Effect of a needs-based model of care on the characteristics of healthcare services in England: the i-THRIVE National Implementation Programme

Abstract Aims Developing integrated mental health services focused on the needs of children and young people is a key policy goal in England. The THRIVE Framework and its implementation programme, i-THRIVE, are widely used in England. This study examines experiences of staff using i-THRIVE, estimate...

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Main Authors: R Sippy, L Efstathopoulou, E Simes, M Davis, S Howell, B Morris, O Owrid, N Stoll, P Fonagy, A Moore
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:Epidemiology and Psychiatric Sciences
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Online Access:https://www.cambridge.org/core/product/identifier/S2045796025000101/type/journal_article
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Summary:Abstract Aims Developing integrated mental health services focused on the needs of children and young people is a key policy goal in England. The THRIVE Framework and its implementation programme, i-THRIVE, are widely used in England. This study examines experiences of staff using i-THRIVE, estimates its effectiveness, and assesses how local system working relationships influence programme success. Methods This evaluation uses a quasi-experimental design (10 implementation and 10 comparison sites.) Measurements included staff surveys and assessment of ‘THRIVE-like’ features of each site. Additional site-level characteristics were collected from health system reports. The effect of i-THRIVE was evaluated using a four-group propensity-score-weighted difference-in-differences model; the moderating effect of system working relationships was evaluated with a difference-in-difference-in-differences model. Results Implementation site staff were more likely to report using THRIVE and more knowledgeable of THRIVE principles than comparison site staff. The mean improvement of fidelity scores among i-THRIVE sites was 16.7, and 8.8 among comparison sites; the weighted model did not find a statistically significant difference. However, results show that strong working relationships in the local system significantly enhance the effectiveness of i-THRIVE. Sites with highly effective working relationships showed a notable improvement in ‘THRIVE-like’ features, with an average increase of 16.41 points (95% confidence interval: 1.69–31.13, P-value: 0.031) over comparison sites. Sites with ineffective working relationships did not benefit from i-THRIVE (−2.76, 95% confidence interval: − 18.25–12.73, P-value: 0.708). Conclusions The findings underscore the importance of working relationship effectiveness in the successful adoption and implementation of multi-agency health policies like i-THRIVE.
ISSN:2045-7960
2045-7979