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Development of a measure of model fidelity for mental health Crisis Resolution Teams

Lloyd-Evans, B, Bond, GR, Ruud, T, Ivanecka, A, Gray, R, Osborn, D, Nolan, F, Henderson, C, Mason, Oliver, Goater, N , Kelly, K, Ambler, G, Morant, N, Onyett, S, Lamb, D, Fahmy, S, Brown, E, Paterson, B, Sweeney, A, Hindle, D, Fullarton, K, Frerichs, J and Johnson, S (2016) Development of a measure of model fidelity for mental health Crisis Resolution Teams BMC Psychiatry, 16, 427.

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Abstract

Background: Crisis Resolution Teams (CRTs) provide short-term intensive home treatment to people experiencing mental health crisis. Trial evidence suggests CRTs can be effective at reducing hospital admissions and increasing satisfaction with acute care. When scaled up to national level however, CRT implementation and outcomes have been variable. We aimed to develop and test a fidelity scale to assess adherence to a model of best practice for CRTs, based on best available evidence. Methods: A concept mapping process was used to develop a CRT fidelity scale. Participants (n = 68) from a range of stakeholder groups prioritised and grouped statements (n = 72) about important components of the CRT model, generated from a literature review, national survey and qualitative interviews. These data were analysed using Ariadne software and the resultant cluster solution informed item selection for a CRT fidelity scale. Operational criteria and scoring anchor points were developed for each item. The CORE CRT fidelity scale was then piloted in 75 CRTs in the UK to assess the range of scores achieved and feasibility for use in a 1-day fidelity review process. Trained reviewers (n = 16) rated CRT service fidelity in a vignette exercise to test the scale’s inter-rater reliability. Results: There were high levels of agreement within and between stakeholder groups regarding the most important components of the CRT model. A 39-item measure of CRT model fidelity was developed. Piloting indicated that the scale was feasible for use to assess CRT model fidelity and had good face validity. The wide range of item scores and total scores across CRT services in the pilot demonstrate the measure can distinguish lower and higher fidelity services. Moderately good inter-rater reliability was found, with an estimated correlation between individual ratings of 0.65 (95% CI: 0.54 to 0.76). Conclusions: The CORE CRT Fidelity Scale has been developed through a rigorous and systematic process. Promising initial testing indicates its value in assessing adherence to a model of CRT best practice and to support service improvement monitoring and planning. Further research is required to establish its psychometric properties and international applicability.

Item Type: Article
Subjects : Psychology
Divisions : Faculty of Health and Medical Sciences > School of Psychology
Authors :
NameEmailORCID
Lloyd-Evans, BUNSPECIFIEDUNSPECIFIED
Bond, GRUNSPECIFIEDUNSPECIFIED
Ruud, TUNSPECIFIEDUNSPECIFIED
Ivanecka, AUNSPECIFIEDUNSPECIFIED
Gray, RUNSPECIFIEDUNSPECIFIED
Osborn, DUNSPECIFIEDUNSPECIFIED
Nolan, FUNSPECIFIEDUNSPECIFIED
Henderson, CUNSPECIFIEDUNSPECIFIED
Mason, Olivero.mason@surrey.ac.ukUNSPECIFIED
Goater, NUNSPECIFIEDUNSPECIFIED
Kelly, KUNSPECIFIEDUNSPECIFIED
Ambler, GUNSPECIFIEDUNSPECIFIED
Morant, NUNSPECIFIEDUNSPECIFIED
Onyett, SUNSPECIFIEDUNSPECIFIED
Lamb, DUNSPECIFIEDUNSPECIFIED
Fahmy, SUNSPECIFIEDUNSPECIFIED
Brown, EUNSPECIFIEDUNSPECIFIED
Paterson, BUNSPECIFIEDUNSPECIFIED
Sweeney, AUNSPECIFIEDUNSPECIFIED
Hindle, DUNSPECIFIEDUNSPECIFIED
Fullarton, KUNSPECIFIEDUNSPECIFIED
Frerichs, JUNSPECIFIEDUNSPECIFIED
Johnson, SUNSPECIFIEDUNSPECIFIED
Date : 1 December 2016
Identification Number : 10.1186/s12888-016-1139-4
Copyright Disclaimer : © The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords : Crisis Resolution Team, Mental health services, Acute care, Fidelity, Implementation
Depositing User : Symplectic Elements
Date Deposited : 01 Feb 2017 11:23
Last Modified : 19 Jul 2017 09:32
URI: http://epubs.surrey.ac.uk/id/eprint/813422

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