Adapting Intervention Mapping to Improve Patient-Centeredness of Mental Health Services.

Addressing socio-demographic differences that affect mental health service encounters is crucial for ethical practice and enhancing therapeutic alliances. Yet discussing personal perceptions of socio-demographic influences within a large healthcare system can be challenging due to discomfort among staff and the need for engagement at both interpersonal and organizational levels. The SITE project sought to intervene on one healthcare system's mental health providers' willingness to discuss patient background during care coordination. An internal workgroup used intervention mapping enhanced with frameworks from socio-demographic-focused literature and implementation science. Data collection included surveys, interviews, and a participatory consensus process. The results were two multi-component intervention packages designed to address interpersonal and organizational barriers, each targeting providers' willingness and psychological safety in addressing patient-specific background factors with colleagues. The interventions were adopted by the setting and then later dissolved due to administrative shifts. While the resultant interventions are unique to this setting, we demonstrate a repeatable process for adapting a well-known intervention development method (intervention mapping (IM)) informed by theory and implementation science. This process can be applied in other healthcare systems for discerning multi-level interventions appropriate to different contexts.