The role of clinical champions in facilitating the use of evidence-based practice in drug and alcohol and mental health settings: A systematic review

Wood, Katie; Giannopoulos, Vicki; Louie, Eva; Baillie, Andrew; Guajardo, Maria Gabriela Uribe; Lee, Kylie S; Haber, Paul; Morley, Kirsten C.

doi:10.1177/2633489520959072

Cited by 56 publications

(77 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Development of the proposed model was guided by existing literature on champions. Given the recent integrative review on champions in health care ( Miech et al, 2018 ) and systematic review on clinical champions in substance use and mental health ( Wood et al, 2020 ), a new systematic review did not seem warranted. Instead, the model development drew upon the work of these two reviews, relevant studies published after these reviews, and foundational work on champions published in non-health-related sources.…”

Section: Methodsmentioning

confidence: 99%

“…First, champions historically were thought of as being emergent—individuals who assumed the role of champion for a cause they believed in ( Howell and Higgins, 1990b ; Schon, 1963 ). However, in current practice, many organizations appoint individuals to champion roles as an implementation strategy ( Wood et al, 2020 ). This distinction between emergent and appointed champions has been recognized in the literature ( Damschroder et al, 2009 ; Soo et al, 2009 ); however, we do not have much evidence about differential effects of emergent and appointed champions, let alone why one type may be more effective than the other.…”

Section: Methodsmentioning

confidence: 99%

“…This distinction between emergent and appointed champions has been recognized in the literature ( Damschroder et al, 2009 ; Soo et al, 2009 ); however, we do not have much evidence about differential effects of emergent and appointed champions, let alone why one type may be more effective than the other. Given an apparent trend toward appointing champions and potentially insufficient training being provided for the champion role ( Wood et al, 2020 ), identifying approaches for selecting, preparing, and supporting effective champions should be a priority for the field. In fact, expert consensus suggests that identifying and preparing champions is one of the more important and feasible implementation strategies ( Waltz et al, 2015 ).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

A conceptual model to guide research on the activities and effects of innovation champions

Shea

2021

Implementation Research and Practice

View full text Add to dashboard Cite

Background: The importance of having a champion to promote implementation efforts has been discussed in the literature for more than five decades. However, the empirical literature on champions remains underdeveloped. As a result, health organizations commonly use champions in their implementation efforts without the benefit of evidence to guide decisions about how to identify, prepare, and evaluate their champions. The goal of this article is to present a model of champion impact that draws upon previous literature and is intended to inform future research on champions and serve as a guide for practitioners serving in a champion role. Methods: The proposed model is informed by existing literature, both conceptual and empirical. Prior studies and reviews of the literature have faced challenges in terms of operationalizing and reporting on champion characteristics, activities, and impacts. The proposed model addresses this challenge by delineating these constructs, which allows for consolidation of factors previously discussed about champions as well as new hypothesized relationships between constructs. Results: The model proposes that a combination of champion commitment and champion experience and self-efficacy influence champion performance, which influences peer engagement with the champion, which ultimately influences the champion’s impact. Two additional constructs have indirect effects on champion impact. Champion beliefs about the innovation and organizational support for the champion affect champion commitment. Conclusion: The proposed model is intended to support prospective studies of champions by hypothesizing relationships between constructs identified in the champion literature, specifically relationships between modifiable factors that influence a champion’s potential impact. Over time, the model should be modified, as appropriate, based on new findings from champion-related research. Plain language summary An innovation champion is an individual who works within an organization and who dedicates themselves to promoting a change within the organization, such as implementing a new intervention or a new quality improvement effort. Health organizations commonly rely on innovation champions, and existing literature on champions suggests they are important for successful organizational change. However, many questions remain about what effective champions do and what types of support they need to perform their champion role well. The goal of this article is to present a model of champion impact that draws upon previous literature and is intended to serve as a guide for future research on champions. In doing so, the model could support coordinated research efforts that answer questions about the characteristics, activities, and impacts of champions. Ultimately, this research could lead to development of useful guidance and tools for health system leaders to support champions within their organizations.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A conceptual model to guide research on the activities and effects of innovation champions

Shea

2021

Implementation Research and Practice

View full text Add to dashboard Cite

show abstract

“…One way to do this is by identifying a champion within the school, defined as someone whose role is to help others see the advantages of making a change, mentor them through the change, and ultimately persuade others to adopt a new practice (Cranley et al, 2017 ). Indeed, a recent meta-analysis found that champions are critical to influencing organizational structures, as evidenced by increased staff engagement, motivation, and faster adoption and persistence in the delivery of interventions (Wood et al, 2020 ). Research also suggests a two-step process often exists for champion-driven dissemination and adoption.…”

Section: Determinantsmentioning

confidence: 99%

Dissemination Science in School Mental Health: A Framework for Future Research

Baker

Brewer

Cook

et al. 2021

School Mental Health

View full text Add to dashboard Cite

There has been an increase in school mental health research aimed at producing generalizable knowledge to address longstanding science-to-practice gaps to increase children's access to evidence-based mental health services. Successful dissemination and implementation are both important pieces to address science-to-practice gaps, but there is conceptual and semantic imprecision that creates confusion regarding where dissemination ends and implementation begins, as well as an imbalanced focus in research on implementation relative to dissemination. In this paper, we provide an enhanced operational definition of dissemination; offer a conceptual model that outlines elements of effective dissemination that can produce changes in awareness, knowledge, perceptions, and motivation across different stakeholder groups; and delineate guiding principles that can inform dissemination science and practice. The overarching goal of this paper is to stimulate future research that aims to advance dissemination science and practice in school mental health.

show abstract

“…Lastly, while there is limited existing research into the process domain 59 , clinical champions have generally been perceived as a facilitator of implementation efforts 60-63 . There is also evidence to suggest that clinical champions contribute to a faster uptake and sustained use of the intervention 64 , and that they can assist with generating enthusiasm amongst staff, despite systemic barriers 65-67 .…”

Section: Discussionmentioning

confidence: 99%

Implementation of a multi-modal training program for the management of comorbid mental disorders in drug and alcohol settings: Pathways to Comorbidity Care (PCC)

Louie

Morley

Giannopoulos

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundClinical guidelines recommend evidence-based treatments for comorbid mental and substance use disorders but these are not reliably translated into practice. We aimed to evaluate the impact of the Pathways to Comorbidity Care (PCC) training program for alcohol and other drug (AOD) clinicians to improve the management of comorbidity and to identify barriers and facilitators of implementation according to the Consolidated Framework for Implementation Research (CFIR).MethodsA controlled before-and-after study using PCC training was conducted across 6 matched sites in Australia including 35 clinicians. Controls received standard workplace training. PCC training included seminar presentations, workshops conducted by local ‘clinical champions’, individual clinical supervision, and access to an online information portal. A mixed methods approach examined i) identification (screening, assessment) and treatment (treatment, referral) of comorbidity in practice (N = 10 clinical files per clinician), ii) self-efficacy, knowledge and attitudes of clinicians, iii) barriers and facilitators of implementation.ResultsSignificant improvements were observed in the PCC group but not the control sites with regards to the rate of clinical files showing identification of comorbidity (+50% v −12% change from baseline respectively; X2 (1, N = 340) = 35.29, p = .01) with only a trend for improvements in the rate of files demonstrating treatment of comorbidity (X2 (1, N = 340) = 10.45, p = .06). There were significant improvements in the PCC relative to the control group for clinician self-efficacy (F (1,33) = 6.40, p = .02) and knowledge and attitudes of comorbidity monitoring (F (1,33) = 8.745, p = .01). Barriers included inner setting (e.g. allocated time for learning) and characteristics of individuals (e.g. resistance). Facilitators included intervention characteristics (e.g. credible sources), inner setting (e.g. leadership) and outer setting domains (e.g. patient needs). Clinical champions were identified as an important component of the implementation process.ConclusionsThe PCC training package effectively improved identification of comorbidity, self-efficacy and attitudes towards screening and monitoring of comorbidity. Specific barriers included provision of allocated time for learning. Specific facilitators included provision of a credible clinical supervisor, strong leadership engagement and an active clinical champion.

show abstract

The role of clinical champions in facilitating the use of evidence-based practice in drug and alcohol and mental health settings: A systematic review

Cited by 56 publications

References 57 publications

A conceptual model to guide research on the activities and effects of innovation champions

A conceptual model to guide research on the activities and effects of innovation champions

Dissemination Science in School Mental Health: A Framework for Future Research

Implementation of a multi-modal training program for the management of comorbid mental disorders in drug and alcohol settings: Pathways to Comorbidity Care (PCC)

Contact Info

Product

Resources

About