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National integration of mental health screening and treatment into specialized care for cystic fibrosis: What predicts success?
  • +9
  • Alexandra L. Quittner,
  • David Barker,
  • Sonia Graziano,
  • Anna Georgiopoulos,
  • Emily Muther,
  • Marieke Verkleij,
  • Michael S. Schechter,
  • Laura Tillman,
  • Amy Mueller,
  • Paula Lomas,
  • Sarah Hempstead,
  • Beth Smith
Alexandra L. Quittner
Pulmonary and Sleep of Tampa Bay Inc

Corresponding Author:aquittner@mhs.net

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David Barker
Brown University
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Sonia Graziano
Bambino Gesù Children’s Hospital IRCCS
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Anna Georgiopoulos
Massachusetts General Hospital Department of Psychiatry
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Emily Muther
University of Colorado Hospital
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Marieke Verkleij
University of Amsterdam
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Michael S. Schechter
Children's Hospital of Richmond at Virginia Commonwealth University
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Laura Tillman
Community Member
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Amy Mueller
Hartford Hospital
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Paula Lomas
Cystic Fibrosis Foundation Therapeutics Inc
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Sarah Hempstead
Cystic Fibrosis Foundation Therapeutics Inc
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Beth Smith
University at Buffalo Department of Psychiatry
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Abstract

Objectives: The CF Foundation sponsored competitive awards for Mental Health Coordinators (MHCs) from 2016-2018 to implement the international guidelines for mental health screening and treatment in US CF centers. Longitudinal surveys evaluated success in implementing these guidelines using the Consolidated Framework for Implementation Research (CFIR). Methods: MHCs completed annual surveys assessing implementation from Preparation/Basic Implementation (e.g., using recommended screeners) to Full Implementation/Sustainability (e.g., providing evidence-based treatments). Points were assigned to questions through consensus, with higher scores assigned to more complex tasks. Linear regression and mixed effects models were used to: 1) examine differences in centers and MHC characteristics, 2) identify predictors of success, 3) model the longitudinal trajectory of implementation scores. Results: 122 MHCs (88.4% responded): Cohort 1 N=80, Cohort 2 N=30, Cohort 3 N=12. No differences in center characteristics were found. Significant improvements in implementation were observed across centers over time. Years of experience on a CF team was the only significant predictor of success; those with 1-5 years or longer reported the highest implementation scores. Change over time was predicted by >5 years of experience. Conclusions: Implementation of the mental health guidelines was highly successful over time. Funding for MHCs with dedicated time was critical. Longitudinal modeling indicated that CF centers with diverse characteristics could implement them, supported by evidence from the CF Patient Registry showing nearly universal uptake of mental health screening in the US. Years of experience predicted better implementation, suggesting that education and training of MHCs and retention of experienced providers are critical to success.
16 Dec 2022Submitted to Pediatric Pulmonology
16 Dec 2022Submission Checks Completed
16 Dec 2022Assigned to Editor
16 Dec 2022Review(s) Completed, Editorial Evaluation Pending
20 Dec 2022Reviewer(s) Assigned
03 Feb 2023Editorial Decision: Revise Minor
21 Feb 20231st Revision Received
21 Feb 2023Reviewer(s) Assigned
21 Feb 2023Review(s) Completed, Editorial Evaluation Pending
21 Feb 2023Submission Checks Completed
21 Feb 2023Assigned to Editor
16 Mar 2023Editorial Decision: Accept