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. 2013 Oct;52(10):1009-1025.e18.
doi: 10.1016/j.jaac.2013.07.012. Epub 2013 Jul 29.

Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review

Douglas K Novins  1 , Amy E Green, Rupinder K Legha, Gregory A Aarons
Affiliations

Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review

Douglas K Novins et al. J Am Acad Child Adolesc Psychiatry. 2013 Oct.

Erratum in

  • J Am Acad Child Adolesc Psychiatry. 2014 Mar;53(3):382

Abstract

Objective: Although there has been a dramatic increase in the number of evidence-based practices (EBPs) to improve child and adolescent mental health, the poor uptake of these EBPs has led to investigations of factors related to their successful dissemination and implementation. The purpose of this systematic review was to identify key findings from empirical studies examining the dissemination and implementation of EBPs for child and adolescent mental health.

Method: Of 14,247 citations initially identified, 73 articles drawn from 44 studies met inclusion criteria. The articles were classified by implementation phase (exploration, preparation, implementation, and sustainment) and specific implementation factors examined. These factors were divided into outer (i.e., system level) and inner (i.e., organizational level) contexts.

Results: Few studies used true experimental designs; most were observational. Of the many inner context factors that were examined in these studies (e.g., provider characteristics, organizational resources, leadership), fidelity monitoring and supervision had the strongest empirical evidence. Albeit the focus of fewer studies, implementation interventions focused on improving organizational climate and culture were associated with better intervention sustainment as well as child and adolescent outcomes. Outer contextual factors such as training and use of specific technologies to support intervention use were also important in facilitating the implementation process.

Conclusions: The further development and testing of dissemination and implementation strategies is needed to more efficiently move EBPs into usual care.

Keywords: children; dissemination and implementation research; evidence-based practice; mental health substance abuse.

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Figures

Figure 1
Figure 1
Exploration, preparation, implementation, sustainment (EPIS) multilevel implementation framework: factors impacting evidence-based treatment (EBT) implementation in child and adolescent mental health. Note: This figure depicts some examples of factors in the outer and inner contexts to be considered in each phase of the EPIS framework phases found in this study and in the original article. From Aarons et al. Advancing a conceptual model of evidence-based practice implementation in public service sectors. 2011;28(1):4–23. Reprinted with permission from Springer.
Figure 2
Figure 2
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) study selection flow diagram.
See this image and copyright information in PMC

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