The Development of the Practice-Concordant Care Scale: An Assessment Tool to Examine Treatment Strategies Across Evidence-Based Practices

Friday 1:00 – 2:15 Breakout B3

Presentor: Nicole Stadnick

Nicole Stadnick, University of California, San Diego; Department of Psychiatry; Miya Barnett, University of California, Los Angeles; Department of Psychology; Jennifer Regan, University of California, Los Angeles; Department of Psychology; Scott Roesch, San Diego State University; Department of Psychology; Anna Lau, University of California, San Diego; Department of Psychology; Lauren Brookman-Frazee, University of California, San Diego; Department of Psychiatry


To understand the impact of large-scale implementation efforts of evidence-based practices (EBPs) in mental health (MH) systems, it is important to understand if providers are delivering the essential components of the practices. To assess delivery across a range of EBPs, it is necessary to develop a common metric. This project developed the Practice-Concordant Care Scale (PCCS) to assess the extent to which community providers report delivering strategies considered essential to six specific practices that treat a range of ages and presenting problems. Existing practice inventories were reviewed to inform item selection and structure. Twenty-two practice experts (i.e., intervention developers or master trainers) of the six practices completed an electronic survey in which they rated 63 strategies as “essential??? versus “interfering??? on a Likert-scale. Practice-specific and a “common elements??? algorithms were developed using the 56 strategies for which there was inter-rater agreement based on the Delphi rating system. An additional 10 strategies were added based on practice expert input. The current 66-item self-report PCCS will be validated using a corresponding observational coding measure and preliminary data will be presented. The PCCS offers promise to efficiently assess therapist report of practice delivery to facilitate EBP implementation efforts in community MH settings.


Agency Characteristics that Facilitate Efficient and Successful Implementation Efforts

Friday 1:00 – 2:15 Breakout B3

Presentor: Miya Barnett

Miya Barnett, University of California, Los Angeles; Jennifer Regan, University of California, Los Angeles; Nicole Stadnick, University of California, San Diego; Alison Hamilton, University of Califorina, Los Angeles; Anna Lau, University of Califorina, Los Angeles; Lauren Brookman-Frazee, University of California, San Diego


To tailor implementation approaches to community needs, it is important to address the following questions: (1) How do agency characteristics impact efficient, successful evidence-based practice (EBP) uptake? (2) What supports are needed when agencies have barriers to implementation? In 2009, Los Angeles County Department of Mental Health (LACDMH) launched the Prevention and Early Intervention (PEI) Transformation. The PEI Transformation required agencies to quickly change staffing and infrastructure to meet a fiscal mandate, which amended contracts to reimburse only for provision of approved practices. From 2012 to 2013, LACDMH conducted site visits at PEI-contracted agencies to support early implementation efforts. In this project, mixed-methods are being used to integrate qualitative site visit narratives and quantitative claims data from 103 agencies to identify agency characteristics associated with effective implementation efforts. Preliminary qualitative analyses have elucidated several themes related to infrastructure, client characteristics, and administrative challenges. It is hypothesized that agency size will impact implementation outcomes, with larger agencies having or creating infrastructure that promotes successful uptake. Similarly, it is hypothesized that agencies that predominately serve ethnic minorities will need additional implementation support. Results may pinpoint elements of implementation support needed to promote agency success in delivering specific types of EBPs.


Rapid Assessment Process: Application to the Prevention and Early Intervention (PEI) Transformation in Los Angeles County

Friday 1:00 – 2:15 Breakout B3

Presentor: Jennifer Regan

Jennifer Regan, UCLA; Nicole Stadnick, UCSD; Miya Barnett, UCLA; Alison Hamilton, UCLA; Anna Lau, UCLA; Lauren Brookman-Frazee, UCSD



Qualitative data analysis, although greatly informative, is often viewed as time-consuming and labor-intensive. The rapid assessment process (RAP) represents a quick and efficient qualitative analytical method, allowing research teams to swiftly develop a preliminary understanding of complicated situations from an insider’s perspective. This submission will illustrate multiple applications of RAP within an NIMH-funded, mixed-methods study examining the sustainment of specific practices in Los Angeles County following an extensive mental health transformation. RAP procedures will be outlined, including identifying consistent domain names for items, developing a template to summarize domains and assessing its utility, applying summary templates to data, creating a matrix of domains by variables of interest, and comparing data in the matrix according to variables of interest. In application to document review describing early implementation conditions, RAP identified important common themes, such as the development of administrative and procedural infrastructure to facilitate implementation, high level of staff training needs, and use of the train-the-trainer model for sustainment. These findings were used to inform code development for further document review and future applications of RAP to qualitative interviews will inform quantitative data. Take-home points will be conditions that lead to successful RAP application as well as possible challenges in application.