Abstract
Background
The implementation of evidence-based research results in clinical practice is hampered by various obstacles. One of these barriers is the dissemination of information about the provision of new interventions. Using the example of the new CHIMPS-NET (Children of Mentally Ill Parents), a family-centered intervention in German psychiatric clinics, the referral criteria, information dissemination and accessibility of outpatient specialists involved in the access and referral process (gatekeeping) are evaluated.
Methods
We identified all outpatient general and specialist practices (n = 2828) in the regional care areas of the psychiatric specialist clinics that provided the new CHIMPS-NET form of care. Practices in the intervention group (n = 946) received information about the new intervention, while practices in the control group (n = 1882) did not. Before and after the information was sent postal, all participants were asked about their knowledge of family-centered intervention and its importance for the vulnerable target group of children of mentally ill parents by means of a questionnaire at intervals of three months.
Results
Regardless of group affiliation, reaching out to gatekeepers had no influence on knowledge of a new form of care, such as the CHIMPS-NET. The allocation criteria and prevalence estimates for the vulnerable target group have not changed either. However, awareness of family-centered health interventions increased fourfold if the gatekeeper had a psychological professional background.
Conclusion
Following the PRISM implementation framework, three barriers were identified in the provision of information gatekeepers in outpatient care: 1) the external environment, 2) the perspective of patients and gatekeepers and 3) the perspective of recipients. The postal intervention was not effective at communicating information or reaching outpatient referrers. 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, need to be approached more intensively than psychologically trained professionals. It is also recommended that clinics address their regional care sector more intensively and directly.