Evidence map›Paper›PMID 42919361›Full record

ArticleImplementation science communications2026

Adapting the Fiscal Mapping Process to improve the financial sustainability of implementation support and mental health delivery organizations: protocol for a mixed methods study.

Margaret E Crane, Alex R Dopp, Aaron R Lyon, Bo Kim, David C Mohr, William A Aldridge Ii, Joshua J Kemp, A Rani Elwy

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Article in Implementation science communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Margaret E CraneDepartment of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA. margaret_crane@brown.edu.ORCID http://orcid.org/0000-0002-1680-3364
Alex R DoppRAND, 1776 Main Street, Santa Monica, CA, 90401, USA.
Aaron R LyonDepartment of Psychiatry and Behavioral Sciences, University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA, 98115, USA.
Bo KimCenter for Health Optimization and Implementation Research (CHOIR), Boston Healthcare System, 150 S. Huntington Ave, Boston, VA, MA, 02130, USA.
David C MohrCenter for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 06111, USA.
William A Aldridge IiThe Impact Center at Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Campus Box 8180, Chapel Hill, NC, 27599-8180, USA.
Joshua J KempDepartment of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.
A Rani ElwyDepartment of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA.

Funding

UW ALACRITY Center for Psychosocial Interventions ResearchP50MH115837 · NIMH · UNIVERSITY OF WASHINGTON · PI IAN Moore BENNETT · 2018 to 2026
$18.2M
Reducing Addiction through Prevention Infrastructure Development (RAPID)R61DA063683 · NIDA · WAYNE STATE UNIVERSITY · PI Andria B Eisman · 2025 to 2026
$919k
Adapting the Fiscal Mapping Process to Improve the Sustainability of Evidence-Based Mental Health Intervention ImplementationK08MH140067 · NIMH · BROWN UNIVERSITY · PI Margaret Crane · 2025 to 2026
$391k
NIDA NIH HHS R61DA063683NIMH NIH HHS K08MH140067NIMH NIH HHS P50MH115837U.S. Department of Veterans Affairs RCS 23-081
6 · The paper itself

Abstract

backgroundSustainability of evidence-based mental health intervention (EBI) implementation is a challenge to increasing access to mental health services. Funding is a common barrier to sustainment. EBIs, while cost effective, are expensive to implement. The Fiscal Mapping Process is a strategic planning tool designed for behavioral health agencies to plan the financial sustainment of specific EBIs. Financial planning at an organizational level is also required to enable implementation support organizations (ISOs) and mental health delivery organizations (MHDOs) to sustainably operate. Project FISCAL (Financing Implementation for Sustainable Care, Access, and Localization) will adapt the Fiscal Mapping Process for ISOs/MHDOs to plan for financial sustainability while balancing access and high-quality mental health care.

methodsThe study will be guided by the Discover, Design/Build, and Test human-centered design framework. ISOs will include intermediary and purveyor organizations, and MHDOs will include provider and digital mental health organizations. In the Discover Phase (Aim 1), we will identify ISOs'/MHDOs' needs for a strategic financial planning tool through process mapping and a semi-structured qualitative interview. Process mapping also will identify how ISOs/MHDOs selected financing strategies for their organization. In the Design/Build Phase (Aim 2), we will refine the Fiscal Mapping Process using Design Charrettes. In the Test Phase (Aim 3), we will assess the preliminary impact and usability of the Fiscal Mapping Process for ISOs'/MHDOs' financial sustainability using a comparative case study design. Participants in Aims 1-3 will include individuals working in ISOs/MHDOs (n = 20 ISOs/MHDOs per aim) and in Aims 1-2 also will include 5 ISO/MHDO advisors. Data will be analyzed using a convergent mixed methods approach integrating qualitative and quantitative data. DISCUSSION: The adapted Fiscal Mapping Process created in this project will help organizations with strategic financial planning to broadly sustain and scale access to effective mental health treatments. The study addresses two understudied areas of implementation science: sustainability and organizational-level financing strategies. Without careful consideration, ISOs'/MHDOs' business models could unintentionally decrease access to care for some individuals if funding is prioritized or if only certain patient populations are reached.

Indexed as

Evidence-based interventionsFinancial planningFiscal Mapping ProcessHuman-centered designImplementation scienceImplementation support organizationsMental health delivery organizationsMixed methodsSustainability

Identifiers

PMID42919361

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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.