A Pragmatic Study of Brief, Low-Effort Implementation Strategies to Increase Reporting of Evidence-Based Practice Use in a Community Mental Health Program Implementing Multiple EBPs
Sean P. Wright, Liz JacobsBackground
Scaling evidence-based practices (EBPs) to address youth behavioral health needs is a key public health goal. Community mental health settings face challenges in measuring and reporting EBPs used with model fidelity due to resource constraints and complex reporting requirements, particularly when individual providers deliver multiple, distinct EBPs. This practical implementation report describes the development and evaluation of three implementation strategies to support the reporting of EBPs in a community mental health outpatient program in the state of Washington.
Method
Using a pragmatic pre–post study design, we measured clinician EBP use via progress notes and billing claims data. After baseline data collection, we deployed three brief, low-effort implementation strategies, including developing educational materials, conducting an educational visit, and auditing and providing feedback. We compared internally calculated EBP use rates in our program to publicly available data from a state-affiliated reporting and implementation partner, and we characterized attempts to use EBP elements by providers who were not yet eligible to officially report EBP use at the state level.
Results
The overall program EBP use rate was 32.7% in the baseline phase, and 48.9% after the implementation strategies were deployed. Paired pre–post analyses of eligible providers showed significant individual increases in EBP reporting post-deployment. The program's contribution to county-wide EBP services increased from 11.8% to 27.1% (with no change in relative proportion of total county services). Analysis of provider behavior that included all providers in the program supported the view that providers replaced informal use of EBP with formal EBP when possible and not simply a “report more EBP” response pattern.
Conclusions
This report highlighted the potential benefits of deploying brief, low-effort implementation strategies to improve implementation outcomes, including self-reported reach and provider behavior. Characterizing EBP use among diverse provider types has practical utility for implementation research and practice.