Background: The National Evidence-Based Practices (EBPs) Project developed and tested a model for facilitating the implementation of five psychosocial EBPs for adults with severe mental illness in the United States. Methods: The implementation model was tested in 53 sites in 8 states. In each site, one of the five EBPs was adopted for implementation and then studied for a 2-year period using a combination of qualitative and quantitative methods. Findings: At baseline, none of the sites had programs attaining high fidelity. Four factors were identified as influencing fidelity: (a) EBP-specific factors, (b) governmental factors, (c) leadership factors, and (d) fidelity review factors. Conclusion: A multipronged implementation strategy was effective in achieving high fidelity in over half of the sites seeking to implement a new EBP.
Backer, T., Liberman, R., & Kuehnel, T. ( 1986). Dissemination and adoption of innovative psychosocial interventions. Journal of Consulting and Clinical Psychology , 54, 111-118.
2.
Becker, D.R., Smith, J., Tanzman, B., Drake, R.E., & Tremblay, T. ( 2001). Fidelity of supported employment programs and employment outcomes. Psychiatric Services, 52, 834-836.
3.
Becker, D.R., Xie, H., McHugo, G.J., Halliday, J., & Martinez, R.A. (2006). What predicts supported employment program outcomes? Community Mental Health Journal , 42, 303-313.
4.
Biegel, D.E., Swanson, S., & Kola, L.A. ( 2007). The Ohio Supported Employment Coordinating Center of Excellence. Administration and Society, 39, 504-512.
5.
Blakely, C., Mayer, J., Gottschalk, R., Schmitt, N., Davidson, W., Roitman, D., et al. (1987). The fidelity-adaptation debate: Implications for the implementation of public sector social programs. American Journal of Community Psychology, 15, 253-268.
6.
Blumenthal, D., & Kilo, C.M. ( 1998). A report card on continuous quality improvement. Milbank Quarterly, 76, 625-648.
Bond, G.R., Becker, D.R., Drake, R.E., Rapp, C.A., Meisler, N., Lehman, A.F., et al. (2001). Implementing supported employment as an evidence-based practice. Psychiatric Services, 52, 313-322.
9.
Bond, G.R., Becker, D.R., Drake, R.E., & Vogler, K.M. ( 1997). A fidelity scale for the Individual Placement and Support model of supported employment. Rehabilitation Counseling Bulletin , 40, 265-284.
10.
Bond, G.R., Drake, R.E., Mueser, K.T., & Latimer, E. ( 2001). Assertive community treatment for people with severe mental illness: Critical ingredients and impact on patients. Disease Management and Health Outcomes, 9, 141-159.
11.
Bond, G.R., Evans, L., Salyers, M.P., Williams, J., & Kim, H.K. ( 2000). Measurement of fidelity in psychiatric rehabilitation . Mental Health Services Research, 2, 75-87.
12.
Bond, G.R., McHugo, G.J., Becker, D.R., Rapp, C.A., & Whitley, R. ( 2008). Fidelity of supported employment: Lessons learned from the National Evidence-Based Practices Project. Psychiatric Rehabilitation Journal, 31, 300-305.
13.
Bond, G.R., & Salyers, M.P. ( 2004). Prediction of outcome from the Dartmouth ACT Fidelity Scale. CNS Spectrums, 9, 937-942.
14.
Brekke, J.S. ( 1988). What do we really know about community support programs? Strategies for better monitoring. Hospital and Community Psychiatry , 39, 946-952.
15.
Deci, P.A., Santos, A.B., Hiott, D.W., Schoenwald, S., & Dias, J.K. ( 1995). Dissemination of assertive community treatment teams . Psychiatric Services, 46, 676-678.
16.
Dixon, L., McFarlane, W.R., Lefley, H., Lucksted, A., Cohen, M., Falloon, I., et al. (2001). Evidence-based practices for services to families of people with psychiatric disabilities. Psychiatric Services, 52, 903-910.
17.
Drake, R.E., Bond, G.R., & Rapp, C.A. ( 2006). Explaining the variance within supported employment programs: Comment on ‘‘what predicts supported employment outcomes? ’’ Community Mental Health Journal, 42, 315-318.
18.
Drake, R.E., Essock, S.M., Shaner, A., Carey, K.B., Minkoff, K., Kola, L., et al. (2001). Implementing dual diagnosis services for clients with severe mental illness. Psychiatric Services, 52, 469-476.
19.
Drake, R.E., Goldman, H.H., Leff, H.S., Lehman, A.F., Dixon, L., Mueser, K.T., et al. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services , 52, 179-182.
20.
Drake, R.E., McHugo, G.J., Becker, D.R., Anthony, W.A., & Clark, R.E. ( 1996). The New Hampshire study of supported employment for people with severe mental illness: Vocational outcomes. Journal of Consulting and Clinical Psychology, 64, 391-399.
21.
Drake, R. E., Merrens, M. R., & Lynde, D. W. (Eds.). (2005). Evidence-based mental health practice: A textbook . New York: WW Norton and Company .
22.
Drake, R.E., Rosenberg, S.D., Teague, G.B., Bartels, S.J., & Torrey, W.C. ( 2003). Fundamental principles of evidence-based medicine applied to mental health care. Psychiatric Clinics of North America , 24, 811-820.
23.
Fairweather, G.W. ( 1980). The Fairweather lodge: A twenty-five year retrospective . New Directions for Mental Health Services, 7.
24.
Finnerty, M.T., Rapp, C.A., Bond, G.R., Lynde, D.W., Ganju, V.J., & Goldman, H.H. ( 2009). The State Health Authority Yardstick (SHAY). Community Mental Health Journal, 45. Published online: 21 March 2009.
25.
Fixsen, D.L., Naoom, S.F., Blase, K.A., Friedman, R.M., & Wallace, F. ( 2005). Implementation research: A synthesis of the literature . Tampa, FL: University of South Florida.
26.
Henggeler, S.W., Pickrel, S.G., & Brondino, M.J. (1999). Multisystemic treatment of substance-abusing and -dependent delinquents: Outcomes, treatment fidelity, and transportability. Mental Health Services Research, 1, 171-184.
27.
Hermann, R.C., Chan, J.A., Zazzali, J.L., & Lerner, D. ( 2006). Aligning measurement-based quality improvement with implementation of evidence-based practices. Administration and Policy in Mental Health and Mental Health Services Research, 34, 636-645.
28.
Institute of Medicine. (2006). Improving the quality of health care for mental and substance-use conditions . Washington, DC: National Academies Press.
29.
Isett, K.R., Burnam, M.A., Coleman-Beattie, B., Hyde, P.S., Morrissey, J.P., Magnabosco, J., et al. (2007). The state policy context of implementation issues for evidence-based practices in mental health. Psychiatric Services, 58, 914-921.
30.
Isett, K.R., Burnam, M.A., Coleman-Beattie, B., Hyde, P.S., Morrissey, J.P., Magnabosco, J., et al. (IN PRESS). The role of state mental health authorities in managing change for the implementation of evidence-based practices. Community Mental Health Journal.
31.
Jerrell, J.M., & Ridgely, M.S. ( 1999). Impact of robustness of program implementation on outcomes of clients in dual diagnosis programs. Psychiatric Services , 50, 109-112.
32.
Latimer, E. ( 1999). Economic impacts of assertive community treatment: A review of the literature. Canadian Journal of Psychiatry, 44, 443-454.
33.
Lehman, A.F., Kreyenbuhl, J., Buchanan, R.W., Dickerson, F.B., Dixon, L.B., Goldberg, R., et al. (2004). The Schizophrenia Patient Outcomes Research Team (PORT): Updated treatment recommendations 2003. Schizophrenia Bulletin, 30, 193-217.
34.
Lehman, A.F., Steinwachs, D.M. ( 1998). Patterns of usual care for schizophrenia: Initial results from the Schizophrenia Patient Outcomes Research Team (PORT) client survey . Schizophrenia Bulletin, 24, 11-23.
35.
Lehman, A.F., & Steinwachs, D.M. & Port Co-Investigators (1998). At issue: Translating research into practice: The Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations. Schizophrenia Bulletin , 24, 1-10.
36.
McDonnell, J., Nofs, D., Hardman, M., & Chambless, C. ( 1989). An analysis of the procedural components of supported employment programs associated with employment outcomes. Journal of Applied Behavior Analysis, 22, 417-428.
37.
McGraw, K.O., & Wong, S.P. ( 1996). Forming inferences about some intraclass correlation coefficients. Psychological Methods, 1, 30-46.
38.
McGrew, J.H. ( 2007). IPS fidelity survey of 17 supported employment programs in Indiana: Final report to SECT Center. Indianapolis: Indiana University-Purdue University Indianapolis.
39.
McGrew, J.H., & Bond, G.R. ( 1995). Critical ingredients of assertive community treatment: Judgments of the experts. Journal of Mental Health Administration , 22, 113-125.
40.
McGrew, J.H., Bond, G.R., Dietzen, L.L., & Salyers, M.P. ( 1994). Measuring the fidelity of implementation of a mental health program model. Journal of Consulting and Clinical Psychology , 62, 670-678.
41.
McGrew, J., & Griss, M. ( 2005). Concurrent and predictive validity of two scales to assess the fidelity of implementation of supported employment. Psychiatric Rehabilitation Journal, 29, 41-47.
42.
McHugo, G.J., Drake, R.E., Teague, G.B., & Xie, H. ( 1999). Fidelity to assertive community treatment and client outcomes in the New Hampshire Dual Disorders Study. Psychiatric Services, 50, 818-824.
43.
McHugo, G.J., Drake, R.E., Whitley, R., Bond, G.R., Campbell, K., Rapp, C.A., et al. (2007). Fidelity outcomes in the National Evidence-Based Practices Project. Psychiatric Services, 58, 1279-1284.
44.
Mellman, T.A., Miller, A.L., Weissman, E.M., Crismon, M.L., Essock, S.M., & Marder, S.R. ( 2001). Evidence-based pharmacologic treatment for people with severe mental illness: A focus on guidelines and algorithms. Psychiatric Services, 52, 619-625.
45.
Moser, L.L., DeLuca, N.L., Bond, G.R., & Rollins, A.L. ( 2004). Implementing evidence based psychosocial practices: Lessons learned from statewide implementation of two practices. CNS Spectrums, 9, 926-936.
46.
Mowbray, C.T., Holder, M., Teague, G.B., & Bybee, D. ( 2003). Fidelity criteria: Development, measurement, and validation . American Journal of Evaluation, 24, 315-340.
47.
Mueser, K.T., Corrigan, P.W., Hilton, D.W., Tanzman, B., Schaub, A., Gingerich, S., et al. (2002). Illness management and recovery: A review of the research. Psychiatric Services, 53, 1272-1284.
48.
Mueser, K.T., Torrey, W.C., Lynde, D., Singer, P., & Drake, R.E. ( 2003). Implementing evidence-based practices for people with severe mental illness. Behavior Modification, 27, 387-411.
49.
Nami. (2006). Grading the states: A report on America’s health care system for serious mental illness . Arlington, VA: National Alliance on Mental Illness.
50.
New Freedom Commission on Mental Health. ( 2003). Achieving the promise: Transforming mental health care in America. Final report. DHHS Pub. No. SMA-03-3832. Rockville, MD: Substance Abuse and Mental Health Services Administration .
51.
Noble, J.H. ( 1991). The benefits and costs of supported employment for people with mental illness and with traumatic brain injury in New York State (C-0023180) . Buffalo, NY: Research Foundation of the State University of New York.
52.
Oxman, T.E., Schulberg, H.C., Greenberg, R.L., Dietrich, A.J., Williams, J.W., Nutting, P.A., et al. (2006). A fidelity measure for integrated management of depression in primary care. Medical Care, 44, 1030-1037.
53.
Phillips, S.D., Burns, B.J., Edgar, E.R., Mueser, K.T., Linkins, K.W., Rosenheck, R.A., et al. (2001). Moving assertive community treatment into standard practice. Psychiatric Services, 52, 771-779.
54.
Rapp, C.A., Bond, G.R., Becker, D.R., Carpinello, S.E., Nikkel, R.E., & Gintoli, G. ( 2005). The role of state mental health authorities in promoting improved client outcome through evidence-based practice. Community Mental Health Journal, 41, 347-363.
55.
Rosenheck, R., Neale, M., Leaf, P., Milstein, R., & Frisman, L. ( 1995). Multisite experimental cost study of intensive psychiatric community care. Schizophrenia Bulletin, 21, 129-140.
56.
Sackett, D.L., Straus, S.E., Richardson, W.S., Rosenberg, W., & Haynes, R.B. ( 2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). Edinburgh: Churchill Livingstone.
57.
Salyers, M.P., McKasson, M., Bond, G.R., McGrew, J.H., Rollins, A.L., & Boyle, C. ( 2007). The role of technical assistance centers in implementing evidence-based practices: Lessons learned. American Journal of Psychiatric Rehabilitation, 10, 85-101.
58.
Shojania, K.G., & Grimshaw, J.M. (2005). Evidence-based quality improvement: The state of the science. Health Affairs, 24, 138-150.
59.
Solberg, L.I. ( 2000). Guideline implementation: What the literature doesn’t tell us. Joint Commission Journal on Quality Improvement, 26, 525-537.
60.
Stein, L.I., & Test, M.A. ( 1980). An alternative to mental health treatment. I: Conceptual model, treatment program, and clinical evaluation. Archives of General Psychiatry, 37, 392-397.
61.
Teague, G.B., Bond, G.R., & Drake, R.E. ( 1998). Program fidelity in assertive community treatment: Development and use of a measure. American Journal of Orthopsychiatry , 68, 216-232.
62.
Test, M.A. ( 1992). Training in community living. In R. P. Liberman (Ed.), Handbook of psychiatric rehabilitation (pp. 153-170). New York: Macmillan.
63.
Torrey, W.C., Drake, R.E., Dixon, L., Burns, B.J., Rush, A.J., Clark, R.E., et al. (2001). Implementing evidence-based practices for persons with severe mental illness. Psychiatric Services, 52, 45-50.
64.
Torrey, W.C., Finnerty, M., Evans, A., & Wyzik, P.F. ( 2003). Strategies for leading the implementation of evidence-based practices. Psychiatric Clinics of North America, 26, 883-897.
65.
Torrey, W.C., Lynde, D.W., & Gorman, P. ( 2005). Promoting the implementation of practices that are supported by research: The National Implementing Evidence-Based Practice Project. Child and Adolescent Psychiatric Clinics of North America, 14, 297-306.
66.
Turner, J.C., & TenHoor, W.J. ( 1978). The NIMH community support program: Pilot approach to a needed social reform. Schizophrenia Bulletin, 4, 319-348.
67.
U.S. Department of Health and Human Services. ( 1999). Mental health: A report of the Surgeon General. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institute of Mental Health.
68.
Uttaro, T., Finnerty, M., White, T., Gaylor, R., & Shindelman, L. (2007). Reduction of concurrent antipsychotic prescribing practices through the use of PSYCKES. Administration and Policy in Mental Health and Mental Health Services Research , 34, 57-61.
69.
Wang, P.S., Demler, O., & Kessler, R.C. ( 2002). Adequacy of treatment for serious mental illness in the United States. American Journal of Public Health, 92, 92-98.
70.
Woltmann, E., & Whitley, R. ( 2007). The role of staffing stability in the implementation of integrated dual disorders treatment: An exploratory study. Journal of Mental Health, 16, 697-701.
71.
Woltmann, E.M., Whitley, R., McHugo, G.J., Brunette, M., Torrey, W.C., Coots, L., Lynde, D., & Drake, R.E. ( 2008). The role of staff turnover in the implementation of evidence-based practices in mental health care. Psychiatric Services, 59, 732-737.
