Implementation strategies are methods or techniques used to adopt, implement, and sustain evidence-based practices (EBPs). Implementation strategies are dynamic and may require adaptation to fit implementation contexts, especially in low-resource settings, which are most likely to serve racially and ethnically diverse patients. The framework for reporting adaptations and modifications to evidence-based implementation strategies (FRAME-IS) was used to document adaptations to implementation strategies to inform an optimization pilot of Access to Tailored Autism Integrated Care (ATTAIN; an integrated care model for children with autism and co-occurring mental health needs) in a federally qualified health center (FQHC) near the United States/Mexico border. Quantitative and qualitative data were collected from 36 primary care providers who participated in the initial ATTAIN feasibility pilot to inform adaptations. Adaptations were mapped to the FRAME-IS through an iterative template analysis to inform an optimization pilot at a FQHC 1-year from the start of the COVID-19 pandemic. Four implementation strategies (training and workflow reminders, provider/clinic champions, periodic reflections, and technical assistance) were employed during the feasibility pilot and were adapted for the optimization pilot to fit the needs of the FQHC and service delivery changes prompted by the pandemic. Findings demonstrate the utility of using the FRAME-IS to systematically inform EBP optimization in a FQHC providing care to underserved communities. Findings will inform future research studies implementing integrated mental health models in low-resourced primary care settings. Implementation outcomes and provider perceptions of ATTAIN at the FQHC are also reported. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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在 FRAME-IS 的指导下优化 ATTAIN 在联邦合格健康中心的实施。

实施策略是用于采用、实施和维持循证实践 (EBP) 的方法或技术。实施策略是动态的，可能需要进行调整以适应实施环境，尤其是在资源匮乏的环境中，这些环境最有可能为不同种族和民族的患者提供服务。报告基于证据的实施策略调整和修改的框架 (FRAME-IS) 用于记录对实施策略的调整，以告知获得定制自闭症综合护理的优化试点（ATTAIN；自闭症儿童综合护理模型和同时发生的心理健康需求）在美国/墨西哥边境附近的联邦合格健康中心（FQHC）。从参与初始 ATTAIN 可行性试点的 36 名初级保健提供者那里收集了定量和定性数据，以告知适应性。通过迭代模板分析将适应映射到 FRAME-IS，以便在 COVID-19 大流行开始后的 1 年内为 FQHC 的优化试点提供信息。在可行性试点期间采用了四种实施策略（培训和工作流程提醒、提供者/诊所冠军、定期反思和技术援助），并针对优化试点进行了调整，以适应 FQHC 的需求和大流行引发的服务交付变化。调查结果证明了使用 FRAME-IS 系统地通知 FQHC 中的 EBP 优化的效用，为服务欠缺的社区提供护理。调查结果将为未来在资源匮乏的初级保健环境中实施综合心理健康模型的研究提供信息。还报告了 FQHC 中 ATTAIN 的实施结果和提供者的看法。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。