Outpatient referrers as a pathway to care for a new family-centered health intervention in psychiatric clinics and how to reach them: evaluation of an implementation strategy.

backgroundThe integration of evidence-based research into clinical practice faces several challenges. One major barrier is the effective dissemination of information regarding new interventions. To illustrate this, the CHIMPS-NET (Children of Mentally Ill Parents) program, a family-centered intervention in German psychiatric clinics, is used as an example. This study evaluates the referral criteria, the dissemination of information, and the accessibility of outpatient specialists involved in the gatekeeping process for accessing and referring patients to CHIMPS-NET. This study serves as part of the implementation strategy for the sustainable anchoring of the CHIMPS-NET program.

methodsWe identified all outpatient professionals (n=2828) in each catchment area of the psychiatric specialist clinics that provided the new CHIMPS-NET form of care. We identified them as potential gatekeepers. These professionals worked across a range of fields, some had a psychological professional background. Professionals in the intervention group (n=946) received information from us about the new intervention, while professionals in the control group (n=1882) did not. Before and after the information was sent by post, all participants were asked via a questionnaire about their knowledge of family-centered intervention and its importance for the vulnerable target group of children of mentally ill parents. There was an interval of three months between the first questionnaire and the information being sent out and a further three months after this the final questionnaire was sent.

resultsThere was no significant change in knowledge across the two measurement points. Reaching out to gatekeepers had no influence on knowledge of the CHIMPS-Net intervention. However, awareness of family-centered health interventions was four times higher if the gatekeeper had a psychological professional background.

conclusionDissemination of information by post about CHIMPS-Net was not effective at communicating information or reaching gatekeepers. Knowledge of family-centered health interventions was four times higher among the group of specialists and therapists with a psychological background. We therefore suggest that general (somatic) practitioners, who make up most of the gatekeeper population in Germany, need to be approached more intensively than professionals with a psychological/psychiatric background. It is also recommended that individual clinics address their catchment area more intensively and directly.