Identifying Barriers and Implementation Strategies to Inform TBI Screening Adoption in Behavioral Healthcare Settings.

Objective: Identify barriers to the adoption of the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) in behavioral healthcare organizations and match these barriers to implementation strategies to inform future implementation efforts. Participants: Twenty behavioral he...

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Publicado en:Journal of Head Trauma Rehabilitation Vol. 39; no. 6; pp. 458 - 472
Autores principales: Hyzak, Kathryn A., Bunger, Alicia C., Bogner, Jennifer A., Davis, Alan K.
Formato: research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Nov/Dec2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov/Dec2024
      vid: 39
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        10.1097/HTR.0000000000001004
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        atl: Identifying Barriers and Implementation Strategies to Inform TBI Screening Adoption in Behavioral Healthcare Settings.
      aug:
        au:
          Hyzak, Kathryn A.
          Bunger, Alicia C.
          Bogner, Jennifer A.
          Davis, Alan K.
        affil: Department of Physical Medicine and Rehabilitation, College of Medicine, The Ohio State University, Columbus, Ohio
      sug:
        subj:
          Brain Injuries Diagnosis
          Ajzen's Theory of Planned Behavior
          Brain Injuries Rehabilitation
          Program Implementation
          Health Promotion
          Health Screening
          Human
          Funding Source
          Male
          Female
          Multimethod Studies
          Semi-Structured Interview
          Thematic Analysis
          Conceptual Framework
          Implementation Science
          Health Behavior
          Self-Efficacy
          Purposive Sample
          Descriptive Statistics
          Male
          Female
      ab: Objective: Identify barriers to the adoption of the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) in behavioral healthcare organizations and match these barriers to implementation strategies to inform future implementation efforts. Participants: Twenty behavioral health providers. Design: Qualitative study involving individual, semi-structured interviews regarding barriers to adopting the OSU TBI-ID. Data were thematically analyzed around constructs from the Consolidated Framework for Implementation Research (CFIR). Results were matched to strategies using the Expert Recommendations for Implementing Change (CFIR/ERIC) matching tool. Results: Ten barriers were identified across 4 CFIR domains. Inner-Setting barriers were inadequate leadership engagement, priorities, resources, and organizational incentives. Individual-Characteristics barriers were insufficient knowledge about the connection between TBI and behavioral health and how to conduct the OSU TBI-ID with fidelity, low self-efficacy to conduct screening, and inadequate motivation and buy-in to conduct screening. Outer-Setting barriers were lack of state-level mandates and inadequate incentives to conduct screenings. The Process domain barrier was an insufficient engagement of key personnel. Strategy recommendations include: identify and prepare champions; alter incentive and allowance structures; inform local opinion leaders; build a coalition; access new funding; conduct local consensus discussions; involve executive boards; capture/share local knowledge; conduct educational meetings; assess for readiness and identify determinants; identify early adopters; fund and contract for the clinical innovation; create a learning collaborative; and conduct a local needs assessment. Conclusions: This is the first study to examine barriers to adopting the OSU TBI-ID in real-world practice settings. Our results suggest that multilevel implementation strategies addressing mechanisms of change are necessary at the provider, organizational, and systems levels to overcome the complex barriers affecting TBI screening adoption and implementation. Future research is needed to test these strategies and their mechanisms of action on the adoption, implementation, and sustainment of TBI screening, as well as their effect on client-level outcomes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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