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Outcomes of a health informatics technology-supported behavioral activation training for care managers in a collaborative care program.
Families, Systems, & Health ( IF 1.2 ) Pub Date : 2020-08-27 , DOI: 10.1037/fsh0000523
Amy M Bauer 1 , Matthew Jakupcak 1 , Matt Hawrilenko 1 , Jared Bechtel 1 , Rob Arao 1 , John C Fortney 1
Affiliation  

INTRODUCTION Health informatics-supported strategies for training and ongoing support may aid the delivery of evidence-based psychotherapies. The objective of this study was to describe the development, implementation, and practice outcomes of a scalable health informatics-supported training program for behavioral activation for patients who screened positive for posttraumatic stress disorder and/or bipolar disorder. METHOD We trained 34 care managers in 12 rural health centers. They used a registry checklist to document the delivery of 10 behavioral activation skills for 4,632 sessions with 455 patients. Care managers received performance feedback based on registry data. Using encounter-level data reported by care managers, we described the implementation outcomes of patient reach and care manager skill adoption. We used cross-classified multilevel modeling to explore variation in skill delivery accounting for patient characteristics, provider characteristics, and change over time. RESULTS Care managers engaged 88% of patients in behavioral activation and completed a minimum course for 57%. The average patient received 5.9 skills during treatment, with substantial variation driven more by providers (63%) than patients (29%). Care managers significantly increased the range of skills offered to patients over time. DISCUSSION The registry-based checklist was a feasible training and support tool for community-based providers to deliver behavioral activation. Providers received data-driven performance feedback and demonstrated skill improvement over time, promoting sustainment. Future research will examine patient-level outcomes. Results underscore the potential public health impact of a simple registry-based skills checklist coupled with a scalable remote training program for evidence-based psychotherapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译:

在协作护理计划中为护理经理提供健康信息学技术支持的行为激活培训的结果。

引言 卫生信息学支持的培训和持续支持策略可能有助于提供循证心理治疗。本研究的目的是描述可扩展的健康信息学支持的行为激活培训计划的开发、实施和实践结果,该培训计划用于为创伤后应激障碍和/或双相情感障碍筛查呈阳性的患者。方法 我们在 12 个农村卫生中心培训了 34 名护理管理人员。他们使用注册表清单记录了 10 项行为激活技能在 455 名患者的 4,632 次会议中的交付。护理经理收到基于注册数据的绩效反馈。使用护理经理报告的遭遇级别数据,我们描述了患者覆盖范围和护理经理技能采用的实施结果。我们使用交叉分类的多级建模来探索技能交付中患者特征、提供者特征和随时间变化的变化。结果 护理经理让 88% 的患者参与了行为激活,并完成了 57% 的最低课程。平均患者在治疗期间获得了 5.9 项技能,其中提供者 (63%) 比患者 (29%) 驱动的显着差异更大。随着时间的推移,护理经理显着增加了提供给患者的技能范围。讨论 基于注册表的检查表是一种可行的培训和支持工具,可用于社区提供者提供行为激活。供应商收到了数据驱动的绩效反馈,并随着时间的推移展示了技能的提高,促进了持续性。未来的研究将检查患者水平的结果。结果强调了一个简单的基于注册表的技能清单加上可扩展的远程循证心理治疗培训计划对公共卫生的潜在影响。(PsycInfo 数据库记录 (c) 2021 APA,保留所有权利)。
更新日期:2020-08-27
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