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Aubyn C Stahmer¹, Anna S Lau², Scott Roesch³

¹Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA, 95819, USA. astahmer@health.ucdavis.edu.

Implementation science : IS

|December 15, 2025

Resumen

Una estrategia de capacitación de liderazgo (TLI) promovió eficazmente las intervenciones basadas en evidencia (EBI) para el autismo al aumentar el apoyo del líder, pero no activó todos los mecanismos propuestos. Se necesita un enfoque adicional en las estrategias a nivel de líder para los sistemas de servicios públicos.

Área de la Ciencia:

Ciencia de la Implementación
Salud Pública
Psicología Infantil

Sus antecedentes:

Comprender la efectividad de la estrategia de implementación requiere examinar la activación de mecanismos.
El ensayo TEAMS investigó estrategias de líder y proveedor para intervenciones sobre el autismo.
Este estudio se centró en los mecanismos activados por estrategias que apoyan AIM HI y CPRT.

Objetivo del estudio:

Examinar si las estrategias a nivel de líder (TLI) y a nivel de proveedor activan los mecanismos de implementación propuestos.
Evaluar si los mecanismos activados median el efecto de las estrategias a nivel de líder en los resultados.
Evaluar la efectividad de la estrategia en entornos de salud mental y educación para intervenciones sobre el autismo.

Principales métodos:

Las organizaciones se asignaron aleatoriamente a TLI, estrategia de proveedor, ambas o ninguna (solo capacitación).
El modelado multinivel analizó datos de 65 programas/distritos, 95 líderes y 385 proveedores.
Los mecanismos hipotetizados incluyeron liderazgo de implementación, clima, apoyo, actitudes hacia las EBI y motivación.

Principales resultados:

La estrategia TLI activó estrategias de apoyo a la implementación, el mecanismo más proximal.
La estrategia a nivel de proveedor no activó ningún mecanismo hipotetizado.
Una interacción favoreció las estrategias combinadas en el clima de implementación y la motivación del proveedor; ningún mecanismo medió los efectos de TLI.

Conclusiones:

La capacitación TLI aumentó las acciones de los líderes que promueven las EBI para el autismo en salud mental y educación.
El efecto de TLI en la fidelidad y los resultados clínicos no se explicó completamente por los mecanismos activados.
Los hallazgos resaltan la importancia de las estrategias de implementación a nivel de líder en los sistemas de servicios públicos.

Palabras clave:

Educación Intervenciones basadas en evidencia para el autismo Mecanismos de implementación Estrategias de implementación Salud mental

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