Measurement-Based Care (MBC) in the child and adolescent obsessive-compulsive disorder (OCD) programme in Calgary:...

Measurement-based care (MBC), defined as the routine use of patient-reported outcome measures (PROMs) to monitor symptoms and inform collaborative treatment decisions, has demonstrated benefits in youth mental healthcare. However, evidence on how to implement MBC within specialised child and adolescent obsessive-compulsive disorder (OCD) services remains limited. Existing MBC implementation studies in paediatric mental health services have largely focused on community, school-based or general outpatient settings, leaving an important knowledge gap in specialised multidisciplinary tertiary care. This protocol aims to assess organisational readiness, guide implementation planning and evaluate early implementation outcomes of MBC within a specialised paediatric OCD programme in Calgary, Alberta.

This protocol describes a single-site, three-phase mixed-methods implementation study that includes organisational readiness assessment, theory-informed implementation planning and evaluation of early implementation outcomes of MBC within a specialised child and adolescent OCD programme. Phase 1 employs an explanatory sequential mixed-methods approach to assess organisational readiness and contextual determinants using the Readiness Thinking Tool, informed by the Consolidated Framework for Implementation Research (CFIR). Phase 2 focuses on developing and operationalising the implementation plan, guided by the Quality Implementation Framework, through stakeholder co-design, workflow integration, staff training and iterative refinement. The MBC model integrates five PROMs: two general mental health measures and three OCD-specific domains. Phase 3 employs a convergent mixed-methods formative evaluation to assess implementation outcomes, using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, while CFIR guides the assessment of contextual and organisational determinants. Data sources include clinician, youth and caregiver surveys and interviews, PROM completion and score data and implementation field notes. Quantitative data will be analysed descriptively, while qualitative data will be analysed using a CFIR-guided directed content analysis approach.

Ethics approval was obtained from the University of Calgary Conjoint Health Research Ethics Board. This study will generate implementation knowledge to inform the integration and sustainment of MBC within specialised paediatric mental health services. By linking readiness assessment, structured implementation planning and formative evaluation, it will produce a context-specific, practice-oriented implementation blueprint for MBC in paediatric OCD clinic. Findings will be disseminated via peer-reviewed publications, conference presentations, stakeholder workshops, clinic feedback sessions and policy-focused knowledge exchange activities.