From Programs to Systems: Deploying Implementation Science and Practice for Sustained Real World Effectiveness in Services for Children and Families.

The transfer of knowledge of effective practice, especially into “usual care” settings, remains challenging. This article argues that to close this gap we need to recognize the particular challenges of whole-system improvement. We need to move beyond a limited focus on individual programs and experi...

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Publicado en:Journal of Clinical Child & Adolescent Psychology Vol. 45; no. 6; pp. 812 - 827
Autor principal: Ghate, Deborah
Formato: Artículo
Publicado: Taylor & Francis Ltd Nov/Dec2016
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov/Dec2016
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      pub: Taylor & Francis Ltd
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        atl: From Programs to Systems: Deploying Implementation Science and Practice for Sustained Real World Effectiveness in Services for Children and Families.
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        au: Ghate, Deborah
        affil: The Colebrooke Centre for Evidence and Implementation
      su:
        Child services
        Family services
        Evidence-based psychiatry
        Evidence-based psychology
        Knowledge transfer
      sug:
        subj:
          Child services
          Family services
          Evidence-based psychiatry
          Evidence-based psychology
          Child and Youth Services
          Other Individual and Family Services
          Knowledge transfer
      ab: The transfer of knowledge of effective practice, especially into “usual care” settings, remains challenging. This article argues that to close this gap we need to recognize the particular challenges of whole-system improvement. We need to move beyond a limited focus on individual programs and experimental research on their effectiveness. The rapidly developing field of implementation science and practice (ISP) provides a particular lens and a set of important constructs that can helpfully accelerate progress. A review of selected key constructs and distinctive features of ISP, including recognizing invisible system infrastructure, co-construction involving active collaboration between stakeholders, and attention to active implementation, supports for providers beyond education and training. Key aspects of an implementation lens likely to be most helpful in sustaining effectiveness include assisting innovators to identify and accommodate the architecture of existing systems, understand the implementation process as a series of distinct but nonlinear stages, identify implementation outcomes as prerequisites for treatment outcomes, and analyse implementation challenges using frameworks of implementation drivers. In complex adaptive systems, how services are implemented may matter more than their specific content, and how services align and adapt to local context may determine their sustained usefulness. To improve implementation-relevant research, we need better process evaluation and cannot rely on experimental methods that do not capture complex systemic contexts. Deployment of an implementation lens may perhaps help to avoid future “rigor mortis,” enabling more productively flexible and integrative approaches to both program design and evaluation.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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