The State Policy Context of Implementation Issues for Evidence-Based Practices in Mental Health

Isett, Kimberley R.; Burnam, M. Audrey; Coleman-Beattie, Brenda; Hyde, Pamela S.; Morrissey, J; Magnabosco, Jennifer L.; Rapp, Charles A.; Ganju, Vijay; Goldman, Howard H.

doi:10.1176/ps.2007.58.7.914

Cited by 119 publications

(42 citation statements)

References 14 publications

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“…[18][19][20][21] We then conducted analyses to create a model of implementation barriers and facilitators that can serve as a heuristic for policymakers and researchers and can be tested in real-world settings. This inquiry thus complements recent work examining factors affecting EBP implementation at the state level 22 and for other public sectors such as child welfare systems. 23,24 This discussion raises the question of the meaning of evidence when one considers multiple stakeholder perspectives across system levels.…”

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confidence: 62%

Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis

et al. 2009

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Objectives. We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Methods. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Results. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Conclusions. Implementation of EBP is a complex process. Cross-system–level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns.

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confidence: 62%

Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis

et al. 2009

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“…Leaders have multiple means to communicate the commitment to EBPs, including a commitment of resources, mission statements, and internal and external collaborations. 19,51,52 Various methods SSA policymakers can use to promulgate their expectations include state-provider contracts, design of RFPs and grant funding decisions, licensing regulations, quality improvement plans, and media dissemination (e.g., newsletters, reports, press releases, and presentations). 15,52 Of course, these efforts are dependent on appropriate financial support.…”

Section: Discussionmentioning

confidence: 99%

“…19,51,52 Various methods SSA policymakers can use to promulgate their expectations include state-provider contracts, design of RFPs and grant funding decisions, licensing regulations, quality improvement plans, and media dissemination (e.g., newsletters, reports, press releases, and presentations). 15,52 Of course, these efforts are dependent on appropriate financial support. Therefore, state effort and strategies to increase adoption of EBPs are encouraging, but without attention to key issues such as financing, implementation possibilities may be minimized.…”

Section: Discussionmentioning

confidence: 99%

Implementation of Evidence-Based Practices for Treatment of Alcohol and Drug Disorders: The Role of the State Authority

Rieckmann

Kovas

Fussell

et al. 2008

J Behav Health Serv Res

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The current climate of increasing performance expectations and diminishing resources, along with innovations in evidence-based practices (EBPs), creates new dilemmas for substance abuse treatment providers, policymakers, funders, and the service delivery system. This paper describes findings from baseline interviews with representatives from 49 state substance abuse authorities (SSAs). Interviews assessed efforts aimed at facilitating EBP adoption in each state and the District of Columbia. Results suggested that SSAs are concentrating more effort on EBP implementation strategies such as education, training, and infrastructure development, and less effort on financial mechanisms, regulations, and accreditation. The majority of SSAs use EBPs as a criterion in their contracts with providers, and just over half reported that EBP use is tied to state funding. To date, Oregon remains the only state with legislation that mandates treatment expenditures for EBPs; North Carolina follows suit with legislation that requires EBP promotion within current resources.

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“…Barriers may exist when policies or mandates for EBP use are enacted without incentives or other changes to the system to support their adoption, integration, and sustainment. While scant, the literature on funding and financing EBPs in healthcare indicates that funding plays an important role in obtaining training in EBPs, its implementation, and sustainment (Bond et al, 2014;Isett et al, 2007;Magnabosco, 2006;Massatti, Sweeney, Panzano, & Roth, 2008;Swain, Whitley, McHugo, & Drake, 2010). Incentives may be useful and may include financial incentives as well as the benefits associated with an improved work environment or reputation associated with EBP use (Mendel et al, 2008).…”

Section: The System Levelmentioning

confidence: 99%

Contextual Influences and Strategies for Dissemination and Implementation in Mental Health

Wolk

Powell

Beidas

2015

Oxford Handbook Topics in Psychology

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Implementation science has emerged to bridge the gap between research and practice. A number of conceptual frameworks have been developed to advance implementation research and illuminate the contextual influences that can facilitate or impede the implementation of evidence-based practices. Contextual factors that may be important in the dissemination and implementation of evidence-based practice may occur at the system-, organizational-, and provider-levels. System-level barriers may include external policies, incentives, and peer pressure. Organizational-level factors that are important in implementation include organizational culture and climate and implementation climate. At the individual provider-level, barriers may occur around provider attitudes, knowledge, and self-efficacy. Finally, additional barriers such as client-level that can be used to overcome contextual barriers when attempting to implement evidence-based practices into new settings. Several exemplar implementation strategies are discussed, including the Availability, Responsiveness, and Continuity intervention, Community Development Team model, and Interagency Collaborative Team Model. Abstract and KeywordsImplementation science has emerged to bridge the gap between research and practice. A number of conceptual frameworks have been developed to advance implementation research and illuminate the contextual influences that can facilitate or impede the implementation of evidence-based practices. Contextual factors that may be important in the dissemination and implementation of evidence-based practice may occur at the system-, organizational-, and provider-levels. System-level barriers may include external policies, incentives, and peer pressure. Organizational-level factors that are important in implementation include organizational culture and climate and implementation climate. At the individual provider-level, barriers may occur around provider attitudes, knowledge, and self-efficacy. Finally, additional barriers such as client-level factors and characteristics of the intervention itself can exist. Implementation strategies have been developed that can be used to overcome contextual barriers when attempting to implement evidence-based practices into new settings. Several exemplar implementation strategies are discussed, including the Availability, Responsiveness, and Continuity intervention, Community Development Team model, and Interagency Collaborative Team Model.

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The State Policy Context of Implementation Issues for Evidence-Based Practices in Mental Health

Abstract: States are key to implementing evidence-based practices, but state mental health authorities should note that each of the practices requires different skill sets and involves different stakeholders. Thus implementing many evidence-based practices at once may not yield economies of scale.

Cited by 119 publications

References 14 publications

Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis

Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis

Implementation of Evidence-Based Practices for Treatment of Alcohol and Drug Disorders: The Role of the State Authority

Contextual Influences and Strategies for Dissemination and Implementation in Mental Health

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