Co-creating fit: How staff work together to adapt and implement clinically relevant measures in child and youth mental health agencies

Abstract

Multi-purpose clinically relevant measures can be useful for improving mental health services at the individual client, program, organization, and system levels. Yet, emerging research suggests that such measures are often not used consistently or effectively (Mellor-Clark et al., 2016), and that low use of these measures can be in part attributed to how they were put into practice (de Jong, 2016). The current study examined the factors and processes that contribute to the effective implementation of clinically relevant measures, as well as the role of staff participation in the implementation process. The study employed qualitative, multiple-case study methods. Four child and youth mental health agencies in Ontario participated, including a total of 44 staff. Results suggest that staff participation in the process of putting clinically relevant measures into practice contributes to effective implementation and increased uptake and use of the measures. When staff are engaged in the process, they have reasons and opportunities to interact and “co-create fit” between the measure and their work context. This improved fit then facilitates increased staff commitment and ability to use the measure effectively. The findings have important implications for research and practice, which will be discussed.