Assessing the Implementation of a Novel Digital Measurement-Based Care Training in Behavioral Health Using the PRISM...

Background: Measurement-Based Care (MBC) is an evidence-based practice that has demonstrated challenges integrating into care settings even under ideal circumstances. This study uses the PRISM framework to critically examine a systematic integration of MBC as standard behavioral healthcare in an adult ambulatory psychiatric clinic. Since the initial implementation in 2018, 33 distinct implementation strategies were used to enhance the uptake of this practice. To prepare for sustainment, our team developed a digital Measurement-based care Training for Resilient Implementation in a Clinical setting (METRIC) to improve implementation. The present study evaluates the reach, implementation, and contextual domains impacting METRIC. Methods: METRIC was IRB-approved and distributed to 56 multidisciplinary clinicians through the institutional learning hub. Providers completed surveys about implementation and clinician attitudes of METRIC before, 1 month, and 3 months after training. Patient attitudes were assessed before (n = 98) and after (n = 80) implementation. Clinician and patient attitudes were analyzed using the Friedman and Wilcoxon tests, respectively. Results: Forty-seven out of 56 (83.9%) clinicians completed METRIC. Implementation measures suggest there were promising acceptability, appropriateness, and feasibility. Clinicians positively rated METRIC. Clinicians answered 84% of module questions correctly, though their attitudes about MBC did not significantly change after METRIC. Patient attitudes did not significantly change. Conclusions: This study evaluated the implementation of METRIC in an ambulatory mental health clinic for its feasibility, acceptability, and appropriateness. After implementing strategies to enhance provider uptake, METRIC was piloted to standardize MBC training and prepare for sustainment. METRIC was well-received and provides an opportunity for less provider reliance on system champions and academic partnerships to sustain MBC utilization in mental health settings. Our findings define positive aspects of digital MBC training and areas for additional research, which include exploring the benefits of MBC training, examining need and frequency, and whether specialized training is beneficial.