The Sustainability of Evidence-Based Practices in Routine Mental Health Agencies

Abstract

The research presented here reports on sustainability of the practices within the National Implementing Evidence Based Practices Project for people with serious mental illness. Forty-nine sites completed the initial 2-year implementation phase and were the focus of our study. Our aims were to discern the number of sites that sustained practices 2 years after implementation, the reasons for sustaining or not sustaining, differences in characteristics between the two groups, and the extent and nature of practice adaptations. We used a mixed-methods approach, based on a telephone survey that gathered qualitative and quantitative data from site representatives and others familiar with the sites and practices during the follow-up period. We found that 80% of sites sustained their practices for 2 years post-implementation, that sustainers differed from non-sustainers in several domains: financing, training, fidelity and agency leadership, and that most sites adapted practices moderately to meet state and local needs.

Improving the Dual Diagnosis Capability of Addiction and Mental Health Treatment Services: Implementation Factors Associated With Program Level Changes

“…These studies have found that administrative leadership, external consultation and training, supervisor mastery and actual supervision, staff stability, and financial support were all associated with fidelity to IDDT over time McHugo et al, 2007;Swain, Whitley, McHugo, & Drake, 2010). These same components were replicated by Rapp and colleagues (2008) in a qualitative study of the implementation of IDDT and supported employment.…”

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

“…They are outer contextual factors (e.g., sociopolitical context, funding environment), inner contextual or organizational factors (e.g., financial resources, leadership, program champions, organizational support, staff stability, policy alignment), processes (e.g., training, strategic planning, stakeholder engagement, partnerships), intervention characteristics (e.g., adaptability, fit with context and population, benefits/effectiveness), and implementer characteristics (e.g., skills, attitude, motivations) (15,115,118,135,139).…”

Assessing program sustainability in an eating disorder prevention effectiveness trial delivered by college clinicians

“…Basic components proposed to facilitate sustainability include program usefulness, cost effectiveness, fit with agency mission and the skills of available providers, program adaptability, and natural sources of funding (Hans & Weiss, 2005; Jana, Basu, Rotheram-Borus, & Newman, 2004; Scheirer, 2005; Swain et al, 2010). Johnson et al (2004) proposed a conceptual model to guide sustainability, which begins with two causal factors of an existing infrastructure (e.g., internal resources and policies, internal leaders championing innovation) and innovation attributes such as the program aligning with perceived needs, positive relations among the key implementers, and ownership by the prevention stakeholders.…”

“…The report has three aims: (1) Describe the reactions of participating clinicians to the intervention, training, and supervision processes; (2) Examine the extent to which the Body Project continued to be delivered in the two years following study involvement; and (3) Describe perceived barriers to program sustainability. Following the practice generally used in sustainability research (e.g., Swain, Whitley, McHugo, & Drake, 2010), we created qualitative and quantitative items specific to the setting, assessing the occurrence of barriers related to three main categories: students (e.g., student lack of interest, stigma associated with participation, competing time demands for students), staff (e.g., insufficient training, inadequate supervision, time constraints), and the system (e.g., cost, staff availability, space limitations). To our knowledge, no previous research has focused on the sustainability of eating disorder prevention programs.…”