Abstract：
Measurement-based care (MBC) is an underutilized evidence-based practice, and current implementation efforts demonstrate limited success in increasing MBC use. A better understanding of MBC implementation determinants is needed to improve these efforts, particularly from studies examining the full range of MBC practices and that span multiple samples of diverse providers using different MBC systems. This study addressed these limitations by conducting a multi-site survey examining MBC predictors and use in youth treatment. Participants were 159 clinicians and care coordinators working in youth mental health care settings across the United States. Participants were drawn from three program evaluations of MBC implementation. Providers completed measures assessing use of five MBC practices (administering measures, viewing feedback, reviewing feedback in supervision, sharing feedback with clients in session, and using feedback to plan treatment), MBC self-efficacy, and MBC attitudes. Despite expectations that MBC should be standard care for all clients, providers reported only administering measures to 40-60% of clients on average, with practices related to the use of feedback falling in the 1-39% range. Higher MBC self-efficacy and more positive views of MBC practicality predicted higher MBC use, although other attitude measures were not significant predictors. Effects of predictors were not moderated by site, suggesting consistent predictors across implementation settings. Implications of study findings for future research and for the implementation of MBC are discussed.
摘要：
基于测量的护理(MBC)是一种未充分利用的循证实践，当前的实施工作表明，在增加MBC使用方面取得的成功有限。需要更好地了解MBC实施决定因素，以改进这些努力，特别是来自研究全方位的MBC实践，并且跨越使用不同MBC系统的不同提供者的多个样本。这项研究通过进行多站点调查来检查MBC预测因子并在青少年治疗中的使用，从而解决了这些局限性。参与者是在美国青年精神卫生保健机构工作的159名临床医生和护理协调员。参与者来自对MBC实施的三项计划评估。供应商完成了评估使用五种MBC做法的措施(管理措施，查看反馈，审查监督中的反馈，在会话中与客户端共享反馈，并使用反馈来计划治疗)，MBC自我效能感,和MBC态度。尽管人们期望MBC应该成为所有客户的标准护理，提供商平均只报告了对40-60%的客户的管理措施，与使用反馈相关的实践在1-39%的范围内。较高的MBC自我效能感和对MBC实用性的积极看法预示着较高的MBC使用率，尽管其他态度测量并不是重要的预测因素。预测因子的影响不是由地点调节的，在实施设置中建议一致的预测因素。讨论了研究结果对未来研究和实施MBC的影响。
