Abstract

Primary care frequently cares for patients with mental health concerns. Tele-mental health (TMH) interventions are becoming used as alternatives to the traditional methods of mental health care delivery. However, implementation of these interventions has met with uneven implementation success. Task sharing is a care model that trains less specialized health care workers to perform tasks typically done by specialized health care workers. Few studies have examined the combination of Task sharing and TMH intervention for the management of mental conditions. This dissertation project utilized implementation science methodology for formative assessment of task sharing of TMH interventions. The goals of the dissertation studies were to examine the organizational readiness, acceptability, appropriateness, and feasibility for the implementation strategy of task sharing of TMH interventions in primary care clinic. The case study approach described the process of using Consolidate Framework for Implementation Research (CFIR), Expert Recommendations for Implementing Change (ERIC), and the CFIR-ERIC Mapping Tool to identify methods to aid implementation of a complex innovation. The case study identified many issues with using the CFIR-Mapping Tool. The explanatory sequential mixed methods studies found that health care providers from clinics that had behavioral/mental health services integrated with primary care (BHI) perceived their organization as ready to implement change and had an implementation climate more supportive for evidence-based practice. However, the behavioral mental health specialists, primary care providers, and nurses show differences in scores for acceptability, appropriateness, and feasibility of implementing task sharing of TMH interventions in primary care. The qualitative data showed that the BMH specialists and PCPs expressed the most concerns. These concerns were coded with CFIR constructs of Available Resources, Knowledge & Beliefs of the Innovation, Self-Efficacy, Needs & Resources of Those Served by the Organization, External Policies & Incentives, and Complexity.

Description

Method/Study/Design Used: Case Study, Explanatory Sequential Mixed-Methods

Author Details

Frances Chu, PhD, MLIS, MSN, RN - Frances Chu is a medical librarian and registered nurse (RN) working at Providence Swedish Seattle First Hill campus. She has mainly been working as a medical/health science librarian since 2006 after many years as a nurse. She has worked in health focused competitive intelligence/business libraries, pharmaceutical libraries, and academic health science libraries. She has an MLIS (library and information science), and MSN plus PhD in Nursing. Her research focus has been on implementation science, human centered design, and gerontechnology. She also has research interests in health literacy, team science, interprofessional education, and age friendly systems. She has knowledge and skills on evidence-based practice, systematic/scoping reviews, research designs (quantitative, qualitative, and mixed-methods), data collection tools like REDCap, data analysis/visualization tools like SPSS and Tableau, and citation management tools like Endnote, RefWorks, and Zotero.

Sigma Membership

Psi at-Large

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Mixed/Multi Method Research

Keywords:

Gerontechnology, Implementation Science, Research Implementation, Telemental Health Interventions, Mental Health Services, Telemedicine, Telepsychology, Task Sharing, Counseling, Task Shifting

Advisor

Oleg Zaslavsky

Second Advisor

Brenna Renn

Third Advisor

Erin Blakeney

Degree

PhD

Degree Grantor

University of Washington

Degree Year

2023

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2026-05-27

Full Text of Presentation

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