Mental health and social service provider attitudes toward evidence-based practice have been measured through the development and validation of the Evidence-Based Practice Attitude Scale (EBPAS; Aarons, Ment Health Serv Res 6(2):61–74, 2004). Scores on the EBPAS scales are related to provider demographic characteristics, organizational characteristics, and leadership. However, the EBPAS assesses only four domains of attitudes toward EBP. The current study expands and further identifies additional domains of attitudes towards evidence-based practice. A qualitative and quantitative mixed-methods approach was used to: (1) generate items from multiples sources (researcher, mental health program manager, clinician/therapist), (2) identify potential content domains, and (3) examine the preliminary domains and factor structure through exploratory factor analysis. Participants for item generation included the investigative team, a group of mental health program managers (n = 6), and a group of clinicians/therapists (n = 8). For quantitative analyses a sample of 422 mental health service providers from 65 outpatient programs in San Diego County completed a survey that included the new items. Eight new EBPAS factors comprised of 35 items were identified. Factor loadings were moderate to large and internal consistency reliabilities were fair to excellent. We found that the convergence of these factors with the four previously identified evidence-based practice attitude factors (15 items) was small to moderate suggesting that the newly identified factors represent distinct dimensions of mental health and social service provider attitudes toward adopting EBP. Combining the original 15 items with the 35 new items comprises the EBPAS 50-item version (EBPAS-50) that adds to our understanding of provider attitudes toward adopting EBPs. Directions for future research are discussed.

Purpose-This longitudinal study examined the relationship between mental and physical health problems in a sample of high-risk youth served in the public sector.Methods-Participants included youth ages 9 to 18 at baseline, randomly sampled from one of five public service sectors in San Diego County, California and youths may have been active to more than one sector. Diagnoses for mood, anxiety, and disruptive disorders based on structured diagnostic interviews were determined at baseline and data regarding health-related problems were collected two years post-baseline.Results-Mood and disruptive behavior disorders were related to cumulative health problem incidence, as well as aggregate measures of health problems and severe health problems. Additionally, mood disorder diagnosis was associated with higher rates of infectious diseases, respiratory problems, and weight problems. Disruptive disorder diagnosis was related to higher rates of risk-behavior related health problems.Conclusions-The present work extends the research on the relationship between mental and physical health problems to adolescents served in the public sector, who are at especially high risk for behavioral and emotional problems. Potential mechanisms by which mental health problems may impact health problems are discussed. We suggest the development of effective interagency cooperation between medical and mental health systems in order to improve the care of youth with comorbid mental and physical disorders.There is increasing concern and attention to the relation of mental health disorders and physical health problems as evidenced by published studies and by the National Institutes of Health (NIH) support for research addressing this issue. Adults with mental illness are at higher risk for physical health problems than those without mental illness [1][2][3], but less is known about Correspondence to: Gregory A. Aarons, Ph.D., Associate Professor of Psychiatry, University of California, San Diego, Child & Adolescent Services Research Center, 3020 Children's Way, MC-5033, San Diego, CA 92123-4282, Tel: 858.966.7703 ext. 3550, Fax: 858.966.7704, gaarons@ucsd.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. [4,6,9,10], oppositional defiant disorder (ODD), and conduct disorder (CD) [4,11,12]. However, studies of adolescents tend to be either crosssectional or conducted in clinical samples focused only on one type of disorder. NIH Public AccessMental illness may have a direct or indirect impact on physical health. For instance, mental disorders, such as depression, may directly lead to physical...