Optimizing Evidence-Based Practice Implementation for Clinical Impact: the IMPACT Center

Abstract:

Optimizing Evidence-Based Practice Implementation for Clinical Impact The goal of the IMPACT Center is to accelerate the impact of evidence-based practices (EBPs) for youth receiving mental healthcare in low-resourced community-based settings. These settings, which include community mental health centers and schools, provide mental healthcare to most low-income, ethnically diverse youth who receive services. In these settings, EBPs are not implemented widely or with fidelity, and youth have high unmet mental health needs, leading to adverse outcomes.

In IMPACT, we focus on optimizing EBP implementation in low-resourced community settings for four of the most common youth mental health conditions: depression, anxiety including posttraumatic stress, and behavioral conditions. To provide high-quality treatment for youth, community settings need support to optimize EBP implementation. The field of implementation science has tried to address this research-practice gap; however, a recent editorial call for more “practical implementation science” that generates solutions in partnership with the practice community leading to tools they can use independently for EBP implementation. In IMPACT, we will partner with stakeholders in developing, refining, employing, and disseminating user-friendly methods and tools to accelerate the impact of EBPs for youth.

IMPACT targets 3 implementation challenges: (I) Identify and prioritize determinants to EBP implementation; (II) Match implementation strategies to prioritized determinants; and (III) Test and optimize strategies according to practice partner goals (e.g., reach, preference, impact, efficiency, affordability). Our Methods Core is a trans-disciplinary team from clinical, community, and organizational psychology; information, computer, and implementation sciences; anthropology; medicine; public health; and user-centered design. We will develop methods and toolkits for each challenge, co-designed and refined with practice partners for acceptability, feasibility, and appropriateness. Our partnership with the WA EBP Initiative is an ideal laboratory for developing new methods.

The IMPACT Center, a Kaiser Permanente Washington Health Research Institute-University of Washington partnership, is codirected by Weiner and Dorsey. The Administrative Core will support stakeholder engagement, maximize Center learning, and foster synergy and integration across the Cores, exploratory projects, and pilot grant program. This Core will lead dissemination to the practice and scientific communities, training, and evaluation of IMPACT. The Methods Core will collaboratively develop new methods, support investigators and trainees, and actively participate in outreach.

The exploratory projects will employ and refine methods from IMPACT’s three challenges, developing and testing practical implementation strategies to improve treatment quality and client outcomes via EBP implementation. Project 1 optimizes measurement-based care, a foundational frame- work to guide EBP delivery. Project 2 optimizes and tests a peer-led, frontline leader-focused strategy to optimize cognitive behavioral therapy (CBT) for four most common youth conditions. Project 3 increases reach and impact of an effective, multicomponent engagement strategy for clinicians in schools to use trauma-focused CBT.