115. USING IMPLEMENTATION RESEARCH FRAMEWORK TO FOCUS ON PEDIATRIC MENTAL HEALTH

Surveys of pediatric program directors have identified the need for dissemination of mental health guidelines into pediatric training programs./Education on guidelines is challenging without an underlying framework for implementation./The Consolidated Framework for Implementation Research (CFIR) has been used in medical education settings. We utilized the CFIR to develop a multidisciplinary intervention that implemented 2011 AAP ADHD guidelines into an academic pediatric residency practice. Our desired outcomes included increasing confidence, improved use of Vanderbilt Screening and improved continuity of care for patients with ADHD. Utilizing the CFIR, we created a process to transform the un-adapted intervention (ADHD guidelines) into an adapted intervention directly applicable to patients. See figure 1. Providers were surveyed pre-intervention (PI), immediate post-intervention (IPI) and six months following intervention (FI). Investigators audited charts for conformity with the guidelines, continuity of care, intervals of visit, standardized documentation and receipt of Vanderbilt screening measures. Sixty-three providers participated. We aggregated data for the 63 and paired responses for 29 participants. When given the statement “there is a standard of care for patients,” 35.3% agreed PI, 82.4% agreed IPI and 83% agreed FI. Participants who indicated some or greater confidence in applying the AAP clinical guidelines moved from 31.8% PI to 86.4% IPI and 83.3% FI. Participants indicated that there was a teacher Vanderbilt available for their patients \u003e50% of the time at 43% PI, 70.7% IPI and 83.3% FI. Respondents were asked “how often are you the primary care provider for patient visits regarding ADHD?” Participants answered that they were the PCP \u003e50% of the time 22.9% PI, 23.7% IPI and 51.7% FI. The CFIR works as a framework to implement a mental health guideline into pediatric practice that may be superior to solely curriculum-based efforts alone. Outcomes continued to improve FI indicating potential longevity. Use of the CFIR framework could be expanded to implement more pediatric guidelines.