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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 95 Research Studies Displayed
Bender M, Williams M, Cruz MF
A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes.
The authors discuss the Clinical Nurse Leader care model, a Hybrid Type II Implementation-Effectiveness study to evaluate the effect of the care model on standardized quality and safety outcomes and to identify implementation characteristics that are sufficient and necessary to achieve outcomes. Findings are expected to elucidate Registered Nurse's mechanisms of action as organized into frontline models of care and link actions to improved care quality and safety.
Citation: Bender M, Williams M, Cruz MF . A study protocol to evaluate the implementation and effectiveness of the Clinical Nurse Leader care model in improving quality and safety outcomes. Nurs Open 2021 Nov;8(6):3688-96. doi: 10.1002/nop2.910..
Keywords: Implementation, Quality Improvement, Quality of Care, Patient Safety, Nursing, Evidence-Based Practice
Pham-Singer H, Onakomaiya M, Cuthel A
Using a customer relationship management system to manage a quality improvement intervention.
HealthyHearts New York City (HHNYC), one of 7 cooperatives funded through the Agency for Healthcare Research and Quality's EvidenceNOW initiative, evaluated the impact of practice facilitation on implementation of the Million Hearts guidelines for cardiovascular disease prevention and treatment. Tracking the intervention required a system to facilitate process data collection that was also user-friendly and flexible. Coupled with protocols and training, a strategically planned and customizable customer relationship management system (CRMS) was implemented to support the quality improvement intervention with 257 small independent practices.
Citation: Pham-Singer H, Onakomaiya M, Cuthel A . Using a customer relationship management system to manage a quality improvement intervention. Am J Med Qual 2021 Jul-Aug;36(4):247-54. doi: 10.1177/1062860620953214..
Keywords: Quality Improvement, Quality of Care, Implementation, Evidence-Based Practice, Cardiovascular Conditions, Heart Disease and Health, Primary Care
Bishop JR, Huang RS, Brown JT
Pharmacogenomics education, research and clinical implementation in the state of Minnesota.
This article looks at the development and implementation of formal pharmacogenomic (PGx) clinical programs at several healthcare organizations across Minnesota. These programs increase drug safety and effectiveness. The article reviews the state of PGx activities in the state of Minnesota including educational programs, research, national consortia involvement, technology, clinical implementation and utilization and reimbursement, and outlines the challenges and opportunities in equitable implementation of these activities.
Citation: Bishop JR, Huang RS, Brown JT . Pharmacogenomics education, research and clinical implementation in the state of Minnesota. Pharmacogenomics 2021 Jul;22(11):681-91. doi: 10.2217/pgs-2021-0058..
Keywords: Medication, Implementation, Learning Health Systems, Evidence-Based Practice, Patient-Centered Outcomes Research
McGuier EA, Kolko DJ, Klem M
Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol.
Implementation of evidence-based practices and other innovations in these settings requires teams to work together to change processes and behaviors. Accordingly, team functioning may be a key determinant of implementation outcomes. This systematic review identified and summarized empirical research examining associations between team functioning and implementation outcomes in healthcare and human service settings.
Citation: McGuier EA, Kolko DJ, Klem M . Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol. Syst Rev 2021 Jun 26;10(1):189. doi: 10.1186/s13643-021-01747-w..
Keywords: Teams, Innovations and Emerging Issues, Implementation
Stolldorf DP, Ridner SH, Vogus TJ
Implementation strategies in the context of medication reconciliation: a qualitative study.
Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and providers) and limited organizational capacity. Guided by the Expert Recommendations for Implementing Change (ERIC) taxonomy, the authors report the differing strategies hospital implementation teams used to implement an evidence-based MedRec Toolkit (the MARQUIS Toolkit).
Citation: Stolldorf DP, Ridner SH, Vogus TJ . Implementation strategies in the context of medication reconciliation: a qualitative study. Implement Sci Commun 2021 Jun 10;2(1):63. doi: 10.1186/s43058-021-00162-5..
Keywords: Medication: Safety, Medication, Adverse Drug Events (ADE), Medical Errors, Adverse Events, Patient Safety, Implementation, Communications
Popejoy LL, Vogelsmeier AA, Wang Y
Testing re-engineered discharge program implementation strategies in SNFs.
This paper describes a trial of the redesigned Re-Engineered Discharge (RED) program, which was originally designed for hospitals, for use at skilled nursing facilities (SNFs). This tool’s objective is to reduce rehospitalizations after discharge. Two different RED implementation strategies (Enhanced and Standard) were compared pretest-posttest. The Standard group had higher odds of being readmitted in the pre-intervention versus post-intervention program. After adjusting coefficients using Poisson regression, the adjusted number of hospitalizations in the Standard group was 45% higher at 30 days, 50% higher at 60 days, and 39% higher at 180 days.
Citation: Popejoy LL, Vogelsmeier AA, Wang Y . Testing re-engineered discharge program implementation strategies in SNFs. Clin Nurs Res 2021 Jun;30(5):644-53. doi: 10.1177/1054773820982612..
Keywords: Hospital Discharge, Hospital Readmissions, Implementation, Hospitals
Spalluto LB, Lewis JA, Stolldorf D
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not well described. In this study, the investigators evaluated organizational readiness for change and change valence (belief that change is beneficial and valuable) for implementation of LDCT screening.
Citation: Spalluto LB, Lewis JA, Stolldorf D . Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center. J Am Coll Radiol 2021 Jun;18(6):809-19. doi: 10.1016/j.jacr.2020.12.010..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Veterans, Implementation, Organization and Administration
Patel M, Cadzinski AJ, Bell AM
Interprofessional consultations (eConsults) in urology.
This study examined the implementation of an asynchronous form of telehealth called eConsult which is used by primary care providers to consult with a specialist in place of an in-person consultation. The use of eConsult in the practice of urology was analyzed at four academic institutions: University of Michigan, University of California-San Francisco, University of Washington, and Montefiore Medical Center. Data looked at was eConsult conversion rate (to an in-person consultation), response time, completion time, and diagnosis categories. Out of a total of 462 urological eConsults requested, 36% were converted to a traditional in-person visit. Among resolved eConsults, 53.8% were addressed in less than 1 day; 28.6% in 1 day, 8.4% in 2 days, 3.4% in 3 days; 3.4% in 4 days, 1.7% in 5 days, and 0.8% in 6 days or more. Half were completed in 1-10 minutes; 46.7% in 11-20 minutes, 2.8% in 21-39 minutes, and less than 1% in 31 minutes or more.
Citation: Patel M, Cadzinski AJ, Bell AM . Interprofessional consultations (eConsults) in urology. Urol Pract 2021 May;8(3):321-27. doi: 10.1097/upj.0000000000000209..
Keywords: Telehealth, Health Information Technology (HIT), Clinician-Patient Communication, Communications, Implementation
Moniz MH, Bonawitz K, Wetmore MK
Implementing immediate postpartum contraception: a comparative case study at 11 hospitals.
Researchers examined how organizational context and implementation strategies drive successful implementation of immediate postpartum long-acting reversible contraception services, with a goal of informing the design of future implementation interventions. Semi-structured interviews were conducted with clinicians, nurses, residents, pharmacy and revenue cycle staff, and hospital administrators. They found that implementation efforts in maternity settings may be more successful if they select strategies to optimize local conditions for success. They recommended future research to evaluate whether these strategies effectively optimize local conditions for successful implementation in a variety of settings.
AHRQ-funded; HS025465; HS023784.
Citation: Moniz MH, Bonawitz K, Wetmore MK . Implementing immediate postpartum contraception: a comparative case study at 11 hospitals. Implement Sci Commun 2021 Apr 12;2(1):42. doi: 10.1186/s43058-021-00136-7..
Keywords: Contraception, Maternal Care, Women, Hospitals, Implementation
Baloh J, Zhu X, Ward MM
What influences sustainment and nonsustainment of facilitation activities in implementation? Analysis of organizational factors in hospitals implementing TeamSTEPPS.
This study looked at the influences on sustainment of internal facilitation activities. For two years the authors followed 10 small rural hospitals implementing TeamSTEPPS, a patient safety program. Factors the authors examined were the influence of senior management support (SMS), middle management support (MMS), facilitator team time availability (TIME), and team continuity (CONTINUITY). Five hospitals sustained facilitation activities and they found that the combination of SMS, MMS, and CONTINUITY was a sufficient condition for sustainment. The five other hospitals that did not sustain facilitation activities either lacked MMS or lacked both TIME and CONTINUITY. They also discussed the implications for research and practice.
AHRQ-funded; HS024112; HS018396.
Citation: Baloh J, Zhu X, Ward MM . What influences sustainment and nonsustainment of facilitation activities in implementation? Analysis of organizational factors in hospitals implementing TeamSTEPPS. Med Care Res Rev 2021 Apr;78(2):146-56. doi: 10.1177/1077558719848267..
Keywords: TeamSTEPPS, Teams, Implementation, Hospitals, Patient Safety, Rural Health, Organization and Administration
Harrison MI, Shortell SM
AHRQ Author: Harrison MI
Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.
The authors have developed a comprehensive, multilevel framework to inform learning health systems (LHSs) research and practice in order to enhance both research on LHSs and practical steps toward their development. Drawing on the Consolidated Framework for Implementation Research, the social-ecological framework, and the organizational change framework, their new framework can help investigators and practitioners broadly scan and then investigate forces influencing improvement and learning and may point to otherwise unnoticed interactions among influential factors.
Citation: Harrison MI, Shortell SM . Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation. Learn Health Syst 2021 Apr;5(2):e10226. doi: 10.1002/lrh2.10226..
Keywords: Learning Health Systems, Healthcare Systems, Implementation, Organization and Administration
Walunas TL, Ye J, Bannon J
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Practice facilitation is a multicomponent implementation strategy used to improve the capacity for practices to address care quality and implementation gaps. In this study, the investigators sought to assess whether practice facilitators use of coaching strategies aimed at improving self-sufficiency were associated with improved implementation of quality improvement (QI) interventions in the Healthy Hearts in the Heartland Study.
Citation: Walunas TL, Ye J, Bannon J . Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study. Implement Sci 2021 Mar 31;16(1):33. doi: 10.1186/s13012-021-01100-8..
Keywords: Practice Improvement, Quality Improvement, Quality of Care, Implementation, Heart Disease and Health, Cardiovascular Conditions
Nourjah P, Kato E
AHRQ Author: Nourjah P, Kato E
"One size does not fit all" and other lessons learned from grants for implementation of the AHRQ medication assisted treatment for opioid use disorder in rural primary care.
This article summarizes lessons learned from five AHRQ grants to implement Medication for Opioid Use Disorder (MOUD) in rural primary care practices. The experience of these projects suggests that recruiting providers in rural areas and engaging them to initiate and sustain provision of MOUD is very difficult. Implementation of MOUD in rural primary care is challenging but success is more likely if implementers are attentive to the needs of individual providers, are flexible and can tailor implementation to the local situation, and can provide on-going support.
Citation: Nourjah P, Kato E . "One size does not fit all" and other lessons learned from grants for implementation of the AHRQ medication assisted treatment for opioid use disorder in rural primary care. Subst Abus 2021;42(2):136-39. doi: 10.1080/08897077.2021.1891600..
Keywords: Implementation, Opioids, Substance Abuse, Primary Care, Rural Health, Medication
Hung DY, Truong QA, Liang SY
Implementing lean quality improvement in primary care: impact on efficiency in performing common clinical tasks.
Investigators examined 3-year impacts of Lean implementation on the amount of time taken for physicians to complete common clinical tasks. They found that Lean redesigns led to improvements in timely completion of 3 out of 4 common clinical tasks, thus supporting the use of Lean techniques to engage teams in routine aspects of patient care. They recommended more research to understand the mechanisms by which Lean promotes quality improvement and effectiveness of care team workflows.
Citation: Hung DY, Truong QA, Liang SY . Implementing lean quality improvement in primary care: impact on efficiency in performing common clinical tasks. J Gen Intern Med 2021 Feb;36(2):274-79. doi: 10.1007/s11606-020-06317-9..
Keywords: Primary Care, Quality Improvement, Quality of Care, Primary Care: Models of Care, Primary Care, Implementation, Workflow, Teams, Healthcare Delivery
Lee BY, Bartsch SM, Lin MY
How long-term acute care hospitals can play an important role in controlling carbapenem-resistant Enterobacteriaceae in a region: a simulation modeling study.
Researchers investigated how implementing control measures in long-term acute care hospitals (LTACHs) can impact carbapenem-resistant Enterobacteriaceae (CRE) spread regionwide. They used their own Chicago metropolitan region agent-based model to simulate CRE spread and control. They found that a prevention bundle in only LTACHs decreased prevalence and averted new carriers, infections, and deaths over 3 years compared with no CRE control measures. When LTACHs and intensive care units intervened, prevalence decreased further. They concluded that LTACHs may be more important than other acute care settings for controlling CRE, and regional efforts to control drug-resistant organisms should start with LTACHs as a centerpiece.
Citation: Lee BY, Bartsch SM, Lin MY . How long-term acute care hospitals can play an important role in controlling carbapenem-resistant Enterobacteriaceae in a region: a simulation modeling study. Am J Epidemiol 2021 Feb 1;190(3):448-58. doi: 10.1093/aje/kwaa247..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Hospitals, Patient Safety, Implementation
Fournier AK, Wasserman MR, Jones CF
AHRQ Author: Fournier AK, Nourjah P, Bierman AS
Developing AHRQ's feasibility assessment criteria for wide-scale implementation of patient-centered outcomes research findings.
This study’s objective was to develop criteria to assess the feasibility of widely implementing nominated findings from the AHRQ Patient-Centered Outcomes Research (PCOR) Dissemination and Implementation (D&I) Initiative. A literature review was conducted, and thirteen D&I experts were interviewed to identify factors affecting feasibility of implementing PCOR findings. Fourteen technical expert panel (TEP) members discussed the face-validity and relative merits of the themes and additional factors. Seven D&I experts pilot-tested the criteria using sample nominations of findings. Three essential criteria sets were developed for AHRQ to assess feasibility of PCOR findings implementation including 1) acceptability to the implementers; 2) generalizability, adaptability, and ease of implementing with fidelity; and 3) alignment with external policies and incentives. Two supplemental criteria: presence of a plan or toolkit supporting implementation and evidence supporting implementation outside the research setting were also developed.
AHRQ-authored; AHRQ-funded; 233201500021I.
Citation: Fournier AK, Wasserman MR, Jones CF . Developing AHRQ's feasibility assessment criteria for wide-scale implementation of patient-centered outcomes research findings. J Gen Intern Med 2021 Feb;36(2):374-82. doi: 10.1007/s11606-020-06247-6..
Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Implementation
Lee BY, Bartsch SM, Hayden MK
How to choose target facilities in a region to implement carbapenem-resistant Enterobacteriaceae control measures.
The authors investigated how best to choose the highest-yield facilities to target for interventions when trying to control regional spread of antibiotic-resistant pathogens such as carbapenem-resistant Enterobacteriaceae (CRE). They used their own Regional Healthcare Ecosystem Analyst-generated agent-based model of Chicago metropolitan area inpatient facilities to simulate the spread of CRE and to choose facilities to apply prevention bundles. They found that, while choosing target facilities based on single metrics (including most inpatient beds, most connections to other facilities) achieved better control than randomly choosing facilities, more effective targeting occurred when considering how these and other factors (including patient length of stay, care for higher-risk patients) interacted as a system.
Citation: Lee BY, Bartsch SM, Hayden MK . How to choose target facilities in a region to implement carbapenem-resistant Enterobacteriaceae control measures. Clin Infect Dis 2021 Feb 1;72(3):438-47. doi: 10.1093/cid/ciaa072..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Implementation, Prevention, Patient Safety
Tuzzio L, O'Meara ES, Holden E
Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research.
The uptake of cardiovascular disease risk calculators in primary care has been slow despite the recommendation in national cardiovascular disease prevention guidelines. Identifying the barriers to the implementation of cardiovascular disease risk calculators is essential for promoting their adoption. In this study, the authors qualitatively analyzed structured physician educator notes written during an outreach education intervention with 44 small- and medium-sized primary care clinics that participated in the Agency for Healthcare Research and Quality‒funded EvidenceNOW Healthy Hearts Northwest trial.
Citation: Tuzzio L, O'Meara ES, Holden E . Barriers to implementing cardiovascular risk calculation in primary care: alignment with the consolidated framework for implementation research. Am J Prev Med 2021 Feb;60(2):250-57. doi: 10.1016/j.amepre.2020.07.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Risk, Evidence-Based Practice, Implementation
Lee YSH, Cleary PD, Nembhard IM
Effects of leader tactics on the creativity, implementation, and evolution of ideas to improve healthcare delivery.
Researchers examined the association between leader tactics and the creativity, implementation outcome, and evolution of quality improvement ideas from clinicians and staff. They found that two identified tactics, brainstorming and reflection, were helpful depending on goals. They suggested that brainstorming may aide leaders seeking disruptive change via more creative, rapidly implemented ideas, while reflection on team process may aide leaders seeking high-engagement ideas that may be implemented slowly. They concluded that both tactics may help leaders cultivate dynamics that increase implementation of ideas that improve healthcare.
Citation: Lee YSH, Cleary PD, Nembhard IM . Effects of leader tactics on the creativity, implementation, and evolution of ideas to improve healthcare delivery. J Gen Intern Med 2021 Feb;36(2):341-48. doi: 10.1007/s11606-020-06139-9..
Keywords: Organization and Administration, Healthcare Delivery, Quality Improvement, Quality of Care, Implementation
Wang G, Wignall J, Kinard D
An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.
In this study, the investigators aimed to iteratively refine an implementation model for managing cloud-based longitudinal care plans (LCPs) for children with medical complexity (CMC). They conducted iterative 1-on-1 design sessions with CMC caregivers (ie, parents/legal guardians) and providers between August 2017 and March 2019. The investigators concluded that utilizing the management strategies, described in the article, when implementing cloud-based LCPs had the potential to improve team-based care across settings.
Citation: Wang G, Wignall J, Kinard D . An implementation model for managing cloud-based longitudinal care plans for children with medical complexity. J Am Med Inform Assoc 2021 Jan 15;28(1):23-32. doi: 10.1093/jamia/ocaa207..
Keywords: Children/Adolescents, Implementation, Chronic Conditions, Care Management, Care Coordination, Health Information Exchange (HIE), Health Information Technology (HIT), Teams
Pestka DL, Paterson NL, Benedict KA
Delivering care to high-cost high-need patients: lessons learned in the development of a complex care primary care team.
As part of a population health-focused primary care transformation, in 2019 a health system in Minnesota developed a primary care team to exclusively care for high-cost high-need patients. Through its development and implementation, the team has discovered several key lessons in delivering care to complex patients. In this paper, the authors discuss lessons learned from their research.
Citation: Pestka DL, Paterson NL, Benedict KA . Delivering care to high-cost high-need patients: lessons learned in the development of a complex care primary care team. J Prim Care Community Health 2021 Jan-Dec;12:21501327211023888. doi: 10.1177/21501327211023888..
Keywords: Primary Care, Primary Care: Models of Care, Healthcare Delivery, Teams, Communications, Implementation
Cykert S, Keyserling TC, Pignone M
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Researchers assessed the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. They found that a risk-stratified, population management dashboard combined with practice facilitation led to substantial reductions of 10-year atherosclerotic cardiovascular disease risk for patients at high risk. They recommended utilizing similar approaches to lead to effective dissemination and implementation of other new evidence, especially in rural and other under-resourced practices.
Citation: Cykert S, Keyserling TC, Pignone M . A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices. Health Serv Res 2020 Dec;55(6):944-53. doi: 10.1111/1475-6773.13571..
Keywords: Cardiovascular Conditions, Risk, Prevention, Primary Care, Implementation, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Nguyen AM, Cuthel AM, Rogers ES
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
This study called HealthyHearts NYC was a stepped wedge randomized control trial that tested the effectiveness of practice facilitation in small primary care practices in adopting cardiovascular disease guidelines. The practice-level benchmark desired was having 70% or greater of hypertensive patients having controlled blood pressure. A mixed methods multiple-case study design was used and implemented at 6 small practices. The investigator’s first key finding was that the high-performing and improved practices in their study looked and acted similarly during the intervention implementation. Three key attributes of these practices were found to be: 1) advanced use of electronic health records; 2) dedicated resources and commitment to quality improvement; and 3) an actively engaged lead clinician and office manager.
Citation: Nguyen AM, Cuthel AM, Rogers ES . Attributes of high-performing small practices in a guideline implementation: a multiple-case study. J Prim Care Community Health 2020 Jan-Dec;11. doi: 10.1177/2150132720984411..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Guidelines, Implementation
Yeung K, Richards J, Goemer E
Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system.
The purpose of this study was to describe the cost of using evidence-based implementation strategies for sustained behavioral health integration (BHI) involving population-based screening, assessment, and identification at 25 primary care sites of Kaiser Permanente Washington (2015-2018). The investigators concluded that when spread across patients screened in a single year, BHI implementation costs were well within the range for commonly used diagnostic assessments in primary care (eg, laboratory tests).
Citation: Yeung K, Richards J, Goemer E . Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system. Health Serv Res 2020 Dec;55(6):913-23. doi: 10.1111/1475-6773.13592..
Keywords: Healthcare Costs, Evidence-Based Practice, Implementation, Behavioral Health, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare
Radovic A, Odenthal K, Flores AT
Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents).
Supporting Our Valued Adolescents (SOVA) is a web-based technology intervention designed to increase depression and anxiety treatment uptake by adolescents in the context of an anonymous peer community with an accompanying website for parents. With a goal of informing the design of a hybrid effectiveness-implementation randomized controlled trial, we conducted a pre-implementation study in two primary care practices to guide implementation strategy development. We conducted focus groups with primary care providers (PCPs) at three different timepoints with PCPs (14 total) from two community practices.
Citation: Radovic A, Odenthal K, Flores AT . Prescribing technology to increase uptake of depression treatment in primary care: a pre-implementation focus group study of SOVA (Supporting Our Valued Adolescents). J Clin Psychol Med Settings 2020 Dec;27(4):766-82. doi: 10.1007/s10880-019-09669-5.
Keywords: Children/Adolescents, Depression, Anxiety, Behavioral Health, Primary Care, Health Information Technology (HIT), Implementation