BackgroundA large and growing percentage of medically underserved groups receive care at federally qualified health centers (FQHCs). Care coordination is an evidence-based approach to address disparities in healthcare services. A partnered FQHC established a care coordination model to improve receipt and quality of healthcare for patients most at risk for poor health outcomes. This care coordination model emphasizes identification and support of behavioral health needs (e.g., depression, anxiety) and two evidence-based behavioral health programs needs were selected for implementation within the context of this care coordination model. Implementation Mapping is a systematic process for specifying the implementation strategies and outcomes. The current case study describes the application of Implementation Mapping to inform the selection and testing of implementation strategies to improve implementation of two behavioral health programs in a Care Coordination Program at a partnered FQHC.MethodsWe applied Implementation Mapping to inform the development, selection and testing of implementation strategies to improve the implementation of two evidence-based behavioral health programs within a care coordination program at a partnered FQHC.ResultsResults are presented by Implementation Mapping task, from Task 1 through Task 5. We also describe the integration of additional implementation frameworks (The Consolidated Framework for Implementation Research, Health Equity Implementation Framework) within the Implementation Mapping process to inform determinant identification, performance and change objectives development, design and tailoring of implementation strategies and protocols, and resulting evaluation of implementation outcomes.ConclusionsThe current project is an example of real-world application of Implementation Mapping methodology to improve care outcomes for a high priority population that is generalizable to other settings utilizing similar care models and health equity endeavors. Such case studies are critical to advance our understanding and application of innovative implementation science methods such as Implementation Mapping.

Public programs have been charged with implementation of evidence-based practices (EBPs) to improve outcomes for children with autism. However, research indicates that scale-up of EBPs poses challenges. This study identifies perceived variables linked to effective statewide scale-up of EBPs in special education by exploring implementation climate and leadership across special education organization types (e.g., schools, districts, and regional consortiums). A simultaneous QUAL + QUAN mixed methods design was employed with the primary function of convergence and triangulation. Data included focus groups with 30 special educators and a statewide survey completed by 656 school personnel. In general, perceptions of implementation climate and leadership are weak in special education organizations with strengths at regional levels focused on special education and increased challenges at the school and district levels. Implications for practice and future research are identified.

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