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Implementing traumatic brain injury screening in behavioral healthcare: protocol for a prospective mixed methods
Kathryn A Coxe-Hyzak1, Alicia C Bunger2, Jennifer Bogner3
1College of Social Work, The Ohio State University, 1947 College Road N, Columbus, OH, 43210, USA. coxe.6@osu.edu.
Implementation Science Communications
|February 15, 2022
Summary
This study explores provider characteristics and innovation factors influencing the adoption of traumatic brain injury (TBI) screening in behavioral health settings. Findings will guide improved implementation strategies for TBI identification methods.
Area of Science:
- Implementation Science
- Behavioral Health
- Public Health
Background:
- Provider and innovation characteristics are key to evidence-based practice (EBP) adoption.
- Understanding of EBP adoption drivers is limited by a lack of theory-driven hypothesis testing.
- This study addresses this gap by examining factors influencing the adoption of the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID).
Purpose of the Study:
- To disentangle the relationships between provider characteristics and innovation factors on the early adoption of the OSU TBI-ID.
- To test theory-driven hypotheses bridging proximal and distal implementation outcomes.
- To qualitatively assess contextual determinants of TBI screening adoption in behavioral healthcare.
Main Methods:
- An explanatory sequential mixed methods design combining quantitative and qualitative approaches.
- Phase I: Quantitative survey of 200 behavioral health providers assessing attitudes, intentions, and screening behaviors, followed by structural equation modeling.
- Phase II: Qualitative semi-structured interviews with 20 providers to explore contextual determinants, analyzed using thematic analysis.
Main Results:
- Provider characteristics were found to predict TBI screening intentions.
- Provider intentions mediated actual TBI screening behaviors.
- Feasibility, appropriateness, and acceptability moderated the relationship between intentions and behaviors, indicating contextual influences.
Conclusions:
- This study provides theory-driven insights into TBI screening adoption in behavioral healthcare.
- Understanding these drivers is crucial for improving the precision of implementation strategies.
- Results will inform strategies to enhance the adoption, sustainment, and scale-up of TBI screening.
