We propose to develop and sustain an Implementation Partnership that will focus on the adoption of evidence based practices by rural Community Health Centers. We will use Evidence Based Quality Improvement (EBQI) methods to foster a participatory research partnership with (Community Health Center patients and providers) devoted to the adaption, adoption, and evaluation of evidence based practices. The capacity building goals of the Community Health Center partners are to: 1) cultivate and institutionalize a capacity for EBQI in partnership with university research faculty;2) assess and develop an internal capacity for evaluating the implementation of evidence based practices;3) develop an internal capacity to successfully apply for external funding to finance the sustained implementation of evidence based practices. The clinical goals of the partnership are to implement evidence based practices for bipolar disorder and alcohol use disorders in rural primary care clinics. The scientific goals of the partnership are to: 1) identify, understand, and overcome barriers to developing and maintaining a partnership devoted to the implementation of evidence based practices in rural Community Health Centers;and 2) develop, refine, and manualize an EBQI Guide for rural Community Health Centers. METHODS - Building on our implementation research experience in the Department of Veterans Affairs Mental Health Quality Enhancement Research Initiative, we will collaborate with Community Health Center patients and providers to adapt evidence based practices for bipolar disorder and alcohol use disorders. Using the RE-AIM evaluation framework, we will evaluate the impact of implementation on patient level and organizational level outcomes. A formative evaluation of the Implementation Partnership and the EQBI process will also be conducted in order to improve the structure/process of the Implementation Partnership and to refine EBQI methods in real time. A summative evaluation will assess the sustainability of the evidence based practices.

Public Health Relevance

Community Health Centers are the nation's largest primary care network, providing services to over 15 million Americans living in medically underserved rural communities (53%) and inner-city neighborhoods (47%). Implementation if evidence-based practices improves clinical outcomes, yet adoption rates are low. Findings and products from the proposed Implementation Partnership will have relevance to hundreds of clinics and millions of patients, and could promote the sustained adoption of evidence-based practices across rural America.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Resource-Related Research Projects (R24)
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Mental Health Services in MH Specialty Settings (SRSP)
Program Officer
Chambers, David A
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University of Arkansas for Medical Sciences
Schools of Medicine
Little Rock
United States
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Fortney, John C; Pyne, Jeffrey M; Ward-Jones, Susan et al. (2018) Implementation of evidence-based practices for complex mood disorders in primary care safety net clinics. Fam Syst Health 36:267-280
Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M et al. (2017) Assessing Culture and Climate of Federally Qualified Health Centers: A Plan for Implementing Behavioral Health Interventions. J Health Care Poor Underserved 28:973-987
Hunt, Justin B; Curran, Geoffrey; Kramer, Teresa et al. (2012) Partnership for implementation of evidence-based mental health practices in rural federally qualified health centers: theory and methods. Prog Community Health Partnersh 6:389-98