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Abstract：
This article presents the results of a qualitative study conducted to understand the barriers and facilitators in implementing a pilot trial of Critical Time Intervention-Task-Shifting-a time-limited, community-based, recovery-oriented intervention for individuals with psychosis-in Rio de Janeiro, Brazil, and Santiago, Chile. Data included 40 semi-structured interviews with service users, task-shifting providers, and administrators. Analysis proceeded in three iterative phases and combined inductive and deductive approaches. Coding frameworks for implementation factors, and whether or not they acted as barriers and facilitators, were developed and refined using many domains and constructs from the Consolidated Framework for Implementation Research. Barriers and facilitators were ultimately grouped into five domains: 1-Personal; 2-Interpersonal; 3-Intervention; 4-Mental Health System; and 5-Contextual. A rating system was also developed and applied, which enabled comparisons across stakeholders and study sites. Major facilitators included intervention characteristics such as the roles of the task-shifting providers and community-based care. Top barriers included mental health stigma and community conditions (violence). Nevertheless, the findings suggest that Critical Time Intervention-Task-Shifting is largely acceptable and feasible, and could contribute to efforts to strengthen community mental health systems of care for individuals with psychosis in Latin America, especially in advancing the task-shifting strategy and the recovery-oriented approach.
摘要：
本文介绍了一项定性研究的结果，该研究旨在了解实施关键时间干预-任务转移-有时间限制的试点试验中的障碍和促进因素，以社区为基础,在里约热内卢，对精神病患者进行以康复为导向的干预，巴西,还有圣地亚哥,智利。数据包括对服务用户的40次半结构化访谈，任务转移提供者，和管理员。分析分为三个迭代阶段，并结合了归纳和演绎方法。实施因素的编码框架，以及他们是否充当障碍和促进者，是使用实施研究综合框架中的许多领域和结构开发和完善的。障碍和促进者最终分为五个领域：1-个人；2-人际；3-干预；4-心理健康系统；和5-上下文。还开发并应用了评级系统,这使得能够在利益相关者和研究地点进行比较。主要促进者包括干预特征，例如任务转移提供者和社区护理的作用。主要障碍包括心理健康污名和社区条件（暴力）。然而，研究结果表明，关键时间干预-任务转移在很大程度上是可以接受和可行的，并可能有助于努力加强拉丁美洲精神病患者的社区心理健康系统，特别是在推进任务转移战略和面向复苏的方法方面。
