Stakeholder & Policy Analysis Archives - Implementation Science at UW

✪ Partnering with Policymakers to Design Suicide Care Research: Maximizing Impact in Adolescent Mental Health Policy

Abstract:

Outpatient medical settings are a critical source of mental health care for adolescents and young adults. This is due to the familiarity and accessibility of those settings and challenges accessing mental health care elsewhere. Adolescents and young adults who die by suicide are more likely to have seen a medical provider in the prior month than a mental health specialist, but few suicide care interventions have been developed to specifically address the challenges of working in these outpatient medical settings. This paper provides the perspective of the University of Washington Suicide Care Research Center on the importance of incorporating evidence into public policy decisions regarding workforce development and standards of care for adolescents and young adults experiencing suicidal thoughts and behaviors, their families, and their outpatient medical setting providers; and the equal importance of integrating policy and funding perspectives in clinical services and implementation science. The paper will review the trends in suicide care policy and funding structures as relevant to adolescents and young adults in outpatient medical settings, provide recommendations to advance the translation of research into evidence-based policy decisions for adolescents and young adults at risk of suicide, and recommendations for researchers on incorporating policy perspectives in the development and evaluation of evidence-based interventions. We will share how the University of Washington Suicide Care Research Center is operationalizing these recommendations.

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Pilot Testing a Digital Transdiagnostic Mental Health Intervention for Use Among Immigrant and Refugee Youth in the USA: A Mixed Methods Evaluation of Clinical and Implementation Outcomes

Better Guidelines and Policies: AAP’s Partnership for Policy Implementation

✪ Enhanced or hindered research benefits? A realist review of community engagement and participatory research practices for non-communicable disease prevention in low- and middle-income countries

Abstract:

Introduction

Community engagement and participatory research are widely used and considered important for ethical health research and interventions. Based on calls to unpack their complexity and observed biases in their favour, we conducted a realist review with a focus on non-communicable disease prevention. The aim was to generate an understanding of how and why engagement or participatory practices enhance or hinder the benefits of non-communicable disease research and interventions in low- and middle-income countries.

Methods

We retroductively formulated theories based on existing literature and realist interviews. After initial searches, preliminary theories and a search strategy were developed. We searched three databases and screened records with a focus on theoretical and empirical relevance. Insights about contexts, strategies, mechanisms and outcomes were extracted and synthesised into six theories. Five realist interviews were conducted to complement literature-based theorising. The final synthesis included 17 quality-appraised articles describing 15 studies.

Results

We developed six theories explaining how community engagement or participatory research practices either enhance or hinder the benefits of non-communicable disease research or interventions. Benefit-enhancing mechanisms include community members’ agency being realised, a shared understanding of the benefits of health promotion, communities feeling empowered, and community members feeling solidarity and unity. Benefit-hindering mechanisms include community members’ agency remaining unrealised and participation being driven by financial motives or reputational expectations

Conclusion

Our review challenges assumptions about community engagement and participatory research being solely beneficial in the context of non-communicable disease prevention in low- and middle-income countries. We present both helpful and harmful pathways through which health and research outcomes are affected. Our practical recommendations relate to maximising benefits and minimising harm by addressing institutional inflexibility and researcher capabilities, managing expectations on research, promoting solidarity in solving public health challenges and sharing decision-making power.

^{**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**}

✪ A policy implementation study of earmarked taxes for mental health services: study protocol

Abstract:

Background

Insufficient funding is frequently identified as a critical barrier to the implementation and sustainment of evidence-based practices (EBPs). Thus, increasing access to funding is recognized as an implementation strategy. Policies that create earmarked taxes—defined as taxes for which revenue can only be spent on specific activities—are an increasingly common mental health financing strategy that could improve the reach of EBPs. This project’s specific aims are to (1) identify all jurisdictions in the USA that have implemented earmarked taxes for mental health and catalogue information about tax design; (2) characterize experiences implementing earmarked taxes among local (e.g., county, city) mental health agency leaders and other government and community organization officials and assess their perceptions of the acceptability and feasibility of different types of policy implementation strategies; and (3) develop a framework to guide effect earmarked tax designs, inform the selection of implementation strategies, and disseminate the framework to policy audiences.

Methods

The project uses the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to inform data collection about the determinants and processes of tax implementation and Leeman’s typology of implementation strategies to examine the acceptability and feasibility strategies which could support earmarked tax policy implementation. A legal mapping will be conducted to achieve aim 1. To achieve aim 2, a survey will be conducted of 300 local mental health agency leaders and other government and community organization officials involved with the implementation of earmarked taxes for mental health. The survey will be followed by approximately 50 interviews with these officials. To achieve aim 3, quantitative and qualitative data will be integrated through a systematic framework development and dissemination process.

Discussion

This exploratory policy implementation process study will build the evidence base for outer-context implementation determinants and strategies by focusing on policies that earmarked taxes for mental health services.

^{**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**}

Authors:

✪ Open Access

Read the full text in the open access journal Evidence-Based Practice in Child and Adolescent Mental Health

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Subscription Required for Full Text Access

Read the full text in the subscription access Journal of Technology in Behavioral Science

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Subscription Required for Full Text Access

Read the full text in the subscription access journal Pediatrics

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✪ Open Access

Read the full text in the open access journal BMJ Global Health

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Introduction

Methods

Results

Conclusion

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✪ Open Access

Read the full text in the open access journal Implementation Science Communications

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Background

Methods

Discussion

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✪ Open Access

Read the full text in the open access journal Nutrition Reviews

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Subscription Required for Full Text Access

Read the full text in the subscription access journal Administration and Policy in Mental Health and Mental Health Services Research