Implementation of evidence-based practice in rural Sweden - Exploring innovative strategies for realization of national guidelines for treatment and support for people with schizophrenia
The project investigates the experience of introducing scientifically based working methods in the area of mental illness in Swedish rural areas. The project includes a survey of 10 sparsely populated municipalities and a development work where researchers and internships together design and test a methodology to strengthen local implementation work.
Despite innovations in psychosocial interventions for people with mental health problems, access to evidence based interventions for this population is still low, especially for those living in rural areas. National guidelines operate as a fundamental part of efforts to improve health and social care and bridge the research-practice gap. The National Guidelines for Schizophrenia (2018) are now being released and these evidence-based psychosocial methods, which prioritize addressing the complex needs of adults with serious mental illness, have historically been difficult to implement in rural areas. Studies are often based in large cities with more resources for specialized care, which confounds the already complex process of implementing these methods in a Swedish context, where the social services must collaborate with a variety of welfare system actors. The challenge of implementing EBM in real-world contexts is not unique to Sweden, A common theme in the literature is that of developing collaborations between researchers who are experts on implementing evidence based methods, and practitioners who are charged with delivering these services in a relevant and effective manner to their clients.
This study has the aim of developing and testing the feasibility of regionally based “research-practice collaborations” (RPC), in order to implement EBM in rural areas. In a first phase, the conditions and challenges for implementing the national guidelines will be surveyed through a document analysis and a collective field study of rural municipalities. In the second phase, RPC:s will be established within clusters of municipalities in three regions in northern Sweden, in order to develop local implementation models. In the third phase, a specific intervention, chosen by each respective RPC will be implemented. The two later phases will be studied
longitudinally through a series of interviews and an analysis of program fidelity and sustainability in implementation.