Geographical variation in implementation of the Pathways to Comorbidity Care program in Australian drug and alcohol services.
Aim: Comorbid drug and alcohol and mental health disorders are highly prevalent. Significant gaps in service provision make this problem particularly difficult to address in regional Australia. The Pathways to Comorbidity Care (PCC) program was designed to improve management of comorbidity by outpat...
| Published in: | JBI Evidence Implementation Vol. 21; no. 2; pp. 186 - 194 |
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| Main Authors: | , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Lippincott Williams & Wilkins
May2023
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=164081952&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 164081952 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 26913321 MO0F jtl: JBI Evidence Implementation issn: 26913321 maglogo: N pubinfo: dt: May2023 vid: 21 iid: 2 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 164081952 164081952 164081952 10.1097/XEB.0000000000000344 164081952 ppf: 186 ppct: 8 formats: tig: atl: Geographical variation in implementation of the Pathways to Comorbidity Care program in Australian drug and alcohol services. aug: au: Louie, Eva Giannopoulos, Vicki Uribe, Gabriela Wood, Katie Teesson, Maree Childs, Steven Baillie, Andrew Haber, Paul S. Morley, Kirsten C. affil: Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney sug: subj: Geographic Factors Program Implementation Critical Path Comorbidity Prevention and Control Substance Use Rehabilitation Programs Australia Conceptual Framework Implementation Science Mental Disorders Rehabilitation Human Funding Source Australia Self Report Semi-Structured Interview Healthcare Disparities Descriptive Statistics Data Analysis Software Content Analysis Qualitative Studies Quantitative Studies ab: Aim: Comorbid drug and alcohol and mental health disorders are highly prevalent. Significant gaps in service provision make this problem particularly difficult to address in regional Australia. The Pathways to Comorbidity Care (PCC) program was designed to improve management of comorbidity by outpatient drug and alcohol clinicians in New South Wales, Australia. This paper uses the Consolidated Framework for Implementation Research (CFIR) to evaluate variations in implementation outcomes across geographically diverse services. Methods: Twenty clinicians across three drug and alcohol services from metropolitan, outer metropolitan and regional geographic locations were engaged at multiple levels of influence (directors, managers, clinicians) during the implementation of the multimodal PCC training package. The CFIR guided the development of self-report measures and semi-structured interviews evaluating implementation of the PCC training, and disparities in implementation barriers and facilitators were determined. Results: Metropolitan clinicians identified less barriers than regional clinicians on several intervention characteristics (adaptability, complexity, design quality and packaging), as well as outer setting (peer pressure), inner setting (implementation climate, staff incentives, leadership engagement, available resources) and process (planning, opinion leaders, executing) domains. Regional clinicians evaluated the networks and communications construct more favourably. Conclusions: Specific barriers identified more strongly by regional clinicians included the importance of communication with local clinicians and leadership about the practicalities of incorporating the approach into routine practice (allocation of time, increased accessibility of implementation team). Metropolitan clinicians provided more favourable evaluations of the package design, implementation climate and specific implementation processes such as a clear and informative implementation plan. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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