Organizational Factors Influencing Best Practices Adoption

描述（由申请人提供）：本项目建立在对内部结构（例如，文化和气候），可能会阻碍或加强循证实践（EBP）的实施，以社区为基础的精神卫生组织。社区精神卫生组织（CBIVIHO）被定义为提供健康和人类相关服务的组织（例如，生物-心理-社会评估、咨询和/或转诊服务）。这项试点研究试图回答一个问题，即社区精神卫生组织内的文化和/或气候是否预测了该组织采用新的循证干预措施的可能性。这项研究将使用Glisson（2002）的组织社会背景（OSC）来评估机构文化和气候，筛选在西纽约社区精神卫生组织工作的一线临床医生。从这个心理健康组织库中，三个具有“不太理想”的文化和气候分数的机构和三个具有“理想”的文化和气候分数的机构将被邀请参加。这项研究的对象是社区精神卫生组织（CBMHO），这些组织为大量人群提供服务，但不提供针对酒精的服务。在获得六个组织的样本后，他们的前线工作人员将接受培训，以采用NIAAA的2005年临床指南的筛选和简短的干预。培训结束后，将每月对干预措施的使用情况进行评估，共持续六个月。在为期六个月的研究结束时，还将进行定性调查，以评估决定采用或不采用干预措施的因素。在定量数据收集工作正式结束后，将在六个组织中的每一个组织设立一个重点小组。总的来说，这项试点研究试图确定一个组织的文化和气候影响采用基于酒精的酒精筛查和简短的干预CBMHO内不专门提供酒精相关服务的机制。 公共卫生相关性：该项目与公共卫生的相关性在于，它将使目前不提供任何酒精相关服务的社区组织能够将酒精筛查和简短干预纳入其系统。由于这些社区组织为许多人服务，它们可以降低有高风险饮酒问题的个人的整体健康风险。

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.