Systems antecedents for dissemination and implementation: a review and analysis of measures.

Dana-Farber Cancer Institute/Harvard School of Public Health, Boston, MA, USA.
Health Education &amp Behavior (Impact Factor: 1.54). 07/2011; 39(1):87-105. DOI: 10.1177/1090198111409748
Source: PubMed

ABSTRACT There is a growing emphasis on the role of organizations as settings for dissemination and implementation. Only recently has the field begun to consider features of organizations that affect dissemination and implementation of evidence-based interventions. This manuscript identifies and evaluates available measures for five key organizational-level constructs: (a) leadership, (b) vision, (c) managerial relations, (d) climate, and (e) absorptive capacity. Overall the picture was the same across the five constructs--no measure was used in more than one study, many studies did not report the psychometric properties of the measures, some assessments were based on a single response per unit, and the level of the instrument and analysis did not always match. One must seriously consider the development and evaluation of a robust set of measures that will serve as the basis of building the field, allow for comparisons across organizational types and intervention topics, and allow a robust area of dissemination and implementation research to develop.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Through two case studies of Catholic parishes in Massachusetts, this study explores the implications of leader-centered versus distributed leadership in Catholic parishes for the implementation of evidence-based health interventions. The two parishes involved in the study differ from each other in several ways. In the first, parishioners are less engaged in leadership activities at the decision-making level in the parish. A small group of lay volunteers work with the parish priest and other ordained leaders on parish activities. In the second parish, a large and active lay volunteer leadership have forged an organizational structure that allows more independence from the pastor’s direct oversight. In this parish, lay volunteer leaders are the prime drivers of organizational programs and events. In 2012-2013, three types of networks were assessed at each parish: discussion, collaboration, and outside-of-parish ties. The contrasts between each parish include differences in density of collaboration, in frequency of discussion, and network centrality of the respective parish priests. We further identified key actors in the network structures at each parish. We discuss the implications of these findings for understanding organizational capacity in the context of health program implementation.
    Social Science [?] Medicine 10/2014; DOI:10.1016/j.socscimed.2014.10.012 · 2.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this article is to provide insight into how the presence of diverging organizational logics influences the outcome of worksite health promotion projects. The study is based on a one-year qualitative single-case study of the implementation of a health promotional physical exercise pro-gram in a transnational transport and logistics company based in Norway. While the program that was implemented was based on dominant logics in Norway, i.e., the emphasis on worker participa-tion and influence, the organizational logics of the transport company defined company–worker relationships in other terms. We found that the logic of a highly specialized work organization that combined strict work distribution with a set of narrowly 1 defined work tasks contradicted the logic that underpinned the health promotional program, and that this contradiction is an important reason why the initiative failed. We therefore conclude that in implementing health promotion projects at the workplace, there is a need to observe the relationship between logics related both to the project and to the organization.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Although the importance of the organizational environment for implementing evidence-based practices (EBP) has been widely recognized, there are limited options for measuring implementation climate in public sector health settings. The goal of this research was to develop and test a measure of EBP implementation climate that would both capture a broad range of issues important for effective EBP implementation and be of practical use to researchers and managers seeking to understand and improve the implementation of EBPs.Methods Participants were 630 clinicians working in 128 work groups in 32 US-based mental health agencies. Items to measure climate for EBP implementation were developed based on past literature on implementation climate and other strategic climates and in consultation with experts on the implementation of EBPs in mental health settings. The sample was randomly split at the work group level of analysis; half of the sample was used for exploratory factor analysis (EFA), and the other half was used for confirmatory factor analysis (CFA). The entire sample was utilized for additional analyses assessing the reliability, support for level of aggregation, and construct-based evidence of validity.ResultsThe EFA resulted in a final factor structure of six dimensions for the Implementation Climate Scale (ICS): 1) focus on EBP, 2) educational support for EBP, 3) recognition for EBP, 4) rewards for EBP, 5) selection for EBP, and 6) selection for openness. This structure was supported in the other half of the sample using CFA. Additional analyses supported the reliability and construct-based evidence of validity for the ICS, as well as the aggregation of the measure to the work group level.Conclusions The ICS is a very brief (18 item) and pragmatic measure of a strategic climate for EBP implementation. It captures six dimensions of the organizational context that indicate to employees the extent to which their organization prioritizes and values the successful implementation of EBPs. The ICS can be used by researchers to better understand the role of the organizational context on implementation outcomes and by organizations to evaluate their current climate as they consider how to improve the likelihood of implementation success.
    Implementation Science 10/2014; 9(1):157. DOI:10.1186/s13012-014-0157-1 · 3.47 Impact Factor


Available from