Effects of an Organizational Implementation Strategy on Sustainment of Measurement-Based Care in Community Mental Health

• DOI: 10.1176/appi.ps.20240302
• Publication Date: 2025-01-30T08:01:07Z
• Authors: Nathaniel J. Will...; Gregory A. Aarons; Mark G. Ehrhart; Susan Esp; Nallely Vega; Marisa Sklar; Kristine Carandang; Lauren Brookman-F...; Steven C. Marcus
• Keywords: Reimbursement

Little is known about how to sustain evidence-based interventions with fidelity in community mental health settings. Phase 1 of the Working Implement and Sustain Digital Outcome Measures (WISDOM) trial showed that an organizational strategy improved implementation measurement-based care (MBC) services for youths 1-12 months after clinician MBC training. The authors report results from phase 2 trial, which strategy's effects on sustainment 13-26 training were examined. Twenty-one outpatient clinics randomly assigned technical assistance plus Leadership Organizational Change Implementation (LOCI) (11 clinics) or only (10 clinics). In 2, primary outcomes completion rate, youth symptom improvement, examined 452 who entered treatment No differences found rate improvement between two conditions; however, among 81 received MBC, was significantly higher at LOCI sites relative control (24%, SE=11.1 vs. 1%, SE=1.0, respectively; p=0.003). During (vs. sites) sustained superior when used; rates clinical not sustained. Sustainment may require strategies improve its fit regulatory reimbursement environments addition develop clinic infrastructure.