Implementation barriers in the Czech mental health care : What are the obstacles to overcome to bridge the evidence-practice GAP? : dissertation project
Abstrakt
Introduction Presented dissertation project is focused on implementation barriers and implementation facilitators relevant to the mental health care sector with an emphasis on suicide prevention policies and interventions. Previous knowledge of barriers allows easier implementation of evidence-based policies and interventions, thereby contributing to a reduction of the so-called evidence-practice gap.
These topics are relevant to the field of public policy as well as to practice. The dissertation is theoretically anchored in the field of implementation science and draws on the theoretical frameworks working with the determinants of successful implementation.
Objectives The primary objective of the project is to identify implementation barriers (and factors facilitating implementation) and to establish relationships between them. This objective is relevant not only for the possibility of informing local practice and practice of other Central and Eastern European countries but also for an international audience interested in the topic of implementation of health care policies and innovations.
Methods The author will conduct a systematic review of relevant scientific as well as grey literature on the topic of implementation barriers in the selected field of mental health care - suicide prevention. Results of the review will provide him with the background for the field work.
In the next step, the author will conduct a series of semi-structured interviews with relevant actors in the field of mental health care and other sectors relevant to suicide prevention. Also, international experts will be interviewed.
The topics of the interviews will be a) the current state of the art of suicide prevention in the Czech Republic in different sectors and b) existing barriers to implementation of the new approaches to the prevention. Interviews will be analysed in the Atlas.ti software.
Interviewees will be then invited to discuss the results of the qualitative analysis in the focus group. The whole dissertation will be supported by the quantitative data from the Czech Statistical Office and the Czech Health Registers.
Findings So far, more than twenty interviews with relevant stakeholders mainly from mental-health care sector were conducted. In interviews, strenghts and weaknesses and readiness for implementation were discussed.
Interviews were not analysed yet. The author provides a protocol of the intended systematic review of the literature on implementation barriers and facilitators.
Conclusion The dissertation is in its initial phase, but the theoretical base of the topic seems to be solid, and at the same time the very topic is unexplored, which is a rationale for undertaking the systematic review.