Adoption of evidence-based practices in community mental health: a mixed-method study of practitioner experience.
ABSTRACT This mixed method study examined practitioners as they adopted four evidence-based practices (EBPs) in a community mental health center. In-depth semi-structured interviews; a measure of EBPs attitudes; and a final focus-group were used over a 2-year study period to assess 14 mental health practitioners on one immersion team. The framework for data collection was adapted from organizational theories that view culture and climate as mediating factors. Analysis of practitioner themes demonstrated that there were facilitating and impeding factors in the adoption process. Practitioners reported positive changes in their individual competency but two years was inadequate for training on four EBPs. Involvement of agency administration and consistent supervision were regarded by practitioners as crucial to successful adoption of EBPs.
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- "The process of mixing methods in the large majority (n = 18) of these studies involved embedding the qualitative study within the larger quantitative study. In one study (Gioia and Dziadosz 2008 "
ABSTRACT: Purposeful sampling is widely used in qualitative research for the identification and selection of information-rich cases related to the phenomenon of interest. Although there are several different purposeful sampling strategies, criterion sampling appears to be used most commonly in implementation research. However, combining sampling strategies may be more appropriate to the aims of implementation research and more consistent with recent developments in quantitative methods. This paper reviews the principles and practice of purposeful sampling in implementation research, summarizes types and categories of purposeful sampling strategies and provides a set of recommendations for use of single strategy or multistage strategy designs, particularly for state implementation research.Administration and Policy in Mental Health and Mental Health Services Research 11/2013; 42(5). DOI:10.1007/s10488-013-0528-y · 3.44 Impact Factor
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ABSTRACT: Implementing quality improvement efforts in clinics is challenging. Assessment of organizational "readiness" for change can set the stage for implementation by providing information regarding existing strengths and deficiencies, thereby increasing the chance of a successful improvement effort. This paper discusses organizational assessment in specialty mental health, in preparation for improving care for individuals with schizophrenia. To assess organizational readiness for change in specialty mental health in order to facilitate locally tailored implementation strategies. EQUIP-2 is a site-level controlled trial at nine VA medical centers (four intervention, five control). Providers at all sites completed an organizational readiness for change (ORC) measure, and key stakeholders at the intervention sites completed a semi-structured interview at baseline. At the four intervention sites, 16 administrators and 43 clinical staff completed the ORC, and 38 key stakeholders were interviewed. The readiness domains of training needs, communication, and change were the domains with lower mean scores (i.e., potential deficiencies) ranging from a low of 23.8 to a high of 36.2 on a scale of 10-50, while staff attributes of growth and adaptability had higher mean scores (i.e., potential strengths) ranging from a low of 35.4 to a high of 41.1. Semi-structured interviews revealed that staff perceptions and experiences of change and decision-making are affected by larger structural factors such as change mandates from VA headquarters. Motivation for change, organizational climate, staff perceptions and beliefs, and prior experience with change efforts contribute to readiness for change in specialty mental health. Sites with less readiness for change may require more flexibility in the implementation of a quality improvement intervention. We suggest that uptake of evidence-based practices can be enhanced by tailoring implementation efforts to the strengths and deficiencies of the organizations that are implementing quality improvement changes.Journal of General Internal Medicine 01/2010; 25 Suppl 1(Suppl 1):27-31. DOI:10.1007/s11606-009-1133-3 · 3.42 Impact Factor
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ABSTRACT: The translation and adoption of evidence-based practice principles has proved to be more difficult than researchers anticipated. Schools of social work are in a unique position to support this process within their home communities. Using the evidence-based practice process steps outlined by previous researchers, this article identifies specific strategies that schools of social work can adopt to support their broader communities as they attempt to adopt and sustain empirically supported interventions.Journal of Evidence-Based Social Work 10/2010; 7(5):400-11. DOI:10.1080/15433711003591101