Barriers and facilitators to implementing measurement-based care for depression in Shanghai, China: a situational analysis

BMC Psychiatry

Heather Colquhoun¹  Jill K. Murphy²  Hannah Burton²  Raymond W. Lam²  Erin E. Michalak²  Jing Liu²  Ping Zhang³  Zuowei Wang⁴  Leping Huang⁴  Yue Fei⁴  Tianli Liu⁵  Yanling He⁶  Yousong Su⁷  Lu Yang⁷  Xing Wang⁷  Xiao Lin⁷  Xiaorui Yang⁷  Yiru Fang⁷  Jun Chen⁷  Jia Huang⁷  Yifeng Xu⁷  Tao Yang⁷ 

[1] Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada;Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada;Fengxian District Mental Health Center, Shanghai, China;Hongkou District Mental Health Center, Shanghai, China;Peking University, Institute of Population Research, Beijing, China;Shanghai CDC for Mental Health, Division of Training and Health Education, Shanghai, China;Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China;

关键词: Measurement-based care;    Digital health;    Depression;    Global mental health;    Implementation;    Situational analysis;   

DOI  :  10.1186/s12888-021-03442-5

来源: Springer

【 摘 要 】

BackgroundMeasurement-based care (MBC) is an evidence-based practice for depression, but its use by clinicians remains low. Enhanced MBC (eMBC), which uses digital technologies, can help to facilitate the use of MBC by clinicians and patients. Understanding factors that act as barriers and drivers to the implementation of MBC and eMBC is important to support the design of implementation strategies, promoting uptake by clinicians and patients.ObjectiveThis situational analysis identifies barriers and facilitators to the implementation of standard and eMBC at mental health centers in Shanghai, China.MethodsWe used mixed methods to develop a comprehensive understanding of the factors influencing MBC and eMBC implementation in Shanghai. This study took place across three mental health centers in Shanghai. We used situational analysis tools to collect contextual information about the three centers, conducted surveys with n = 116 clinicians and n = 301 patients, conducted semi-structured interviews with n = 30 clinicians and six focus groups with a total of n = 19 patients. Surveys were analysed using descriptive statistics, and semi-structured interviews and focus groups were analysed using framework analysis.ResultsSeveral potential barriers and facilitators to MBC and eMBC implementation were identified. Infrastructure, cost, attitudes and beliefs, and perceptions about feasibility and efficacy emerged as both challenges and drivers to MBC and eMBC implementation in Shanghai.ConclusionsThe results of this study will directly inform the design of an implementation strategy for MBC and eMBC in Shanghai, that will be tested via a randomized controlled trial. This study contributes to the emerging body of literature on MBC implementation and, to the best of our knowledge, is the first such study to take place in Asia. This study identifies several factors that are relevant to the equitable delivery of MBC, recognizing the need to explicitly address equity concerns in global mental health implementation research.

【 授权许可】

CC BY