Designing the relational team development intervention to improve management of mental health in primary care using iterative stakeholder engagement

Loeb, Danielle F.; Kline, Danielle; Kroenke, Kurt; Boyd, Cynthia M.; Bayliss, Elizabeth A.; Ludman, Evette; Dickinson, L. Miriam; Binswanger, Ingrid A.; Monson, Samantha Pelican

doi:10.1186/s12875-019-1010-z

Cited by 3 publications

(3 citation statements)

References 75 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We utilized a convergent parallel mixed method approach to evaluate the acceptability and feasibility as well as preliminary efficacy of the RELATED intervention. The initial iterative development of the RELATED intervention is previously described [66]. We continued the iterative development of RELATED by conducting consecutive pilot studies in two clinics and making modifications to the intervention between the first and second clinic pilot.…”

Section: Methodsmentioning

confidence: 99%

“…To address psychosocal factors of implementation, we developed Relational Team Development (RELATED), a brief clinic-wide intervention that combines team-level practice facilitation and PCP-level clinical coaching [66]. RELATED is an enhanced practice facilitation strategy that draws upon psychological clinical supervision models for the PCP-level clinical coaching.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mixed method evaluation of Relational Team Development (RELATED) to improve team-based care for complex patients with mental illness in primary care

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Patients with mental illness are frequently treated in primary care, where Primary Care Providers (PCPs) report feeling ill-equipped to manage their care. Team-based models of care improve outcomes for patients with mental illness, but multiple barriers limit adoption. Barriers include practical issues and psychosocial factors associated with the reorganization of care. Practice facilitation can improve implementation, but does not directly address the psychosocial factors or gaps in PCP skills in managing mental illness. To address these gaps, we developed Relational Team Development (RELATED). Methods RELATED is an implementation strategy combining practice facilitation and psychology clinical supervision methodologies to improve implementation of team-based care. It includes PCP-level clinical coaching and a team-level practice change activity. We performed a preliminary assessment of RELATED with a convergent parallel mixed method study in 2 primary care clinics in an urban Federally Qualified Health Center in Southwest, USA, 2017-2018. Study participants included PCPs, clinic staff, and patient representatives. Clinic staff and patients were recruited for the practice change activity only. Primary outcomes were feasibility and acceptability. Feasibility was assessed as ease of recruitment and implementation. Acceptability was measured in surveys of PCPs and staff and focus groups. We conducted semi-structured focus groups with 3 participant groups in each clinic: PCPs; staff and patients; and leadership. Secondary outcomes were change in pre- post- intervention PCP self-efficacy in mental illness management and team-based care. We conducted qualitative observations to better understand clinic climate. Results We recruited 18 PCPs, 17 staff members, and 3 patient representatives. We ended recruitment early due to over recruitment. Both clinics developed and implemented practice change activities. The mean acceptability score was 3.7 (SD=0.3) on a 4-point Likert scale. PCPs had a statistically significant increase in their mental illness management self-efficacy [change = 0.9, p-value= <.01]. Focus group comments were largely positive, with PCPs requesting additional coaching. Conclusions RELATED was feasible and highly acceptable. It led to positive changes in PCP self-efficacy in Mental Illness Management. If confirmed as an effective implementation strategy, RELATED has the potential to significantly impact implementation of evidence-based interventions for patients with mental illness in primary care.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mixed method evaluation of Relational Team Development (RELATED) to improve team-based care for complex patients with mental illness in primary care

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Especially when it is unclear which quadrant the strategy belongs to, it can help to place the previously articulated alternative strategies on to the same chart for comparison. As is the case for Components 1 and 2, it is recommended that this component closely involve stakeholders (28), who can clarify their previously expressed perspectives, when needed, to collaboratively reach a decision with the implementation team.…”

Section: Component 3: Decide Whether To Use or Abandon The Technological Implementation Strategymentioning

confidence: 99%

Systematic Decision-Making for Using Technological Strategies to Implement Evidence-Based Interventions: An Illustrated Case Study

et al. 2021

View full text Add to dashboard Cite

Technology can improve implementation strategies' efficiency, simplifying progress tracking and removing distance-related barriers. However, incorporating technology is meaningful only if the resulting strategy is usable and useful. Hence, we must systematically assess technological strategies' usability and usefulness before employing them. Our objective was therefore to adapt the effort-vs-impact assessment (commonly used in systems science and operations planning) to decision-making for technological implementation strategies. The approach includes three components – assessing the effort needed to make a technological implementation strategy usable, assessing its impact (i.e., usefulness regarding performance/efficiency/quality), and deciding whether/how to use it. The approach generates a two-by-two effort-vs-impact chart that categorizes the strategy by effort (little/much) and impact (small/large), which serves as a guide for deciding whether/how to use the strategy. We provide a case study of applying this approach to design a package of technological strategies for implementing a 5 A's tobacco cessation intervention at a Federally Qualified Health Center. The effort-vs-impact chart guides stakeholder-involved decision-making around considered technologies. Specification of less technological alternatives helps tailor each technological strategy within the package (minimizing the effort needed to make the strategy usable while maximizing its usefulness), aligning to organizational priorities and clinical tasks. Our three-component approach enables methodical and documentable assessments of whether/how to use a technological implementation strategy, building on stakeholder-involved perceptions of its usability and usefulness. As technology advances, results of effort-vs-impact assessments will likely also change. Thus, even for a single technological implementation strategy, the three-component approach can be repeatedly applied to guide implementation in dynamic contexts.

show abstract

Examining the Social Validity of a Universal Intervention for Reducing Exclusionary Discipline through Stakeholder Voice

Furjanic

Mannan

Hamilton

et al. 2021

Journal of Applied School Psychology

View full text Add to dashboard Cite

Designing the relational team development intervention to improve management of mental health in primary care using iterative stakeholder engagement

Cited by 3 publications

References 75 publications

Mixed method evaluation of Relational Team Development (RELATED) to improve team-based care for complex patients with mental illness in primary care

Mixed method evaluation of Relational Team Development (RELATED) to improve team-based care for complex patients with mental illness in primary care

Systematic Decision-Making for Using Technological Strategies to Implement Evidence-Based Interventions: An Illustrated Case Study

Examining the Social Validity of a Universal Intervention for Reducing Exclusionary Discipline through Stakeholder Voice

Contact Info

Product

Resources

About