JMIR Publications

ABSTRACT

Background:

Efficacious psychiatric treatments are not consistently deployed in community practice and clinical outcomes are attenuated compared with those achieved in clinical trials. A major focus for mental health services research is to develop effective and cost-effective strategies that increase the use of evidence-based assessment, prevention, and treatment approaches in community settings

Objective:

The goal of this program of research is to apply insights from behavioral economics and participatory design to advance the science and practice of implementing evidence-based practice for individuals with psychiatric disorders across the lifespan.

Methods:

Project 1 (Assisting Depressed Adults in Primary care Treatment; ADAPT) is patient-focused and leverages decision-making heuristics to compare ways to incentivize adherence to anti-depressant medications in the first six weeks of treatment among adults newly diagnosed with depression. Project 2 (App for Strengthening Services In Specialized Therapeutic Support; ASSISTS) is provider-focused and utilizes normative pressure and social status to increase data collection among community mental health workers treating children with autism. Project 3 (Motivating Outpatient Therapists to Implement: Valuing a Team Effort; MOTIVATE) explores how participatory design can be used to design organizational-level implementation strategies to increase clinician use of evidence-base practices. The projects are supported by a Methods Core that provides expertise in implementation science, behavioral economics, participatory design, measurement, and associated statistical approaches. Discussion: This research will advance the science of implementation through efforts to improve implementation strategy design, measurement, and statistical methods. First, we will test and refine approaches to collaboratively designing implementation strategies with stakeholders (e.g., discrete choice experiments; innovation tournaments). Second, we will refine measurement of mechanisms related to heuristics used in decision-making. Third, we will develop new ways to test mechanisms in multilevel implementation trials. This trifecta, coupled with findings from our three exploratory projects, will lead to improvements in our knowledge of what causes successful implementation, what variables moderate and mediate the effects of those causal factors, and how best to leverage this knowledge to increase the quality of care for people with psychiatric disorders. Trial registration: Clinicaltrials.gov NCT03441399. Registered 15 February 2018. https://www.clinicaltrials.gov/ct2/show/NCT03441399?term=marcus%2C+steven&rank=2.