Users’ involvement in mental health services: programme logic model of an innovative initiative in integrated care

Tremblay, Carolane; Coulombe, Valérie; Briand, Catherine

doi:10.1186/s13033-016-0111-5

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…This study contributes to the literature on recovery from psychological distress, which has mostly focused on recovery from the perspective of high-income countries (Piat et al, 2009;Noiseux et al, 2010;Buchanan et al, 2014;Jacob, 2015;Tremblay et al, 2017). In contrast, this study presented community members' perception of recovery in the fragile setting of Sierra Leone.…”

Section: Discussionmentioning

confidence: 96%

Understanding perceptions of recovery from psychological distress in Sierra Leone through qualitative comparative analysis

Jailobaeva

Horn

Bah

et al. 2021

Humanit Soc Sci Commun

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Qualitative comparative analysis (QCA) is a relatively new method that examines causal complexity. Its use in mental health research is nascent. In low-income and fragile settings, with weak mental health service provision, identifying pathways of recovery from psychological distress can inform the appropriate deployment of scarce community and public resources. This paper examines the use of QCA to identify predictors of recovery in Sierra Leone. Our study explored lay perceptions of the signs of recovery from psychological distress caused by such events as the loss of a family member, severe sickness, and loss of a relationship. The data drew upon 75 interviews with women and men, across four districts of Sierra Leone, who described the signs of recovery from psychological distress they have observed in one person known to them. The truth table generated through QCA software indicated two signs of recovery— work/study and healthy relations—to be the most prevalent across different combinations of predictive factors. Further analysis of the truth table and sub-set relations suggested that work/study and healthy relations frequently served as sufficient conditions for reported recovery from distress to occur. QCA provided a means to identify sufficient predictive factors for recovery from psychological distress to occur. The findings suggest that to enable recovery from psychological distress, support needs to be broad and bring together services that will enable individuals to improve their social and relational wellbeing. Responses to distress need to involve a wide range of community-based stakeholders who will help individuals to engage in constructive activity and strengthen relations with their family members, friends, and the broader community. QCA is potentially well-positioned to unpack complexity in mental health research.

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Section: Discussionmentioning

confidence: 96%

Understanding perceptions of recovery from psychological distress in Sierra Leone through qualitative comparative analysis

Jailobaeva

Horn

Bah

et al. 2021

Humanit Soc Sci Commun

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“…Logic models are used to build a shared understanding of program goals among all stakeholders, support clear communication about the program and its expected impact, and guide program evaluation and improvement efforts (McLaughlin & Jordan, 1999; Smith et al, 2020). Use of logic models for program development and evaluation ensures that activities are consistent with stakeholder preferences, increases the likelihood that program goals are attained (Hayes et al, 2011; Tremblay et al, 2017), promotes replicability, and identifies linkages between intermediate and longer-term outcomes (Smith et al, 2020). As program implementation activities are completed, the logic model and evaluation plan are used interactively, resulting in data-based program revisions and more rigorous program evaluation.…”

Section: Developing the Logic Model And Measurement Batterymentioning

confidence: 99%

Strategic implementation planning for integrated behavioral health services in pediatric primary care

Mautone

Wolk

Cidav

et al. 2021

Implementation Research and Practice

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Background: Delivering physical and behavioral health services in a single setting is associated with improved quality of care and reduced health care costs. Few health systems implementing integrated care develop conceptual models and targeted measurement strategies a priori with an eye toward adoption, implementation, sustainment, and evaluation. This is a broad challenge in the field, which can make it difficult to disentangle why implementation is or is not successful. Method: This article discusses strategic implementation and evaluation planning for a pediatric integrated care program in a large health system. Our team developed a logic model, which defines resources and community characteristics, program components, evaluation activities, short-term activities, and intermediate and anticipated long-term patient-, clinician-, and practice-related outcomes. The model was designed based on research and stakeholder input to support strategic implementation and evaluation of the program. For each aspect of the logic model, a measurement battery was selected. Initial implementation data and intermediate outcomes from a pilot in five practices in a 30-practice pediatric primary care network are presented to illustrate how the logic model and evaluation plan have been used to guide the iterative process of program development. Results: A total of 4,619 office visits were completed during the 2 years of the pilot. Primary care clinicians were highly satisfied with the integrated primary care program and provided feedback on ways to further improve the program. Members of the primary care team and behavioral health providers rated the program as being relatively well integrated into the practices after the second year of the pilot. Conclusion: This logic model and evaluation plan provide a template for future projects integrating behavioral health services in non-specialty mental health settings, including pediatric primary care, and can be used broadly to provide structure to implementation and evaluation activities and promote replication of effective initiatives. Plain language abstract: Up to 1 in 5 youth have difficulties with mental health; however, the majority of these youth do not receive the care they need. Many youth seek support from their primary care clinicians. Pediatric primary care practices have increasingly integrated behavioral health clinicians into the care team to improve access to services and encourage high-quality team-based care. Definitions of “behavioral health integration” vary across disciplines and organizations, and little is known about how integrated behavioral health care is actually implemented in most pediatric settings. In addition, program evaluation activities have not included a thorough examination of long-term outcomes. This article provides detailed information on the implementation planning and evaluation activities for an integrated behavioral health program in pediatric primary care. This work has been guided by a logic model, an important implementation science tool to guide the development and evaluation of new programs and promote replication. The logic model and measurement plan we developed provides a guide for policy makers, researchers, and clinicians seeking to develop and evaluate similar programs in other systems and community settings. This work will enable greater adoption, implementation, and sustainment of integrated care models and increase access to high-quality care.

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“…Participation in health is a polysemic concept involving different practices, goals and rationales . Most of the literature on participation has been produced in high‐income countries, and it is based on formal projects with clear boundaries in time and space . It usually embraces an evaluative or critical focus, identifying gaps between design and implementation and/or highlighting the political, economic or ideological drives behind participatory discourses and actions .…”

Section: Introductionmentioning

confidence: 99%

Communities, health‐care organizations and the contingencies and contradictions of engagement: A case study from Chile

Montenegro

Mercado²

2019

Health Expectations

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Context Despite a growing interest in service‐user involvement in mental health services, the interaction between health institutions and local groups is only beginning to receive attention, particularly in global south settings. Objective Looking at a participatory initiative in Chile, this study explores how, under unfavourable administrative conditions, health organizations approach and work with communities. Methods We interviewed policy‐makers (5), local professionals (10), service users and community representatives (6) linked to a concrete participatory initiative. Participant observation in relevant meetings helped to enrich the interpretations. Thematic analysis was applied to interview transcripts and field notes. Findings The findings present a sequence of actions starting with the creation of a network of community‐based groups. A set of problems ensued, related to the group's diversity, internal representation, decision‐making and funding processes. In response, processionals implemented simultaneously bureaucratic and democratic adjustments, developing a vision of community that ignored the particularities—including the motivations—of local groups. Discussion and conclusion Based on these findings, we argue that participatory initiatives should be studied as on‐going achievements shaped by broad policy orientations and local configurations of interest. In the process, they produce ad hoc forms of knowledge and visions of community that provide orientation to the agents involved.

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