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1.
JMIR Form Res ; 8: e53206, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38767942

RESUMEN

BACKGROUND: Primary care research networks can generate important information in the setting where most patients are seen and treated. However, this requires a suitable IT infrastructure (ITI), which the North Rhine-Westphalian general practice research network is looking to implement. OBJECTIVE: This mixed methods research study aims to evaluate (study 1) requirements for an ITI and (study 2) the usability of an IT solution already available on the market, the FallAkte Plus (FA+) system for the North Rhine-Westphalian general practice research network, which comprises 8 primary care university institutes in Germany's largest state. METHODS: In study 1, a survey was conducted among researchers from the institutes to identify the requirements for a suitable ITI. The questionnaire consisted of standardized questions with open-ended responses. In study 2, a mixed method approach combining a think-aloud approach and a quantitative survey was used to evaluate the usability and acceptance of the FA+ system among 3 user groups: researchers, general practitioners, and practice assistants. Respondents were asked to assess the usability with the validated system usability scale and to test a short questionnaire on vaccination management through FA+. RESULTS: In study 1, five of 8 institutes participated in the requirements survey. A total of 32 user requirements related primarily to study management were identified, including data entry, data storage, and user access management. In study 2, a total of 36 participants (24 researchers and 12 general practitioners or practice assistants) were surveyed in the mixed methods study of an already existing IT solution. The tutorial video and handouts explaining how to use the FA+ system were well received. Researchers, unlike practice personnel, were concerned about data security and data protection regarding the system's emergency feature, which enables access to all patient data. The median overall system usability scale rating was 60 (IQR 33.0-85.0), whereby practice personnel (median 82, IQR 58.0-94.0) assigned higher ratings than researchers (median 44, IQR 14.0-61.5). Users appreciated the option to integrate data from practices and other health care facilities. However, they voted against the use of the FA+ system due to a lack of support for various study formats. CONCLUSIONS: Usability assessments vary markedly by professional group and role. In its current stage of development, the FA+ system does not fully meet the requirements for a suitable ITI. Improvements in the user interface, performance, interoperability, security, and advanced features are necessary to make it more effective and user-friendly. Collaborating with end users and incorporating their feedback are crucial for the successful development of any practice network research ITI.

2.
Artículo en Inglés | MEDLINE | ID: mdl-37615809

RESUMEN

The supply / demand issue in behavioral health care is a well-established fact, and the mental health toll of the COVID-19 pandemic continues to add challenges to an already taxed system. Existing healthcare models are not set up to adequately address the increasing mental health related needs. As such, innovative models are needed to provide patients with access to appropriate, evidence-based behavioral health care within routine clinical care. This paper introduces Precision Behavioral Health (PBH) as an example of such a model. PBH is an innovative, digital first care delivery model that provides an ecosystem of evidence-based digital mental health interventions to patients as a frontline behavioral health treatment within routine care in a large multispecialty group medical center in the United States. This paper describes the implementation of PBH within a practice research network set-up as part of an integrated behavioral health department. We will present how our team leveraged the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance; "What is RE-AIM?," n.d.) implementation science framework, which emphasizes the design, dissemination, and implementation processes at the individual, staff, and organizational levels, to prioritize key implementation constructs to enhance the successful integration of PBH within routine care. We describe how each of these constructs were operationalized to aid data gathering for rapid evaluation and lessons learned. We discuss the benefits of these types of initiatives across multiple stakeholders including patients, providers, organizations, payers, and digital intervention vendors.

3.
Psychother Res ; 32(5): 663-677, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-34763613

RESUMEN

While agreement between clients and their clinicians on therapy goals has frequently been investigated as a process-level variable (i.e., working alliance), dyadic convergence on presenting concerns is also important for initial case formulation. Transdiagnostic presenting problems, like sleep difficulty, pose a particular challenge for client-therapist convergence. The current study describes sleep difficulty in a treatment-seeking college population and investigates the impact of client and therapist baseline sleep problem reports on therapy outcomes.Data were collected through a large practice research network, with the sample comprising 47,023 clients from 99 university counseling centers across the United States.A larger proportion of clients (49.3%) had self-reported high baseline sleep difficulty than those with a clinician-identified sleep concern (16.0%). Clients with baseline sleep difficulty were more likely to end treatment with greater self-reported sleep difficulty and psychological symptom distress, although they may experience larger gross symptom change than clients without baseline sleep difficulty. Clinician-identified sleep concerns were significantly associated with client outcomes, particularly when clients did not report baseline sleep difficulty themselves.Findings from this study suggest that it may be efficacious and efficient with limited time for treatment to address sleep concerns in a college setting.Clinicians' attendance to their clients' transdiagnostic presenting concerns, like sleep difficulty, may increase clients' own awareness of problematic patterns of behavior. When time for therapy is short, as is often the case in college counseling, it may be efficient to prioritize these concerns with the potential to impact a broad range of symptoms.


Asunto(s)
Relaciones Profesional-Paciente , Trastornos del Sueño-Vigilia , Consejo , Humanos , Autoinforme , Resultado del Tratamiento
4.
Fam Process ; 59(4): 1946-1957, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-31894586

RESUMEN

SYPRENE, a new international Systemic Practice Research Network (PRN), has been established to fill the gap in practice-based research on the effectiveness and efficiency of strategic therapies. This article presents the rationale for the creation of SYPRENE and describes data collection methods, and the encoding system implemented within this PRN. More developments are expected in the recruitment of practitioners, the types of data collected, findings, and the implementation of SYPRENE in supervision, trainings, and professional schools.


SYPRENE, una nueva red internacional sistémica de investigación basada en la práctica (PRN), se ha establecido para llenar vacíos en la investigación basada en la práctica sobre la eficacia y la eficiencia de las terapias estratégicas. Este artículo presenta las razones de la creación de SYPRENE y describe los métodos de recopilación de datos y el sistema de codificación implementado dentro de esta red de investigación basada en la práctica. Se esperan más novedades en la contratación de profesionales, los tipos de datos recogidos, los hallazgos y la implementación de SYPRENE en supervisión, capacitaciones y escuelas profesionales.


Asunto(s)
Investigación sobre Servicios de Salud/organización & administración , Agencias Internacionales/organización & administración , Servicios de Salud Mental/organización & administración , Psicoterapia/organización & administración , Humanos
5.
Adm Policy Ment Health ; 44(6): 919-931, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28667572

RESUMEN

Practice research networks (PRNs) can support the implementation of evidence based practice in routine services and generate practice based evidence. This paper describes the structure, processes and learning from a new PRN in the Improving Access to Psychological Therapies programme in England, in relation to an implementation framework and using one study as a case example. Challenges related to: ethics and governance processes; communications with multiple stakeholders; competing time pressures and linking outcome data. Enablers included: early tangible outputs and impact; a collaborative approach; engaging with local research leads; clarity of processes; effective dissemination; and committed leadership.


Asunto(s)
Práctica Clínica Basada en la Evidencia/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Investigación sobre Servicios de Salud/métodos , Psicoterapia/organización & administración , Comunicación , Conducta Cooperativa , Difusión de Innovaciones , Inglaterra , Práctica Clínica Basada en la Evidencia/normas , Accesibilidad a los Servicios de Salud/normas , Humanos , Psicoterapia/normas , Factores de Tiempo
6.
Psychother Res ; 25(1): 52-66, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-24279593

RESUMEN

Learning how to conduct clinically meaningful and actionable research while simultaneously training to be a competent clinician may be an optimal way to develop an early attachment to the scientific-practitioner model. In this paper, the transformation of a training clinic into a practice research network (PRN) is presented as a strategy to foster a seamless integration of clinical, training, and research facets of graduate training in psychology. With the hope of providing helpful guidance to trainers and trainees interested in building such an infrastructure, the authors describe the context in which they developed their training clinic PRN, its major components, and some of the studies that have been conducted in this network. Benefits earned and lessons learned (in terms of obstacles faced and strategies implemented to deal with them) are described, as well as general recommendations and future directions regarding the implementation and impact of training clinic PRNs.


Asunto(s)
Competencia Clínica/normas , Educación de Postgrado/normas , Investigación sobre Servicios de Salud/normas , Evaluación de Resultado en la Atención de Salud/normas , Psicoterapia/normas , Humanos , Psicoterapia/educación
7.
Psychother Res ; 25(1): 1-5, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25325680

RESUMEN

This paper is an introduction to a special series that attempts to foster collaboration between clinicians and researchers by presenting the experiences of 11 groups of contributors who have conducted practice-oriented research (POR) in various countries and naturalistic settings. Each of these groups was asked to describe the context in which their collaborative initiatives took place, as well as some of the studies conducted, obstacles faced, strategies employed to address these challenges, and benefits earned. Authors were also invited to provide general recommendations to facilitate future POR. In order to integrate the lessons learned so far, as well as to consolidate suggestions for future collaboration of clinicians, researchers, and other stakeholders in the field of mental health, the series ends with a conclusion paper that identifies convergences and particular characteristics that cut across the partnerships featured.


Asunto(s)
Conducta Cooperativa , Práctica Clínica Basada en la Evidencia , Salud Mental , Investigadores , Humanos
8.
Psychother Res ; 25(1): 166-84, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25437382

RESUMEN

In this concluding paper, we identify the type of studies conducted by 11 teams of contributors to a special issue on building clinicians-researchers partnerships. Those studies were conducted across a variety of clinical settings. We also integrate the lessons that have emerged from their collaborative initiatives in terms of obstacles faced, strategies adopted to address these challenges, benefits gained, and general recommendations offered to facilitate studies conducted with or by clinicians. The paper ends with the authors' thoughts about the future success of practice-oriented research in general.


Asunto(s)
Conducta Cooperativa , Investigación sobre Servicios de Salud , Evaluación de Procesos y Resultados en Atención de Salud , Psicoterapia , Investigadores , Humanos
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