Organizational Factors Influencing Best Practices Adoption

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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.