In response to recommendations from the Special Committee on posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs, Veterans Health Administration (VHA) chartered a workgroup to identify strategies for improving the reach and fidelity of evidence-based psychotherapies (EBPs) implemented by VHA through clinician training initiatives. The workgroup, which comprised stakeholders in a variety of roles within the VHA, used an Intervention Mapping process, a practical approach to designing change strategies based on theory, evidence, and stakeholder input. High-level recommendations centered around implementation of recent VHA/Department of Defense (VA/DoD) treatment guidelines. In addition to recommended first-line and suggested second-line treatments, the guidelines include measurement-based care and shared decision making around EBPs and their alternatives to ensure that care is goal-oriented and patient-centered. To support increased reach and fidelity, the workgroup made four broad recommendations: (a) enhancing leadership support; (b) alignment of policies, programs, and processes that influence reach of EBPs as recommended in clinical practice guidelines, including implementation support to accompany EBP trainings; (c) use of clinical data to inform decision making at multiple levels, and to provide fidelity support when outcomes are lower than expected or desired; and (d) increasing veteran and stakeholder education and awareness of guideline recommendations and availability of EBPs. These recommendations accompanied a more detailed set of recommended steps for implementation. This article describes the Intervention Mapping process and a summary of resulting workgroup recommendations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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在复杂的医疗保健系统中增加循证心理治疗的干预映射过程。

为响应创伤后应激障碍 (PTSD) 特别委员会的建议，美国退伍军人事务部、退伍军人健康管理局 (VHA) 成立了一个工作组，以确定提高循证心理治疗 (EBP) 范围和保真度的策略由 VHA 通过临床医生培训计划实施。该工作组由 VHA 内担任各种角色的利益相关者组成，使用了干预映射过程，这是一种基于理论、证据和利益相关者输入设计变革策略的实用方法。高级建议集中在最近 VHA/国防部 (VA/DoD) 治疗指南的实施上。除了推荐的一线和推荐的二线治疗外，该指南包括基于测量的护理和围绕 EBP 及其替代方案的共享决策，以确保护理以目标为导向和以患者为中心。为了支持扩大影响力和忠诚度，工作组提出了四项广泛的建议：(a) 加强领导支持；(b) 按照临床实践指南的建议，调整影响 EBP 范围的政策、计划和流程，包括伴随 EBP 培训的实施支持；(c) 使用临床数据为多个层面的决策提供信息，并在结果低于预期或期望时提供保真支持；(d) 增加退伍军人和利益相关者的教育以及对指南建议和 EBP 可用性的认识。这些建议伴随着一套更详细的建议实施步骤。本文描述了干预映射过程以及由此产生的工作组建议的摘要。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。