Organizational Factors Influencing Implementation of Evidence-Based Practices for Integrated Treatment in Behavioral Health Agencies

Abstract

Objective. In recent years, New Mexico has prioritized integrated treatment for cooccurring mental health and substance use disorders within its public behavioral health system. This report describes factors likely to be important when implementing evidence-based practices (EBPs) in community agencies. Methods. Our mixed-method research design consisted of observations, semistructured interviews, and surveys undertaken with employees at 14 agencies at baseline and after 18 months. We developed four-agency typologies based on iterative coding and analysis of observations and interviews. We then examined survey data from employees at the four exemplar agencies to validate qualitative findings. Results. Financial resources and strong leadership impacted agency capacity to train providers and implement EBPs. Quantitative analysis of service provider survey responses from these agencies (N = 38) supported qualitative findings and demonstrated significant mean score differences in leadership, organizational climate, and attitudes toward EBPs in anticipated directions. Conclusion. The availability of strong leadership and financial resources were key components to initial implementation success in this study of community agencies in New Mexico. Reliance only on external funding poses risks for sustainment when demoralizing work climates precipitate employee turnover. Strong agency leadership does not always compensate for deficient financial resources in vulnerable communities.

Pebbles, rocks, and boulders: The implementation of a school-based social engagement intervention for children with autism

“…While implementation research in schools has increased, the relative contribution of individual- and organizational-level factors that affect successful implementation of autism EBPs is understudied (Bonham, Willging, Sommerfeld, & Aarons, 2014; Beidas et al, 2015), particularly in school settings. Consistent with the Domitrovich and colleagues’ (2008) framework, several individual- and organizational-level constructs emerged (i.e., implementation process, staff, leadership, support, barriers, facilitators).…”

Organizational Stress as Moderator of Relationship Between Mental Health Provider Adaptability and Organizational Commitment

“…The loss of such individuals is detrimental to community mental health agencies as they are more likely to be open to evidence based practice implementation (38), have higher work-team performance and productivity (39), and their loss raises mental healthcare costs for agencies and consumers (40). Given the moderation effect of stressful climates on the relationship between provider adaptability and organizational commitment, mental health programs should assess and understand their organizational climate and intervene when necessary to reduce stressful climates.…”

The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study

“…The Cronbach’s alphas from the present study indicated excellent reliability for transformational leadership (α=0.96) and passive-avoidant leadership (α=0.86), and good reliability for transactional leadership (α=0.76). The validity of the MLQ is supported by studies demonstrating its associations and prediction of important organizational outcomes including change in practice (Leithwood & Jantzi, 2006), attitudes toward EBIs and capacity to train providers and implement EBIs (Aarons, 2006; Bonham, Sommerfeld, Willging, & Aarons, 2014), organizational culture (Aarons, Ehrhart, Farahnak, Sklar, & Horowitz, In press), knowledge sharing (Chen & Barnes, 2006), employee creativity (Dhar, 2015; Jyoti & Dev, 2015), innovation performance (Saad & Mazzarol, 2014), enhanced EBI receptivity, ongoing use, and ability to implement and sustain EBIs (Stetler, Ritchie, Rycroft-Malone, Schultz, & Charns, 2009), organizational climate expectations (von Thiele Schwarz, Hasson, & Tafvelin, 2016), and patient and consumer outcomes (Corrigan, Lickey, Campion, & Rashid, 2000; Wong & Giallonardo, 2015). Home visitors indicated the extent to which their supervisor exhibited specific behaviors on a 5 point Likert-type scale from “Not at all” to “To a very great extent.” Individual leadership scores were computed as item averages.…”