Using implementation science to evaluate mental health intervention: methodological proposal

Abstract

Objective

To describe a methodological proposal for evaluating the implementation process of an intervention focusing on the organization of mental health care in Primary Health Care from the perspective of implementation science.

Methods

Descriptive methodological study supported by the ImpRes-BR tool, which aims to guide the design of implementation research. The Mental Health in PHC intervention was described and its implementation strategies were systematized from the perspective of implementation science. From this, were presented the elements of the proposal for evaluating the implementation process of this intervention named SMAPS-API, guided by four domains of ImpRes-BR and prepared jointly by representatives of research and implementation teams.

Results

As a product of the ImpRes-BR domain related to the characteristics of implementation research, the objective of the SMAPS-API was defined, the intervention implementation stage was identified and the mixed methods multiple case study design was adopted. The Consolidated Framework for Implementation Research was considered as a structure for identifying the determinants of implementation. Implementation outcomes were defined as acceptability, adoption, appropriateness, feasibility, fidelity, penetration and sustainability potential. All decision makers involved were considered and the Power/Interest Matrix was used as a tool to understand the involvement and engagement of these actors in the implementation process.

Conclusion

The study demonstrates the path to defining variables and tools adopted to evaluate the implementation of an intervention to organize mental health care in Primary Care, contributing to the application of implementation science in Brazil.

Keywords
Implementation science; Primary health care; Mental health; Process assessment, health care