背景:尽管正在努力将循证干预措施(EBIs)引入精神卫生保健机构,很少有研究关注这些环境下EBIs的可持续性。大学校园是一个自然的地方,干预年轻人谁是高风险的心理健康障碍,包括饮食失调.当前的研究测试了三个级别的实施支持对基于证据的团体饮食失调预防计划的可持续性的影响,身体项目,由同伴教育者提供。我们还测试了干预措施是否,上下文,或实施过程因素预测的可持续性。
方法:我们招募了63所具有同伴教育者计划的大学,并随机分配给他们(a)接受为期2天的培训师(TTT)培训,其中对同伴教育者进行了培训,以实施身体项目,并向主管教授如何培训未来的同伴教育者(TTT)。(b)TTT培训加技术援助讲习班(TTT+TA),或(c)TTT加上为期1年的TA研讨会和质量保证(QA)咨询(TTTTAQA)。我们测试了实施支持战略,干预措施的感知特征和对基线循证干预措施的态度以及实施年度内已完成的实施活动的比例预测了三个学校层面的二分可持续性结果(提供身体项目组,培训同伴教育者,培训主管)在随后的两年可持续发展期内使用逻辑回归模型。
结果:实施支持策略没有显著预测任何可持续性结果,尽管有趋势表明,随机分配到TTT+TA+QA策略的大学更有可能培训新的主管(OR=5.46,95%CI[0.89-33.38]).完成实施活动比例较高的学院更有可能提供Body项目组(OR=1.53,95%CI[1.19-1.98]),并在可持续性阶段培训新的同伴教育者(OR=1.39,95%CI[1.10-1.74])。身体项目的感知积极特征预测培训新的同伴教育者(OR=18.42,95%CI[1.48-299.66]),这对于提供商营业额较高的常规设置中的可持续性可能至关重要。
结论:帮助学校完成更多的实施活动并增加预防计划的感知积极特征可能会导致预防计划的实施得到更大的维持。
背景:这项研究于17年7月12日在ClinicalTrials.gov进行了预注册,IDNCT03409809,https://clinicaltrials.gov/ct2/show/NCT03409809。
BACKGROUND: Despite ongoing efforts to introduce evidence-based interventions (EBIs) into mental health care settings, little research has focused on the
sustainability of EBIs in these settings. College campuses are a natural place to intervene with young adults who are at high risk for mental health disorders, including eating disorders. The current study tested the effect of three levels of implementation support on the
sustainability of an evidence-based group eating disorder prevention program, the Body Project, delivered by peer educators. We also tested whether intervention, contextual, or implementation process factors predicted
sustainability.
METHODS: We recruited 63 colleges with peer educator programs and randomly assigned them to (a) receive a 2-day Train-the-Trainer (TTT) training in which peer educators were trained to implement the Body Project and supervisors were taught how to train future peer educators (TTT), (b) TTT training plus a technical assistance (TA) workshop (TTT + TA), or (c) TTT plus the TA workshop and quality assurance (QA) consultations over 1-year (TTT + TA + QA). We tested whether implementation support strategies, perceived characteristics of the intervention and attitudes towards evidence-based interventions at baseline and the proportion of completed implementation activities during the implementation year predicted three school-level dichotomous sustainability outcomes (offering Body Project groups, training peer educators, training supervisors) over the subsequent two-year sustainability period using logistic regression models.
RESULTS: Implementation support strategies did not significantly predict any
sustainability outcomes, although a trend suggested that colleges randomized to the TTT + TA + QA strategy were more likely to train new supervisors (OR = 5.46, 95% CI [0.89-33.38]). Colleges that completed a greater proportion of implementation activities were more likely to offer Body Project groups (OR = 1.53, 95% CI [1.19-1.98]) and train new peer educators during the sustainability phase (OR = 1.39, 95% CI [1.10-1.74]). Perceived positive characteristics of the Body Project predicted training new peer educators (OR = 18.42, 95% CI [1.48-299.66]), which may be critical for
sustainability in routine settings with high provider turnover.
CONCLUSIONS: Helping schools complete more implementation activities and increasing the perceived positive characteristics of a prevention program may result in greater sustainment of prevention program implementation.
BACKGROUND: This study was preregistered on 12/07/17 with ClinicalTrials.gov, ID NCT03409809, https://clinicaltrials.gov/ct2/show/NCT03409809 .