ArticleImplementation research and practice2022
Expect the Unexpected: A Qualitative Study of the Ripple Effects of Children's Mental Health Services Implementation Efforts.
Article in Implementation research and practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 28 citations in OpenAlex.
- Implementing Screening, Brief Interventions, and Referral to Treatment at Pediatric Trauma Centers: A Step Wedge Cluster Randomized Trial.Journal of pediatric surgery · 2024Trial
- Inclusivity in Insomnia: Adolescents' Perspectives on the Sleep Solved App: Qualitative Interview Study.JMIR formative research · 2026Article
- What constitutes risk in implementation research? Perspectives from a qualitative key-informant study.Implementation science communications · 2026Article
- Ethical considerations in implementation research: a scoping review of key principles, unintended consequences, and emerging ethical guidance.Implementation science communications · 2025Review
- Radiology Staff Experiences With Integrating Artificial Intelligence Into Radiology Practice in a Swedish Hospital: Qualitative Case Study.JMIR formative research · 2025Article
- Implementation strategies to integrate HIV and hypertension care in Kampala and Wakiso districts, Uganda: study protocol for a stepped wedge cluster randomized trial (PULESA-Uganda).BMC health services research · 2025Article
- Determinants of implementation of child-parent psychotherapy to treat early childhood trauma: a reflexive analysis.BMC health services research · 2025Article
- The implementability and proximal effects of a transdiagnostic mental health intervention for adolescents (Kort): protocol for a mixed-methods intensive longitudinal study.BMC health services research · 2025Article
- Harnessing Implementation Science in Clinical Psychology: Past, Present, and Future.Annual review of clinical psychology · 2025Review
- Conceptualizing patient-level adverse effects in implementation trials.Annals of epidemiology · 2025Article
- Adopting Public Health Genomics when the House Is on Fire: How Will We Navigate to 2030?Public health genomics · 2025Article
- Leveraging group model building to operationalize implementation strategies across implementation phases: an exemplar related to child maltreatment intervention selection.Implementation science communications · 2024Article
- Impact of research activity on performance of general practices: a qualitative study.BJGP open · 2024Article
- A research agenda to advance the study of implementation mechanisms.Implementation science communications · 2024Article
- Specifying cross-system collaboration strategies for implementation: a multi-site qualitative study with child welfare and behavioral health organizations.Implementation science : IS · 2024Article
- Developing ethical standards for dissemination and implementation research: a roadmap for consensus and guidance.Implementation science communications · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
Background: Strategies to implement evidence-based interventions (EBIs) in children's mental health services have complex direct and indirect causal impacts on multiple outcomes. Ripple effects are outcomes caused by EBI implementation efforts that are unplanned, unanticipated, and/or more salient to stakeholders other than researchers and implementers. The purpose of the current paper is to provide a compilation of possible ripple effects associated with EBI implementation strategies in children's mental health services, to be used for implementation planning, research, and quality improvement. Methods: Participants were identified via expert nomination and snowball sampling. Online surveys were completed by 81 participants, each representing one of five roles: providers of mental health services to children or youth, researchers, policy makers, caregivers, and youth. A partially directed conventional content analysis with consensus decision making was used to code ripple effects. Results: Four hundred and four unique responses were coded into 66 ripple effects and 14 categories. Categories include general knowledge, skills, attitudes, and confidence about using EBIs; general job-related ripple effects; EBI treatment adherence, fidelity, and alignment; gaming the system; equity and stigma; shifting roles, role clarity, and task shifting; economic costs and benefits; EBI treatment availability, access, participation, attendance, barriers, and facilitators; clinical process and treatment quality; client engagement, therapeutic alliance, and client satisfaction; clinical organization structure, relationships in the organization, process, and functioning; youth client and caregiver outcomes; and use of EBI strategies and insights in one's own life. Conclusions: This research advances the field by providing children's mental health implementers, researchers, funders, policy makers, and consumers with a menu of potential ripple effects. It can be a practical tool to ensure compliance with guidance from Quality Improvement/Quality Assurance, Complexity Science, and Diffusion of Innovation Theory. Future phases will match potential ripple effects with salient children's mental health implementation strategies for each participant role.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.