End-user centered dissemination: using co-design to advance evidence-based behavioral health practice in the Veterans Health Administration
OA Version
Citation
Abstract
BACKGROUND: The Veterans Health Administration (VA) implemented an evidence-based mental health program, the Behavioral Health Interdisciplinary Program – Collaborative Chronic Care Model (BHIP-CCM). Although BHIP-CCM research findings were published in scientific literature, no systematic dissemination with staff, providers, and patients (i.e., end-users) occurred to increase awareness of the BHIP-CCM evidence. This project aims to engage staff, providers, and patients to disseminate BHIP-CCM findings using end-users’ preferred modes of communication.
METHODS: BHIP-CCM experts used a prioritization matrix and nominal group technique to select evidence to disseminate with end-users from 13 peer-reviewed publications. At 4 VA sites, 13 staff and providers and 9 Veterans participated in co-design sessions to create products tailored to end-users’ preferences.
A mixed-methods evaluation, guided by the Fit-to-Context framework for Designing for Dissemination and Sustainability, contained a validated 12-item survey to measure implementation outcomes: acceptability, appropriateness, and feasibility of dissemination. Survey also measured change in awareness of research findings, and intent-to-use dissemination products. The Consolidated Framework for Implementation Research guided qualitative analyses of interviews, assessing experiences and factors affecting dissemination of BHIP-CCM evidence.
RESULTS: Five VA researchers identified BHIP-CCM effectiveness, sustainability and impact on all-cause mortality among research findings for dissemination. Co-design with end-users led to the creation of 3 products: a PowerPoint resource and 2 infographics. The resource was shared locally and nationally and received 251 online views from 104 unique BHIP-CCM team members within 1-month.
Quantitatively, staff and providers found the resource acceptable (mean 4.84; SD 0.23), the dissemination strategies appropriate (mean 4.64; SD 0.51) and feasible (mean=4.73; SD 0.47), on 5-point scale. Staff and providers awareness of BHIP-CCM evidence increased, and their intention-to-use the resource was high (mean=4.73; SD 065). Qualitatively, barriers to dissemination included: time constraints, clearance to disseminate the resource, and organizational context. Nonetheless, staff and provider end-users were satisfied; they acquired new learning experience and knowledge that reinforced the value of giving BHIP-CCM consistent care.
CONCLUSIONS & IMPLICATIONS: Collaborative dissemination of BHIP-CCM evidence led to increased knowledge transfer to end-users. This process of designing for dissemination can optimize widespread adoption and sustained use of BHIP-CCM and other evidence-based practices for improved health outcomes.
Description
2026