(PS5-3) Assessing Readiness for Measurement-based Care Implementation: A Comparison Between Non-specialist and Specialist Providers

Abstract Text: Leveraging non-specialist providers has been proposed as a solution to mental health workforce shortages (Barnett et al., 2018). However, non-specialist providers have received limited attention in implementation studies, and it remains unclear whether a lack of formal clinical training poses a barrier to successful implementation of evidence-based practices (EBPs) such as measurement-based care (MBC). This poster aims to explore whether non-specialist providers (those without graduate level training) and specialist providers (those with a Master’s Degree or higher) differ in baseline levels of variables that may be foundational to MBC implementation. Understanding if these factors vary will help determine whether MBC implementation faces different barriers when working with a workforce that have varied training backgrounds. This study was a secondary analysis of the Personalized Assessment of Client Experiences (PACE) Study, which compared two different approaches to MBC in community mental health clinics in Tennessee (Clinical Trials.gov record NCT04369924). The clinics had two clinician roles: Family Development Specialists (n=57) that held a Bachelor's degree and Therapists (n=49) that held a Master's or higher. Before MBC training, clinicians completed baseline measures via an online survey and rated self-efficacy for providing feedback (de Jong et al., 2012), graph and numeracy skills (Fagerlin et al., 2007; Galesic & Garcia-Retamero, 2010; Ruiz et al., 2016), openness to technology (Agarwal & Prasad, 1998), and attitudes toward progress monitoring (Jensen-Doss et al., 2018). Progress measure administration was assessed with a single item with options ranging from “Never” to “Every 90 days,” following Jensen-Doss et al., (2018). Independent samples t-tests were used to compare the groups on continuous variables and a Pearson’s Chi-squared test assessed differences in measure administration. Results indicated no statistically significant differences in feedback self-efficacy (t(100) = 0.25, p = 0.80, d = 0.025), numeracy skills (t(101) = 1.11, p = 0.27, d = 0.11), graph skills (t(101) = -0.62, p = 0.54, d = -0.06), openness to new technology (t(101) = 0.11, p = 0.91, d = 0.01), and attitudes about benefits (t(100) = -0.37, p = 0.71, d = -0.04) or harms (t(100) = 0.61, p = 0.54, d = 0.061) of feedback between therapists and Family Development Specialists. There was a statistically significant difference between therapists and Family Development Specialists self-rated treatment progress measure administration (χ2(3, N = 99) = 8.42, p = 0.04, V = 0.29), with therapists more likely to report “Never” (55.3%). These findings suggest that formal clinical training may not be a prerequisite for provider readiness in MBC implementation, as non-specialist and specialist providers had comparable baseline levels of key implementation-relevant variables. However, differences in treatment progress measure administration suggest that training level or role requirements may influence the manner or frequency in which providers use MBC. Future research should address limitations related to the use of self-report measures and influence of unmeasured factors, such as prior MBC training and organizational role requirements.