Using the practical, robust implementation and sustainability model assessment to enhance the implementation of electronic screening in military to Veterans Affairs programs.

Abstract

The Practical, Robust Implementation and Sustainability Model (PRISM) was utilized to develop an assessment for improving fit between implementation context, intervention, and implementation efforts. We present findings from the PRISM assessment used in seven military to Veterans Affairs clinics implementing eScreening to improve rate and time for the completion of mental health screenings for veterans and increasing referral to mental health treatment. Questions developed by Glasgow et al. (2020) were adapted to the study context covering the PRISM domains (six items) and reach, effectiveness, adoption, implementation, and maintenance (13 items) outcomes. Assessment results were summarized for each site graphically including comments and were presented in a discussion-based action-planning meeting. Group discussion involving implementation partners and research team members, including an external facilitator, focused on identifying ways to improve the implementation of eScreening. Participants across all sites identified areas of concern related to reach, adoption, and patient expectations. Survey data and comments on these concerns drove the team discussion and identification of implementation activities, which included (a) increasing communication of the value for veteran care, (b) standardizing minimum-effort workflows, and (c) increasing buy-in and collaboration with leadership and other facility services. In this study, the PRISM assessment was used as a one-time activity to enhance implementation across military to Veterans Affairs clinics. The assessment was feasible, and discussion yielded important data on alignment and potential adaptations of the implementation efforts within the dynamically changing local context. Recommendations are provided for those interested in applying the PRISM assessment in their studies. (PsycInfo Database Record (c) 2025 APA, all rights reserved).