title: Implementing evidence-based practices for youth in an HMO: the roles of external ratings and market share.
abstract: A qualitative study of child clinicians in a non-profit HMO examined implementation of evidence-based practices (EBPs) for anxiety and oppositional defiant disorders using interviews and focus groups with 33 clinicians (97% of participants), and ethnography of emails and meetings. Analysis showed statistical measures of access and service-key elements of rating organizations' "report cards"- were central in creating "pressure" making transition to EBPs difficult. EBPs were secondary to access and service targets. "Research" and "statistics" were perceived as unrealistic, "literature" as lacking authority. Rating organizations should include outcome and fidelity metrics to align market share pressures with children's health.
authors: The Permanente Medical Group, Sacramento, CA 95825, USA. john.hamilton@kp.org
authors: John
authors: J
authors: Hamilton
authors: Eric
authors: E
authors: Daleiden
authors: Sue
authors: S
authors: Dopson
mesh_terms: D001007:Anxiety / Q000523:psychology* / Q000628:therapy; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000523:psychology* / Q000628:therapy; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D005260:Female; D017144:Focus Groups; D006279:Health Maintenance Organizations; D006284:Health Plan Implementation / Q000379:methods*; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008389:Marketing of Health Services; D009939:Organizations, Nonprofit; D010865:Pilot Projects; D036301:Qualitative Research