Organizational factors influencing implementation of evidence-based practices for integrated treatment in behavioral health agencies.
Organizational factors influencing implementation of evidence-based practices for integrated treatment in behavioral health agencies.
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DOI：
10.1155/2014/802983
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发表时间：
2014
影响因子：
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通讯作者：
Aarons GA
中科院分区：
文献类型：
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作者：
Bonham CA;Sommerfeld D;Willging C;Aarons GA
Objective.近年来，新墨西哥州在其公共行为卫生系统中优先考虑对同时发生的精神健康和物质使用障碍进行综合治疗。本报告描述了在社区机构实施循证实践（EBP）时可能很重要的因素。 方法.我们的混合方法的研究设计包括观察，半结构化访谈，并在基线和18个月后与14个机构的员工进行调查。我们开发了四个机构类型的基础上迭代编码和分析的观察和采访。然后，我们检查了来自四个示范机构的员工的调查数据，以验证定性结果。结果财政资源和强有力的领导影响了机构培训供应商和实施循证业务的能力。定量分析服务提供商的调查答复，这些机构（N = 38）支持定性的研究结果，并表现出显着的平均得分差异的领导，组织气氛和对EBP的态度在预期的方向。结论在这项对新墨西哥州社区机构的研究中，强有力的领导和财政资源的可用性是初步实施成功的关键组成部分。如果士气低落的工作环境导致雇员更替，那么仅仅依赖外部资金就有可能造成维持风险。强有力的机构领导并不总能弥补脆弱社区财政资源的不足。
Objective. In recent years, New Mexico has prioritized integrated treatment for cooccurring mental health and substance use disorders within its public behavioral health system. This report describes factors likely to be important when implementing evidence-based practices (EBPs) in community agencies. Methods. Our mixed-method research design consisted of observations, semistructured interviews, and surveys undertaken with employees at 14 agencies at baseline and after 18 months. We developed four-agency typologies based on iterative coding and analysis of observations and interviews. We then examined survey data from employees at the four exemplar agencies to validate qualitative findings. Results. Financial resources and strong leadership impacted agency capacity to train providers and implement EBPs. Quantitative analysis of service provider survey responses from these agencies (N = 38) supported qualitative findings and demonstrated significant mean score differences in leadership, organizational climate, and attitudes toward EBPs in anticipated directions. Conclusion. The availability of strong leadership and financial resources were key components to initial implementation success in this study of community agencies in New Mexico. Reliance only on external funding poses risks for sustainment when demoralizing work climates precipitate employee turnover. Strong agency leadership does not always compensate for deficient financial resources in vulnerable communities.