Practice-Based Research for Implementing Scalable Evidence-Based Prevention Interventions in Primary Care Settings
NAMHC Concept Clearance •
Eve E. Reider, Ph.D.
Division of Services and Intervention Research
The goal of this concept is to encourage practice-based research aimed at refining and testing developmentally-focused theory-based efficacious prevention interventions and to be scalable and sustainable for implementation in pediatric-serving primary care settings. This concept has an emphasis on underserved populations.
Substantial progress has been made at developing and testing efficacious theory-based, developmentally-focused prevention interventions that target modifiable proximal risk and protective factors to prevent commonly occurring mental health problems. Ultimately, sustainable approaches to prevention will require: 1) delivery in a system where youth who might benefit from prevention can be systematically identified and served; and 2) interventions that are service-ready and matched in terms of intensity/dose to the severity/need, to the child/family’s tolerance, and to the capacity within the delivery setting, such that they can be delivered with fidelity by setting providers. Pediatric-serving primary care health care settings hold potential for the implementation of mental health prevention interventions because it offers broad access, is non-stigmatizing, and can reach underserved populations to address issues of disparity and equity. In addition, there is the potential for prevention interventions found to be efficacious in the primary care setting to be endorsed by the United States Prevention Services Task Force (USPSTF) and covered under insurance.
This concept encourages research that leverages health care systems or other existing health services resources as a platform for rapidly refining and testing efficacious prevention interventions (e.g., for identifying, recruiting, delivering and assessing the outcome of interventions) and as a platform for ultimately delivering scalable interventions in a sustainable manner. The general scope of research would include developing and testing:
- Algorithms and strategies for identifying at-risk youth and for matching youth to preventive interventions of appropriate intensity/dose;
- Service-ready preventive interventions that are efficacious, of appropriate intensity/dose, and scalable, such that they can be delivered with fidelity by setting providers; and
- Strategies to train providers and support them in delivering interventions with fidelity.
The ultimate goal of this research is to contribute to an evidence base of effective prevention interventions that can be sustainably implemented in pediatric-serving primary care settings, including those that reach underserved populations, and that have potential to be endorsed by the USPSTF and covered by insurance.