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Table 4 Blueprint for implementation

From: A methodology for generating a tailored implementation blueprint: an exemplar from a youth residential setting

Importance Goal Responsible Feasibility Impact Implementation category Action step
H 1, 2, 3 B H 3 Train and educate stakeholders/provide interactive assistance Beck/IU training/supervision
H 1, 2, 3 IT L 2 Develop stakeholder interrelationships Hold cross-staff clinical meetings
H 1, 3 B/IT H 2 Adapt and tailor to context Facilitate, structure, and promote adaptability (Beck to work with IT to modify CBT to fit the sites)
H 2 B L 3 Train and educate stakeholders Conduct educational outreach visits
H 3 IT L 3 Utilize financial strategies Shift resources (ensure strategy for monitoring outcomes)
H 2 IT H 1 Develop stakeholder interrelationships Identify early adopters (have person shadowed, talk in clinical meetings about overcoming barriers)
H 2 B L 3 Provide interactive assistance Provide clinical supervision––include IT on calls
H 1, 2 B/IT L 3 Train and educate stakeholders Use train-the-trainers strategies
H 2, 3 IT L 3 Change infrastructure Increase demand––present data to courts and state level
H 2 IT H 2 Support clinicians Change performance evaluations, change professional roles
M 2 B/IT H 1 Use evaluative and iterative strategies Develop and institute self-assessment of competency
M 2, 3 IT H 2 Develop stakeholder interrelationships Capture and share local knowledge
M 2 IT H 1 Support clinicians Remind clinicians
L 3 B/IT L 2 Train and educate stakeholders Prep CBT client handouts (Beck to provide examples)
L 1, 2 B/IT L 2 Utilize financial strategies Alter incentives (certification, vacation, salary)
L 1, 3 B/IT L 2 Support clinicians Facilitate relay of clinical data to providers (data parties)
L 1, 2 IT L 2 Support clinicians Modify context to prompt new behaviors
L 1, 2, 3 IT L 2 Train and educate stakeholders Shadow other experts
L 1, 2, 3 IT L 2 Use evaluative and iterative strategies Obtain and use consumer and family feedback (exit interviews and surveys)
  1. “Importance” contains “H” for “High” (i.e., strategy must be enacted because it targets a highly important barrier), “M” for “Moderate” (i.e., the strategy should be prioritized if resources are available), or an “L” for “Low” (i.e., strategy should only be enacted if time and resources are available). “Goal” contains a 1, 2, or 3 to indicate which of the top 3 goals the strategy would primarily target. “Responsible” reflects whether the strategy should be enacted by the “IT” (i.e., Implementation Team at Wolverine Human Services) or “B” (i.e., Beck Institute or other external experts). “Feasibility” contains either “H” for “High” or “L” for “Low” in terms of the ease with which a given strategy could be enacted. “Impact” contains a score from 1 to 3 to reflect the degree to which the strategy would likely impact the fidelity with which CBT would be delivered. “Implementation Category” is derived from an expert-engaged concept mapping exercise in which nine conceptually distinct categories emerged: adapt and tailor to the context, change infrastructure, develop stakeholder interrelationships, engage consumers, provide interactive assistance, support clinicians, train and educate stakeholders, utilize financial strategies, and use evaluative and iterative strategies. Implementation strategy contains the name of the strategy to be enacted. Timeline: 3 years total; 3–5 day training every 6 months
  2. Note. Goals: 1 continue to enhance climate, teamwork, communication, attitudes, and satisfaction; 2 increase CBT knowledge, skill––integrate into care; 3 demonstrate benefit to youth