Policy in implementation science: Considerations for measurement-based care in the Canadian Armed Forces

Area of Science:

• Implementation Science
• Health Services Research
• Health Policy Analysis

Background:

• Policy is a critical but understudied component of implementation science.
• Existing literature shows varying conceptualizations of policy and multiple policy-making approaches.
• Policy can be a powerful lever for mobilizing and increasing uptake of evidence-based practices.

Purpose of the Study:

• To examine policy as an implementation strategy using an implementation science lens.
• To use the Canadian Armed Forces' (CAF's) implementation of measurement-based care (MBC) as a case example.
• To identify considerations for refining policy approaches to improve intervention uptake.

Main Methods:

• Literature review of policy in implementation science.
• Case study analysis of MBC implementation in the CAF.
• Drawing on implementation science literature regarding policy development and implementation, contextual adaptation, and stakeholder consultation.

Main Results:

• The CAF mandated measurement-based care (MBC) in 2014.
• Despite being mandatory, adherence to MBC in the CAF remains below target levels.
• Policy refinement requires consideration of contextual adaptation and stakeholder engagement.

Conclusions:

• Policy is a crucial implementation strategy that requires careful consideration and adaptation.
• The CAF's experience highlights challenges in policy adherence even when mandated.
• Further research and strategic policy refinement are needed to optimize intervention uptake in military mental health systems.