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Implementing CommonGround in a community mental health center: Lessons in a computerized decision support system.

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The CommonGround intervention, designed to promote shared decision making (SDM) in mental health, faced implementation challenges due to technological issues and poor integration with existing services. Strategies are suggested to improve future adoption and maximize benefits.

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Area of Science:

  • Health Services Research
  • Mental Health Interventions
  • Shared Decision Making (SDM)

Background:

  • Shared decision making (SDM) is crucial for client-centered care but adoption remains low.
  • Interventions are needed to promote SDM in clinical practice.
  • The CommonGround intervention uses peer specialists and technology to facilitate SDM.

Purpose of the Study:

  • To explore the implementation process of the CommonGround SDM intervention.
  • To identify barriers and facilitators to the successful adoption of CommonGround.
  • To report strategies for maximizing the implementation of SDM interventions.

Main Methods:

  • The CommonGround intervention was implemented in 4 community mental health center treatment teams.
  • Semistructured interviews were conducted with 12 integral staff members.
  • Content analysis was used to analyze interview data; program fidelity and client use were also assessed.

Main Results:

  • While client and staff benefits like improved engagement were noted, consistent client use of CommonGround was limited.
  • Program barriers included technological difficulties and increased staff burden.
  • Contextual barriers involved poor service structure fit, suboptimal center location, and staff turnover.

Conclusions:

  • Implementation of CommonGround was hindered by program and contextual barriers.
  • Future implementations should incorporate identified strategies to enhance buy-in and utilization.
  • Addressing identified barriers is essential to realize the full benefits of SDM interventions.