This study was funded by an R21 grant from the National Institute of Mental Health (R21MH119360). Our research was intended to uncover the ripple effects that reasonably might result from the most common strategies to implement evidence based mental health interventions for children and youth. To obtain the data used in our ripple effect tool, we administered three rounds of surveys to five roles most knowledgeable about the implementation and delivery of mental health surveys.
The first survey had 81 participants, 23 (28.4%) providers of mental health services to children and youth, 14 (17.3%) researchers, 6 (7.4%) policy makers, 18 (22.2%) caregivers of youth consumers of mental health services, and 20 (24.7%) youth consumers of mental health services. In addition to a list of potential participants who were brainstormed by our team, recruitment was supported by several organizational partners. Youth MOVE National and the Family Run Executive Director Leadership Association conducted outreach to potential youth and caregiver participants. Researchers and provider recruitment was supported by listservs from the School Mental Health Assessment Research and Training Center and the Society for Implementation Research Collaboration. Policy maker recruitment was supported by contacts provided by the National Association of State Mental Health Program Directors.
SURVEY 1
Survey 1 asked participants to read through a list of the 20 most common implementation strategies used in children’s mental health services (e.g., training providers, delivering services in a setting other than a clinical office, using peer support providers) and to endorse which of these strategies were most relevant to their role. They were thin provided with a definition and three examples of ripple effects and asked to brainstorm up to 15 ripple effects relevant to their role. Participants were provided $100 for completion and to encourage brainstorming, participants were told that for every ripple effect they provided, they would be entered in a drawing for an extra $100 gift card.
There were 404 unique responses to the ripple effects question. These qualitative data were analyzed by the research team, which coded them into 66 unique ripple effects grouped into 13 categories.
SURVEYS 2 AND 3
Surveys 2 and 3 presented therapists, policy makers, caregivers, and youth with 6 implementation strategies (3 on each survey) deemed most relevant for their role based on their responses to Survey 1. For each implementation strategy, the strategy was described and then participants could endorse which of the 13 categories of ripple effects they believed were reasonable to be impacted by the strategy. For each category they endorsed, they were provided a list of all possible ripple effects within that category and were asked to endorse which specific ripple effect they believed were reasonable to be impacted by the strategy. Researchers were presented with 4 strategies (2 on each survey) and asked to rate their belief about whether the implementation strategy would reasonably lead to each ripple effect for caregivers, youth, and therapists.
The tool in this website uses data from these surveys to describe the possible ripple effects and the proportion of participants who endorsed each role x implementation strategy x ripple effect combination.