An intervention mapping process to increase evidence-based psychotherapy within a complex healthcare system.

Abstract

In response to recommendations from the Special Committee on posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs, Veterans Health Administration (VHA) chartered a workgroup to identify strategies for improving the reach and fidelity of evidence-based psychotherapies (EBPs) implemented by VHA through clinician training initiatives. The workgroup, which comprised stakeholders in a variety of roles within the VHA, used an Intervention Mapping process, a practical approach to designing change strategies based on theory, evidence, and stakeholder input. High-level recommendations centered around implementation of recent VHA/Department of Defense (VA/DoD) treatment guidelines. In addition to recommended first-line and suggested second-line treatments, the guidelines include measurement-based care and shared decision making around EBPs and their alternatives to ensure that care is goal-oriented and patient-centered. To support increased reach and fidelity, the workgroup made four broad recommendations: (a) enhancing leadership support; (b) alignment of policies, programs, and processes that influence reach of EBPs as recommended in clinical practice guidelines, including implementation support to accompany EBP trainings; (c) use of clinical data to inform decision making at multiple levels, and to provide fidelity support when outcomes are lower than expected or desired; and (d) increasing veteran and stakeholder education and awareness of guideline recommendations and availability of EBPs. These recommendations accompanied a more detailed set of recommended steps for implementation. This article describes the Intervention Mapping process and a summary of resulting workgroup recommendations.Editor's note. This article is part of a special issue, "Expanding the Impact of Psychology Through Implementation Science," published in the November 2020 issue of American Psychologist. Shannon Wiltsey Stirman and Rinad S. Beidas served as editors of the special issue, with Anne E. Kazak as advisory editor and action editor for this article.

Multilevel factors in providers’ decisions to utilize CPT in military- and veteran-serving treatment settings.

“…They suggested that it is important to ensure that all patients and their families are aware of EBPs, as well as their evidence and availability. This suggestion is consistent with a key recommendation of a recent national workgroup that focused on improving EBP reach and fidelity within the VA (Crowe et al, 2020).…”

Current Practices and Beliefs Regarding Screening Patients with Burns for Acute Stress Disorder and Posttraumatic Stress Disorder: A Survey of the American Burn Association Membership

“…The US Department of Veteran Affairs, Veterans Health Administration recently published guidelines for improving their care for veterans with PTSD. Their roadmap included leadership support, alignment of procedures across institutions, and education for healthcare providers [19]. A similar set of standard procedures with detailed processes for screening and follow-up of at-risk patients would increase the equity and quality of care for patients with burn injuries in the US.…”

Implementing a text-messaging intervention for unhealthy alcohol use in emergency departments: protocol for implementation strategy development and a pilot cluster randomized implementation trial

“…We will use a systematic 4-step intervention mapping method [59,[61][62][63] to develop our implementation strategy. We will leverage aim 1 results and three stakeholder meetings.…”

“…Rigorous methods are needed to select strategies that take into account relevant theory and stakeholder participation and that are specified clearly enough to be replicated [59,60]. This study will use a systematic intervention mapping process to develop the facilitated implementation strategy [59,[61][62][63][64]. The aims of this study are to: Aim 1: examine potential barriers and facilitators to staff offering and patients accepting a text-messaging intervention in the ED using an explanatory, sequential mixed methods approach O'Grady et al Implementation Science Communications (2022) 3:86 Aim 2: use a stakeholder-engaged intervention mapping process to develop a multi-component implementation strategy for EDs Aim 3: conduct a mixed method 2-arm cluster randomized pilot study in 4 EDs that serve ~11,000 UAU patients per year to assess the feasibility, acceptability, and preliminary effectiveness of the implementation strategy…”