Organizational Factors Influencing Best Practices Adoption

描述(由申请者提供)：本项目建立在组织对内部结构(例如，文化和气候)的研究中获得的知识，这些结构可能会阻碍或加强基于证据的实践(EBP)在社区精神卫生组织中的实施。以社区为基础的精神卫生组织(CBIVIHO)被定义为向个人和/或家庭提供健康和与人类相关的服务(例如，生物-心理-社会评估、咨询和/或转介服务)的组织。这项先导性研究试图回答这样一个问题，即社区精神卫生组织内的文化和/或气候是否预测该组织将采取新的循证干预措施的可能性。这项研究将筛选在纽约西部社区心理健康组织工作的一线临床医生，使用Glisson(2002)的组织社会背景(OSC)来评估机构文化和环境。从这个心理健康组织池中，将邀请三个文化和气候得分“不太理想”的机构和三个文化和气候得分“理想”的机构参加。这项研究旨在为社区精神卫生组织(CBMHO)提供服务，这些组织为大量人提供服务，但不提供针对酒精的服务。在取得六个机构的样本后，他们的前线工作人员将接受培训，以采用NIAAA的2005年临床指南的筛查和简短干预。培训结束后，将每月对干预措施的使用情况进行评估，总共为期六个月。在为期六个月的研究结束时，还将进行定性调查，以评估采取或不采取干预措施的决定考虑了哪些因素。在量化数据收集正式结束后，将在这六个组织中的每个组织举办一个重点小组。总体而言，这项试点研究试图确定组织的文化和气候通过哪些机制影响采用基于经验的酒精筛查，并在CBMHO中进行短暂干预，而不是专门提供与酒精相关的服务。

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.