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Challenges Implementing Youth-Focused Evidence-Based Practices in Rural Areas: A Rapid Ethnographic Study
Noah S Triplett1, Sophia Nahabedian2, Hasan Mirzoyev2
1Department of Behavioral and Community Health, University of Maryland, College Park.
Rural Mental Health
|January 26, 2026
Summary
Implementing evidence-based practices (EBPs) for rural youth mental health is challenging due to staffing shortages and unique contextual factors. Rural community mental health centers offer comprehensive services beyond traditional EBPs to meet diverse client needs.
Area of Science:
- Rural mental health
- Implementation science
- Youth psychology
Background:
- Significant mental health challenges and service access disparities affect rural youth.
- Limited research exists on evidence-based practice (EBP) implementation in rural community mental health (CMH) settings.
- Understanding implementation determinants is crucial for improving rural youth mental health services.
Purpose of the Study:
- To explore determinants of EBP implementation in a rural CMH agency.
- To understand contextual factors influencing EBP use among rural youth.
- To identify barriers and facilitators for implementing EBPs in rural settings.
Main Methods:
- Rapid ethnographic assessment.
- Semi-structured interviews with 11 clinic staff.
- Site visits guided by the Consolidated Framework for Implementation Research (CFIR).
Main Results:
- Staff viewed EBPs positively but noted limitations for high-acuity, socioeconomically disadvantaged youth.
- Barriers included staffing shortages, clinician burnout, limited resources, and transportation issues.
- Rural context factors like intergenerational trauma and substance use impacted implementation.
Conclusions:
- Rural CMH centers provide comprehensive services beyond EBPs to address complex client needs.
- Traditional EBP models require adaptation for rural youth mental health.
- Insights can inform responsive approaches to improve EBP implementation and rural youth mental health outcomes.
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