Using a Rapid Learning Health System for Stratified Care in Emerging Adult Mental Health Services: Protocol for the Implementation of Patient-Reported Outcome Measures.

Journal: JMIR research protocols

Volume: 13

Issue: 

Year of Publication: 

Affiliated Institutions:  Mathison Centre for Mental Health & Education, University of Calgary, Calgary, AB, Canada. Alberta Health Services, Edmonton, AB, Canada. Brain and Mind Centre, The University of Sydney, Sydney, Australia.

Abstract summary 

Mental illness among emerging adults is often difficult to ameliorate due to fluctuating symptoms and heterogeneity. Recently, innovative approaches have been developed to improve mental health care for emerging adults, including (1) implementing patient-reported outcome measures (PROMs) to assess illness severity and inform stratified care to assign emerging adults to a treatment modality commensurate with their level of impairment and (2) implementing a rapid learning health system in which data are continuously collected and analyzed to generate new insights, which are then translated to clinical practice, including collaboration among clients, health care providers, and researchers to co-design and coevaluate assessment and treatment strategies.The aim of the study is to determine the feasibility and acceptability of implementing a rapid learning health system to enable a measurement-based, stratified care treatment strategy for emerging adults.This study takes place at a specialty clinic serving emerging adults (age 16-24 years) in Calgary, Canada, and involves extensive collaboration among researchers, providers, and youth. The study design includes six phases: (1) developing a transdiagnostic platform for PROMs, (2) designing an initial stratified care model, (3) combining the implementation of PROMs with stratified care, (4) evaluating outcomes and disseminating results, (5) modification of stratified care based on data derived from PROMs, and (6) spread and scale to new sites. Qualitative and quantitative feedback will be collected from health care providers and youth throughout the implementation process. These data will be analyzed at regular intervals and used to modify the way future services are delivered. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is used to organize and evaluate implementation according to 3 key objectives: improving treatment selection, reducing average wait time and treatment duration, and increasing the value of services.This project was funded through a program grant running from 2021 to 2026. Ethics approval for this study was received in February 2023. Presently, we have developed a system of PROMs and organized clinical services into strata of care. We will soon begin using PROMs to assign clients to a stratum of care and using feedback from youth and clinicians to understand how to improve experiences and outcomes.This study has key implications for researchers and clinicians looking to understand how to customize emerging adult mental health services to improve the quality of care and satisfaction with care. This study has significant implications for mental health care systems as part of a movement toward value-based health care.PRR1-10.2196/51667.

Authors & Co-authors:  Dimitropoulos Lindenbach Potestio Mogan Richardson Anderson Heintz Moskovic Gondziola Bradley LaMonica Iorfino Hickie Patten Arnold

Study Outcome 

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Statistics
Citations : 
Authors :  15
Identifiers
Doi : 10.2196/51667
SSN : 1929-0748
Study Population
Male,Female
Mesh Terms
Other Terms
RE-AIM;Reach, Effectiveness, Adoption, Implementation, and Maintenance;acceptability;adult;e-mental health;emerging adults;health system;implementation;implementation science;learning health system;measurement-based care;mental health;patient-reported outcome measures;pragmatic clinical trials;protocol papers;stratified care;treatment
Study Design
Study Approach
Quantitative,Qualitative
Country of Study
Publication Country
Canada