1 - (SYM 61) FOCUS on Implementation: Strategies to Support Real-world Translation of an Evidence-based Mhealth Intervention for Serious Mental Illness

FOCUS, a self-management mobile health (mHealth) intervention for people with serious mental illness (SMI), produces robust engagement, satisfaction, and clinical improvements even when compared to more complex and resource intensive person-delivered treatments for SMI (Ben-Zeev et al., 2018). Individuals who use FOCUS find it highly acceptable and see significant improvements in general psychopathology, depression, and recovery (Ben-Zeev et al., 2014). Successfully incorporating FOCUS and other similar mHealth interventions into clinical workflows at community mental health centers (CMHCs) has potential to improve outcomes, reduce costs, and relieve burden on understaffed CMHCs (Achtyes et al., 2019; Ben-Zeev et al., 2021). Supporting adoption and sustainability of FOCUS requires the development, tailoring, and testing of implementation strategies that may be particularly useful for mHealth in the context of CMHCs (Graham et al., 2020).  



To this end, the current study engages 24 CMHCs in a statewide implementation of FOCUS. The goal of this study is to test two models of practice facilitation, an evidence-based implementation strategy. The first model is internal facilitation, where a practice facilitator is identified from within an agency to champion and conduct the FOCUS intervention. The second model is external facilitation wherein a practice facilitator is located at a central location and works with multiple CMHCs at once to champion and facilitate FOCUS. To evaluate the facilitation models’ effectiveness, we compare implementation outcomes (penetration, acceptability, cost) as well as patient outcomes (general psychopathology, depression, and recovery). We will present lessons learned in the development of implementation strategies for mHealth. preliminary implementation and clinical results of this study, and highlight work underway to support sustainability of mHealth in CMHCs. By testing two uniquely different practice facilitation approaches, we have identified strengths and limitations of each that can inform future implementation of FOCUS and other mHealth interventions in CMHCs.