Table 1.
Category | Inclusion | Exclusion |
---|---|---|
Population | Health care systems, organizations, and practitioners that care for children and adolescents or mixed (child and adult) populations with mental health problems | • Health care systems, organizations, and practitioners that care only for adults 18 years of age or older • Health care systems, organizations, and practitioners that care for children and adolescents with only developmental disorders |
Interventions (Strategies) | • Quality improvement strategies (e.g., strategies targeting systems and practitioners of mental health care to children and adolescents with the goal of improved quality of care) | Interventions targeting only patients, only drug interventions (although strategies to implement or disseminate drug interventions would qualify), and interventions not otherwise described in inclusion criteria |
• Implementation strategies (e.g., strategies to integrate evidence-based practice (EBP) interventions that meet National Registry of Evidence-based Programs and Practices (NREPP) inclusion criteria with the goal of changing practice patterns) | ||
• Dissemination strategies (e.g., strategies to enhance the adoption and implementation of evidence-based interventions that meet NREPP inclusion criteria) | ||
Comparator | Any control strategy, including usual care or different variants of the same intervention | None |
Outcomes | Intermediate outcomes (at least one intermediate outcome is required for KQs 1, 3) | All outcomes not otherwise specified |
Patient | ||
• Access to care • Satisfaction • Treatment engagement • Therapeutic alliance with practitioner | ||
Practitioner | ||
• Satisfaction with or acceptability of approach • Protocol adherence/program model fidelity • Competence or skills | ||
System or organization | ||
• Feasibility • Uptake • Timeliness • Penetration • Sustainability • Resources (including costs) | ||
Patient health and service utilization outcomes (at least one of these outcomes is required for KQs 1 and 3 unless the strategy uses an intervention that is an EBP) | ||
Required: | ||
• Change in mental health status, including symptom change, response, remission, relapse, and recurrence | ||
• Coexisting physical health conditions, substance use problems, developmental disorders, other mental health problems | ||
Not Required: | ||
• Mortality • Socialization skills and behavior • Functional status • Quality of life • Service utilization (e.g., visits, hospitalizations) | ||
Harms of strategy | ||
Patient | ||
• Lower treatment engagement or more dropouts • Negative impact on therapeutic relationship • Side effects of EBP incorporated into strategy (e.g., adverse events, suicidality) | ||
Practitioner | ||
• Burnout or exhaustion • Turnover • Resistance to the intervention | ||
System or organization | ||
• Cost • Failure to sustain the EBP • Resistance to change | ||
Timing of outcome measurement | All | None |
Settings | Outpatient settings serving children and adolescents with mental health problems (primary care, specialty care, emergency rooms, community mental health centers, integrated care settings, federally qualified health centers, schools, homes) | Inpatient or residential treatment settings, drug treatment programs, jails or prisons |
Geographic setting | Countries with a very high Human Development Index (HDI) [76] | Countries with high, medium, low, or very low HDI |
Publication language | English | All other languages |
Study design | KQs 1, 3 (benefits) | Case series Case reports Nonsystematic reviews Cross-sectional studies Before and after studies without time-series data Other designs without a control or comparison group |
• RCTs • CCTs • Systematic review and meta-analyses • Cohort studies • Interrupted time series • Case-control studies | ||
KQs 2, 3 (harms): | ||
• RCTs • CCTs • Systematic review and meta-analyses • Cohort studies • Interrupted time series • Case-control studies | ||
Publication type | Any publication reporting primary data | Publications not reporting primary data |
CCT controlled clinical trial, EBP evidence-based practice, D dissemination HDI Human Development Index, I implementation, KQ key question, NREPP National Registry of Evidence-based Programs and Practices, QI quality improvement, RCT randomized controlled trial