Carlos Alberto dos Santos Treichel
Having trained as a bachelor’s and master’s in Nursing at the Federal University of Pelotas, Treichel recently completed his Ph.D. in Public Health at the State University of Campinas, where he develops activities as a Post-Doctoral Researcher. Currently, in addition to integrating the Latin American Network of the Global Implementation Society, he studies the implementation of public mental health policies in Brazil and carries out the adaptation of methodological resources to improve the quality of Implementation Research in the Brazilian context.
Corresponding to a collaborative care proposal, for approximately 10 years matrix support has been consolidated as the Brazilian response to the need to integrate mental health services and primary care . Although studies on its effectiveness are on the rise, to the best of our knowledge, studies focused on the strategies used for its implementation still missing. Thus, our objective was to specify and report the strategies used to implement matrix support in a medium-sized municipality.
Following the conclusion of a 3-year implementation process, core research team members identified the implementation strategies that supported intervention delivery using the established taxonomy of implementation strategies proposed by the ERIC compilation . The actors, actions, action targets, temporality, dose, and implementation outcomes were specified using the implementation strategies reporting guideline proposed by Proctor et al. (2013) .
We identified 24 discrete implementation strategies that were used to implement the matrix support. Most strategies fell within the categories of Develop Stakeholder Interrelationships, Train and Educate Stakeholders, and Use Evaluative and Iterative Strategies. Actors included members of the research team, managers and workers of local health services, and members of partner universities. Strategies were used multiple times during the preparation and implementation phases. Action targets were most often characteristics of the inner setting, characteristics of individuals, and the implementation process. Strategies predominantly targeted the implementation outcomes of acceptability, adoption, appropriateness, and fidelity.
We believe that our study provides evidence that will allow other teams to envision strategies that can be contemplated in undertaking efforts to implement matrix support in the context of mental health care in the future.