Category: Dissemination / Implementation

Symposium

Associations Between Use of Implementation Supports and Attitudes Among Community Mental Health Agency Leaders

Saturday, November 18
10:15 AM - 11:15 AM
Location: Sapphire Ballroom E & F, Level 4, Sapphire Level

Keywords: Implementation | Evidence-Based Practice
Presentation Type: Symposium

Implementation supports (e.g., ongoing consultation, staffing) are critical to the successful uptake of evidence-based practices (EBPs) in community mental health settings and agency leaders often help decide which EBPs and supports to implement. However, little is known about the extent to which supports are used in implementation efforts in routine care settings and how administrative leaders’ attitudes toward EBPs are related to implementation supports used. It is possible that leaders’ attitudes toward EBPs drive which EBPs and supports are utilized. Alternatively, it is possible the type of supports implemented drive attitudes toward the practices. More research is needed to understand these relations. The Prevention and Early Intervention (PEI) Transformation, a large-scale system reform in Los Angeles County providing reimbursement to a limited set of evidence-based or evidence-informed practices, provides a unique context to investigate supports in community agencies implementing multiple EBPs for youth. The present study examines the use of implementation supports in agencies delivering six specific PEI practices, differences in supports by practice, and the association between support type and agency leader attitudes toward EBPs. Leaders (N = 161) from 59 agencies completed an online survey regarding agency characteristics, supports, and attitudes toward EBPs. Leaders reported utilizing a range of implementation support strategies with 11/17 rated as used with moderate to high intensity on a 0-6 Likert scale. For supervision practices, case discussion (M = 5.1, SD = 1.23) and client progress monitoring (M = 4.24, SD = 1.41) were used most intensively. Live observation (M = 1.84, SD = 1.03) and session recording review (M = 2.15, SD = 1.27) were used least intensively. Attitudes were generally favorable across practices (M = 27.56, SD = 7.06). Both attitudes and the intensity of most types of supports varied by practice (p < .001). Hierarchical linear modeling with individual practices (L1) nested within leaders (L2) nested within agencies (L3) indicated that supervision practices (b = 0.12, t = 2.49, p = 0.01), adequate facilities (b = 1.18, t = 3.67, p = 0.000), adequate number of  trained therapists(b = 0.84, t = 2.78, p = 0.006), and ongoing training (b = 0.40, t = 2.03, p = 0.04) predicted more favorable leader attitudes toward PEI practices. Findings suggest that it may be useful to pair implementation supports strategically with specific practices to facilitate leader buy-in toward the practices and, ultimately, implementation.

Jennifer Regan

Hathaway-Sycamores Child and Family Services

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