Supporting Policy In health with Research: An Intervention Trial (SPIRIT) – Protocol and Early Findings
Saturday 1:00 – 2:15 Breakout E4
Presentor: Anna Williamson
Dr. Anna Williamson, The Sax Institute
Many governments internationally have committed to better use of evidence from research in policy. Although many programs are directed at assisting agencies to better use research, there have been few tests of the effectiveness of such programs. This paper describes the protocol and early findings from SPIRIT (Supporting Policy In Health with Research: an Intervention Trial), a stepped wedge cluster randomised trial set in Sydney, Australia and designed to test the effectiveness of a multifaceted program to build organisational capacity for the use of research evidence in policy and program development. The primary aim is to determine whether SPIRIT results in an increase in the extent to which research and research expertise is sought, appraised, generated and used in the development of specific policy products produced by health policy agencies.
From EBP Initiatives to Infrastructure: Lessons Learned from a Public Behavioral Health System’s Efforts to Promote Evidence Based Practices
Saturday 1:00 – 2:15 Breakout E4
Presentor: Ronnie M. Rubin
Ronnie Rubin, Philadelphia Department of Behavioral Health and Intellectual disAbilities Services; Byron J. Powell, University of Pennsylvania; Matthew O. Hurford, Philadelphia Department of Behavioral Health and Intellectual disAbilities Services; Shawna Weaver, Philadelphia Department of Behavioral Health and Intellectual disAbilities Services; Rinad S. Beidas, University of Pennsylvania; David S. Mandell, University of Pennsylvania ; Arthur C. Evans, Philadelphia Department of Behavioral Health and Intellectual disAbilities Services
Over the past decade, the field of implementation science has shifted from a focus on therapist knowledge, skills, and behavior to the inclusion of larger contextual and system factors that influence implementation and clinical outcomes. The Philadelphia Department of Behavioral Health and Intellectual disAbilities Services (DBHIDS) has undergone a similar shift in how evidence based practices (EBPs) are promoted from a system-level perspective. DBHIDS has supported several EBP initiatives, including Cognitive Behavioral Therapy, Prolonged Exposure, Trauma-focused CBT and Dialectical Behavior Therapy. These initiatives have included training, consultation, and implementation support to provider agencies. Implementing multiple EBPs simultaneously in a system has provided a unique vantage point to formulate lessons learned about community EBP implementation. We will present data on the training outcomes and sustainment of these practices, discuss key lessons learned, and describe how DBHIDS early experiences have shaped subsequent efforts to develop an infrastructure for EBP implementation by: 1) aligning system operations, 2) supporting the development of general organizational capacities, and 3) prioritizing the use of data driven decision making and outcome evaluation. Examples of specific strategies intended to support this infrastructure will be presented and future system and research directions will be discussed.
Applying the Policy Ecology Model to Philadelphia’s Behavioral Health Transformation Efforts
Saturday 1:00 – 2:15 Breakout E4
Presentor: Byron J. Powell
Byron J. Powell, University of Pennsylvania; Rinad S. Beidas, University of Pennsylvania; Rebecca E. Stewart, University of Pennsylvania; Courtney Benjamin Wolk, University of Pennsylvania; Ronnie Rubin, Philadelphia Department of Behavioral Health and Intellectual disAbility Services; Samantha Matlin, Philadelphia Department of Behavioral Health and Intellectual disAbility Services ; Arthur C. Evans, Philadelphia Department of Behavioral Health and disAbility Services; Trevor R. Hadley, University of Pennsylvania; David S. Mandell, University of Pennsylvania
Most implementation frameworks emphasize that increasing the use of evidence-based practice requires support at the intervention, individual, team, organizational, and broader system levels; however, most implementation strategies focus narrowly on educating and supporting clinicians. Raghavan et al. (2008) argued the importance of addressing the ‘policy ecology,’ which includes organizations, regulatory and purchasing agencies, political entities, and broader social forces. The present study applied Raghavan et al.’s (2008) policy ecology model to characterize the Philadelphia Department of Behavioral Health’s (DBH) efforts to implement evidence-based practices. Documents (e.g., published reports, white papers, and meeting notes) and semi-structured interviews with DBH leadership and treatment developers were analyzed using qualitative content analysis to identify implementation strategies and match them to the policy ecology levels specified by Raghavan et al. (2008). Results suggest that DBH has used strategies at each level of the policy ecology. We discuss strengths and weaknesses of DBH’s efforts, and suggest several implications for theory, research, and policy. This study contributes to the emerging literature on system-level implementation strategies, demonstrates how they can be used to promote the integration of effective practices, and broadens the scope of activities typically described or empirically tested in the implementation literature.