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