Organizational Factors Influencing Best Practices Adoption

描述（由申请人提供）：本项目建立在组织对内部结构（例如，文化和气候）的组织研究所得的知识基础上，这些组织研究可以阻碍或加强社区精神卫生组织内基于证据的实践（EBP）的实施。社区精神卫生组织（CBIVIHOs）的定义是向个人和/或家庭提供健康和与人有关的服务（如生物-心理-社会评估、咨询和/或转诊服务）的组织。本初步研究试图回答这样一个问题：以社区为基础的精神卫生组织的文化和/或气候是否预测该组织将采用新的循证干预的可能性。本研究将使用Glisson（2002）的组织社会背景（OSC）来筛选在纽约西部社区精神卫生组织工作的一线临床医生，以评估机构文化和气候。从这些心理健康组织中，将邀请文化和气候得分“不理想”的三家机构和文化和气候得分“理想”的三家机构参加。本研究旨在为社区精神卫生组织（CBMHOs）服务大量人群，但不提供酒精特定服务。在获得六个组织的样本后，将对其一线工作人员进行培训，使其采用NIAAA 2005年临床指南的筛查和简短干预。在培训之后，每个月将对干预措施的利用情况进行评估，为期6个月。在为期六个月的研究结束时，还将进行定性调查，以评估哪些因素影响了采用或不采用干预措施的决定。定量数据收集正式结束后，将在六个组织中分别进行焦点小组讨论。总体而言，本试点研究试图确定组织文化和气候如何影响在不专门提供酒精相关服务的cbmo中采用基于经验的酒精筛查和简短干预的机制。

DESCRIPTION (provided by applicant): This project builds on the knowledge drawn from organizational research on internal structures (e.g., culture and climate) that can impede or enhance evidenced-based practice (EBP) implementation within community- based mental health organizations. Community-based mental health organizations (CBIVIHOs) are defined as organizations that provide health and human-related services (e.g., bio-psycho-social assessments, counseling and/or referral services) to individuals and/or families. This pilot study seeks to answer the question of whether the culture and/or climate within a community- based mental health organization predicts the likelihood that the organization will adopt a new evidence- based intervention. The study will screen front-line clinicians working in Western New York community-based mental health organizations using Glisson's (2002) Organizational Social Context (OSC) to assess agency culture and climate. From of this pool of mental health organizations, three agencies having "less than ideal" culture and climate scores and three agencies having "ideal" culture and climate scores will be invited to participate. This study is intended for community-based mental health organizations (CBMHOs) that serve a large number of people but do not provide alcohol-specific services. After obtaining the sample of six organizations, their front-line staff will be trained to adopt NIAAA's 2005 Clinical Guide's screening and brief intervention. Following that training, the utilize of the intervention will be measured each month for a total of six-months. At the end of the six-month study a qualitative investigation will also be conducted in order to evaluate what factors went into the decision to adopt, or not adopt the intervention. A focus group will be conducted at each of the six organizations after quantitative data collection officially ends. Overall, this pilot study attempts to identify mechanisms through which an organization's culture and climate influence the adoption of an empirically-based alcohol screening and brief intervention within CBMHOs not specifically providing alcohol- related services. PUBLIC HEALTH RELEVANCE: The relevance of this project to public health is that it will enable CBOs that do not currently provide any alcohol-related services to integrate an alcohol screening and brief intervention into its system. Because these CBOs serve many people, they could decrease the overall health risk for individuals who have a high-risk drinking problem.