The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study
The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study
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DOI：
10.1186/1748-5908-7-56
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发表时间：
2012-06-22
影响因子：
7.2
通讯作者：
Landsverk, John A.
中科院分区：
文献类型：
--
作者：
Aarons, Gregory A.;Glisson, Charles;Landsverk, John A.
背景资料：尽管有科学证据的支持，在某些情况下甚至有立法或监管行动，但社区精神卫生组织并没有例行采用循证实践。我们研究了临床医生对循证实践的态度与组织文化，气候和美国精神卫生组织全国代表性样本的其他特征之间的关系。在人，组管理的调查进行了抽样1，在美国26个州的100个心理健康服务机构的全国样本中，有112个心理健康服务提供者。本研究探讨了这些协会与两个层次的分层线性模型（HLM）分析的反应，以证据为基础的实践态度量表（EBPAS）在个人临床医生的水平作为一个功能的组织社会背景（OSC）措施在组织层面，控制其他组织和临床医生的特点。我们发现，更熟练的组织文化和更多的参与和压力较小的组织气氛与积极的临床医生态度，采用循证实践。研究结果表明，组织干预策略，以改善组织的社会背景下的精神卫生服务可能有助于成功的循证实践传播和实施的努力，通过影响临床医生的态度。
Background: Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States.Methods: In-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics.Results: We found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice.Conclusions: The findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes.