fiona
|
||
|
|
- family: Chemerinski
|
||
|
|
given: Eran
|
||
|
|
- family: McNagny
|
||
|
|
given: Kirk P.
|
||
|
|
- family: Mullins
|
||
|
|
given: Deborah
|
||
|
|
- family: Reist
|
||
|
|
given: Christopher
|
||
|
|
- family: Schubert
|
||
|
|
given: Max
|
||
|
|
- family: Young
|
||
|
|
given: Alexander S.
|
||
|
|
da: '2023-09-28'
|
||
|
|
doi: 10.1111/1475-6773.12115
|
||
|
|
eissn: 1475-6773
|
||
|
|
files: []
|
||
|
|
issn: 0017-9124
|
||
|
|
journal: HEALTH SERVICES RESEARCH
|
||
|
|
keywords: 'Mixed methods; implementation research; schizophrenia; supported
|
||
|
|
|
||
|
|
employment; health services'
|
||
|
|
keywords-plus: 'SUPPORTED EMPLOYMENT; ORGANIZATIONAL READINESS; COMPETITIVE EMPLOYMENT;
|
||
|
|
|
||
|
|
MIXED METHODS; QUALITY; DESIGNS; MANAGEMENT; ILLNESS; CARE'
|
||
|
|
language: English
|
||
|
|
month: DEC
|
||
|
|
number: 6, 2
|
||
|
|
number-of-cited-references: '37'
|
||
|
|
orcid-numbers: 'Hamilton, Alison B/0000-0003-3998-7212
|
||
|
|
|
||
|
|
McNagny, Kelly/0000-0003-4737-3499'
|
||
|
|
pages: 2224-2244
|
||
|
|
papis_id: ff40ba377bddf2129774bba6d0eb72c7
|
||
|
|
ref: Hamilton2013implementationeviden
|
||
|
|
researcherid-numbers: 'Hamilton, Alison B/IUP-2045-2023
|
||
|
|
|
||
|
|
McNagny, Kelly/P-5239-2014'
|
||
|
|
times-cited: '20'
|
||
|
|
title: Implementation of Evidence-Based Employment Services in Specialty Mental Health
|
||
|
|
type: Article
|
||
|
|
unique-id: WOS:000327391900006
|
||
|
|
usage-count-last-180-days: '0'
|
||
|
|
usage-count-since-2013: '19'
|
||
|
|
volume: '48'
|
||
|
|
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
|
||
|
|
year: '2013'
|