Implementing a rapid-learning health system in early intervention services for psychosis: qualitative evaluation of its feasibility and acceptability.

IF 3.6 2区医学 Q1 HEALTH POLICY & SERVICES Health Research Policy and Systems Pub Date : 2025-03-14 DOI:10.1186/s12961-024-01281-w

Manuela Ferrari, Marianne-Sarah Saulnier, Srividya N Iyer, Marc-André Roy, Amal Abdel-Baki

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Abstract

Background: Heterogeneity in implementing essential evidence-based early intervention for psychosis services (EIS) components persists despite existing fidelity standards/guidelines in many countries. Rapid-learning health systems (RLHS) may remedy these challenges, improving service delivery through systematic data collection, analysis, feedback and capacity-building activities. SARPEP (Système Apprenant Rapide pour les Programmes de Premiers Épisodes Psychotiques) is the first Canadian RLHS for EIS. This paper presents qualitative findings from the mixed-method study that evaluated the feasibility and acceptability of SARPEP.

Methods: We conducted six focus groups on the implementation of SARPEP with 25 participants from all SARPEP stakeholder groups; most were involved from project inception and throughout the 3-year implementation. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework (Glasgow, et al., 2019) and Lessard's dimensions for learning health systems guided data collection and deductive analysis.

Results: Reach: focus group participants reflected SARPEP reach and included all stakeholders involved (six service users, two family members, four psychiatrists, six managers, seven team leaders) who shared their experiences.

Effectiveness: participants confirmed that SARPEP improved program capacity for data collection on core indicators and promoted evidence-based practices. Adoption: participants supported the selection of specific indicators and need to improve data-gathering technologies in the RLHS, even while challenges persisted regarding the integration of digital platform use by service users into routine care. Implementation and maintenance: all participants credited the RLHS with enabling mutual learning, self-reflection of programs and shared improvement of practices.

Conclusions: SARPEP contributes to promote evidence-based care and a sense of belonging within the Quebec EIS network.

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背景：尽管许多国家已经制定了保真标准/指南，但在实施基于证据的精神病早期干预服务（EIS）的基本内容方面仍存在差异。快速学习医疗系统（RLHS）可以解决这些难题，通过系统化的数据收集、分析、反馈和能力建设活动改善服务的提供。SARPEP (Système Apprenant Rapide pour les Programmes de Premiers Épisodes Psychotiques) 是加拿大首个针对 EIS 的快速学习保健系统。本文介绍了对 SARPEP 的可行性和可接受性进行评估的混合方法研究的定性结果：我们就 SARPEP 的实施情况进行了六次焦点小组讨论，25 名参与者来自 SARPEP 的所有利益相关者群体；其中大多数人从项目启动开始就参与其中，并贯穿整个 3 年实施过程。Reach、Effectiveness、Adoption、Implementation、Maintenance（RE-AIM）框架（Glasgow等人，2019年）和Lessard的学习型卫生系统维度为数据收集和演绎分析提供了指导：覆盖面：焦点小组参与者反映了 SARPEP 的覆盖面，包括所有参与其中的利益相关者（6 名服务使用者、2 名家庭成员、4 名精神科医生、6 名管理人员、7 名团队领导），他们分享了各自的经验。有效性：参与者确认，SARPEP 提高了项目收集核心指标数据的能力，并推广了循证实践。采用：尽管在将服务使用者使用数字平台纳入日常护理方面仍存在挑战，但与会者支持选择特定指标，并认为有必要改进区域健康调查中的数据收集技术。实施和维护：所有参与者都认为，区域健康状况调查促进了相互学习、对计划的自我反思以及对实践的共同改进：SARPEP有助于促进循证护理和魁北克 EIS 网络内的归属感。

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来源期刊

Health Research Policy and Systems HEALTH POLICY & SERVICES-

CiteScore

7.50

自引率

7.50%

发文量

124

审稿时长

27 weeks

期刊介绍： Health Research Policy and Systems is an Open Access, peer-reviewed, online journal that aims to provide a platform for the global research community to share their views, findings, insights and successes. Health Research Policy and Systems considers manuscripts that investigate the role of evidence-based health policy and health research systems in ensuring the efficient utilization and application of knowledge to improve health and health equity, especially in developing countries. Research is the foundation for improvements in public health. The problem is that people involved in different areas of research, together with managers and administrators in charge of research entities, do not communicate sufficiently with each other.