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A Literature Review of Learning Collaboratives in Mental Health Care: Used but Untested
Erum Nadeem, Ph.D.; S. Serene Olin, Ph.D.; Laura Campbell Hill, B.A.; Kimberly Eaton Hoagwood, Ph.D.; Sarah McCue Horwitz, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300229
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Except for Ms. Hill , the authors are with the Department of Child and Adolescent Psychiatry, New York University, New York City (e-mail: erum.nadeem@nyumc.org). Ms. Hill is with the School of General Studies, Columbia University, New York City.

Copyright © 2014 by the American Psychiatric Association

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Abstract

Objective  Policy makers have increasingly turned to learning collaboratives (LCs) as a strategy for improving usual care through the dissemination of evidence-based practices. The purpose of this review was to characterize the state of the evidence for use of LCs in mental health care.

Methods  A systematic search of major academic databases for peer-reviewed articles on LCs in mental health care generated 421 unique articles across a range of disciplines; 28 mental health articles were selected for full-text review, and 20 articles representing 16 distinct studies met criteria for final inclusion. Articles were coded to identify the LC components reported, the focus of the research, and key findings.

Results  Most of the articles included assessments of provider- or patient-level variables at baseline and post-LC. Only one study included a comparison condition. LC targets ranged widely, from use of a depression screening tool to implementation of evidence-based treatments. Fourteen crosscutting LC components (for example, in-person learning sessions, phone meetings, data reporting, leadership involvement, and training in quality improvement methods) were identified. The LCs reviewed reported including, on average, seven components, most commonly in-person learning sessions, plan-do-study-act cycles, multidisciplinary quality improvement teams, and data collection for quality improvement.

Conclusions  LCs are being used widely in mental health care, although there is minimal evidence of their effectiveness and unclear reporting in regard to specific components. Rigorous observational and controlled research studies on the impact of LCs on targeted provider- and patient-level outcomes are greatly needed.

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