The Organizational Financial Context of Publicly-Funded Mental Health Clinics: Development and Preliminary Psychometric Evaluation of the Agency Financial Status Scales
The Organizational Financial Context of Publicly-Funded Mental Health Clinics: Development and Preliminary Psychometric Evaluation of the Agency Financial Status Scales
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DOI：
10.1007/s10488-021-01128-4
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发表时间：
2021-03-19
影响因子：
2.6
通讯作者：
Beidas, Rinad S.
中科院分区：
文献类型：
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作者：
Maxwell, Colleen A.;Ehrhart, Mark G.;Beidas, Rinad S.
资金是在公共资助的社区心理健康诊所 (CMHC) 中实施循证实践 (EBP) 的主要障碍。了解如何最好地部署解决这一障碍的实施策略需要更清晰地了解机构内部的财务背景。我们开发了机构财务状况量表 (AFSS)，以评估员工对组织中三种假设和理论资金相关结构水平的看法：(a) 对财务健康状况的看法，(b) 对 EBP 的财务态度，以及 (c) 战略财务环境。本次调查是对该措施的初步评估。参与者包括来自 25 家为年轻人提供门诊心理健康服务的公共资助 CMHC 的 239 名治疗师和 40 名督导员。采用验证性因素分析来研究项目的潜在特征结构。还检查了内部一致性、参与者间一致性、治疗师和督导者之间的一致性以及收敛效度。衡量财务健康状况和战略金融环境认知的双因素模型最适合该数据。对于这两种量表，阿尔法可靠性是可以接受的，并且协议统计数据为组织级别的聚合提供了适度的支持。分析支持量表的收敛有效性。 AFSS 的制定和初步评估是了解公共资助的 CMHC 财务背景的重要第一步。尽管这项调查的结果很有希望，但还需要进行额外的开发和测试，以更全面地了解其结构并提高该措施的有效性和可靠性。
Funding is a major barrier to implementation of evidence-based practices (EBPs) in publicly-funded community mental health clinics (CMHCs). Understanding how best to deploy implementation strategies that address this barrier requires greater clarity on the financial context within agencies. We developed the Agency Financial Status Scales (AFSS) to assess employee perceptions of the level of three hypothesized and theoretical funding related constructs in organizations: (a) perceptions of financial health, (b) financial attitudes toward EBPs, and (c) strategic financial climate. This investigation serves as a preliminary evaluation of this measure. Participants were 239 therapists and 40 supervisors from 25 publicly-funded CMHCs providing outpatient mental health services for young people. Confirmatory factor analysis was used to investigate the latent trait structure of the items. Internal consistency, interrater agreement, concordance between therapists and supervisors, and convergent validity were also examined. A two-factor model measuring perceptions of financial health and strategic financial climate best fit the data. For both of these scales, alpha reliability was acceptable and agreement statistics provided moderate support for aggregation at the organizational level. Analyses supported the convergent validity of the scales. The development and preliminary evaluation of the AFSS is an important first step in understanding the financial context of publicly-funded CMHCs. Though findings from this investigation are promising, additional development and testing are needed to develop a more thorough understanding of the constructs and to improve the validity and reliability of this measure.