Fidelity outcomes in the National Implementing Evidence-Based Practices Project

Area of Science:

• Mental Health Services Research
• Implementation Science
• Public Health Policy

Background:

• Evidence-based practices (EBPs) are crucial for improving mental health outcomes.
• Implementing EBPs in routine public mental health settings presents unique challenges.
• The National Implementing Evidence-Based Practices Project aimed to assess EBP implementation fidelity.

Purpose of the Study:

• To evaluate the fidelity outcomes of five specific EBPs implemented in public mental health centers.
• To identify factors influencing the successful adoption and sustainment of EBPs.
• To understand the trajectory of EBP implementation over a two-year period.

Main Methods:

• 53 community mental health centers across eight states implemented one of five EBPs: supported employment, assertive community treatment, integrated dual disorders treatment, family psychoeducation, and illness management and recovery.
• An intervention model guided dissemination, utilizing consultant-trainers and toolkits.
• External assessors rated fidelity every six months over two years.

Main Results:

• 55% of sites achieved high-fidelity implementation by the end of two years.
• Supported employment and assertive community treatment demonstrated higher fidelity scores compared to other EBPs.
• Fidelity increased significantly within the first 12 months, then plateaued and was sustained through 24 months.

Conclusions:

• Public mental health centers can achieve moderate to high fidelity in implementing EBPs.
• The initial 12 months are critical for EBP implementation gains.
• Sustained fidelity levels were observed beyond the 12-month mark.