References to Evidence-based Program Registry (EBPR) Websites for Behavioral Health in U.S. State Government Statutes and Regulations

Abstract

U.S. state governments have the responsibility to regulate and license behavioral health care interventions, such as for addiction and mental illness, with increasing emphasis on implementing evidence-based programs (EBPs). A serious obstacle to this is lack of clarity or agreement about what constitutes “evidence-based.” The study’s purpose was to determine the extent to which and in what contexts web-based Evidence-based Program Registries (EBPRs) are referenced in state government statutes and regulations (“mandates”) concerning behavioral health care. Examples are What Works Clearinghouse, National Register of Evidence-based Programs and Practices, and Cochrane Database of Systematic Reviews. The study employed the Westlaw Legal Research Database to search for 30 known EBPR websites relevant to behavioral health care within the statutes and regulations of all 50 states. There was low prevalence of EBPR references in state statutes and regulations pertaining to behavioral health care; 20 states had a total of 33 mandates that referenced an EBPR. These mandates usually do not rely on an EBPR as the sole acceptable source for classifying a program or practice as “evidence-based.” Instead, EBPRs were named in conjunction with internal state or external sources of information about putative program effectiveness, which may be less valid than EBPRs, to determine what is “evidence-based.” Greater awareness of scientifically based EBPRs and greater understanding of their advantages need to be fostered among state legislators and regulators charged with making policy to increase or improve the use of evidence-based programs and practices in behavioral health care in the United States.

Utilization of Evidence-based Intervention Criteria in U.S. Federal Grant Funding Announcements for Behavioral Healthcare

“…This is consistent with the findings of previous studies, which found either a general lack or restricted range of references to EBPRs on both state agency websites and within state-level behavioral health policies for the use of EBIs. 23 , 24 EBPRs are potentially valuable resources for identifying EBIs for behavioral health and for obtaining guidance for program implementation. Thus, increasing references to EBPRs in FOAs for federal funding of behavioral healthcare interventions would likely improve the FOA process and increase the societal impact of such interventions.…”

“…Prior studies suggest that inclusion of EBPRs in legislative mandates for the use of evidence-based interventions could clarify and strengthen those mandates. 24 The same seems likely for purchasing levers as well.…”

“… 19 - 22 In order to ensure the implementation of these evidence-based interventions, all actors within these systems must have clear expectations as to what constitutes an evidence-based intervention that is acceptable to implement. 23 , 24 …”

“…[19][20][21][22] In order to ensure the implementation of these evidence-based interventions, all actors within these systems must have clear expectations as to what constitutes an evidence-based intervention that is acceptable to implement. 23,24 The provision of clearly defined criteria about what constitutes an EBI, including specification of multiple tiers of evidence, is considered to be essential to evidence-based policymaking. 25,26 A recent study of state-level mandates for the use of evidence-based interventions found that the majority of mandates included in the study simply mentioned key terms related to evidence-based interventions, but did not elaborate on them to any degree.…”

Variations in Definitions of Evidence-Based Interventions for Behavioral Health in Eight Selected U.S. States

“…The variety of terms that have been associated with the concept of "evidence-based" include "research-based," "science-based," "best practice(s)," "empirically supported treatment," or "promising program or practice." Lee et al (2022) examines references to evidence-based behavioral health program registries in statutes and regulations of state agencies, and Magura et al (2022) examines state behavioral agency personnel's familiarity with behavioral health program registries. However, there is no study to date that examines the official definitions of terms related to the concept of "evidencebased" propagated by statutes and regulations that apply to state behavioral health agencies.…”