One size fits all? A latent Profile Analysis to Identify Care Professional Subgroups Based on Implementation Determinants

Abstract

Introduction: Recent research emphasizes the need for a more holistic approach to implementation science, ackonowledging complex interactions among implementation determinants and heterogeneity in context and care professionals (CPs). To verify this need, we aimed to identify distictive subgroups of CPs based on their unique profiles of implementation determinants concerning the Childcheck, a guideline facilitating early identification of child abuse based on parental characteristics. We also explored the influence of organization type on subgroups of CPs with specific implementation characteristics (subgroup membership) and assessed their relationship to CPs implementation level. Methods: A total of 562 Dutch CPs in Mental Health Care (aMHC) and Forensic Care settings (Forensic MHC, Probation Service, and The Salvation Army) completed a self-reported questionnaire on Childcheck implementation determinants. We conducted Latent Profile Analysis to identify subgroups of CPs. The influence of organization type on subgroup membership was examined using Chi-Squared test and we explored the impact of subgroup membership on implementation levels using a one-way ANOVA. Results: We identified five distinct subgroups. Subgroup A (Reporting Center for Child Abuse and Neglect (RCCAN) collaboration issues, 11.7%) faced issues related to the external organization, such as feedback and collaboration issues. Subgroup B (RCCAN collaboration and organizational issues, 5.0%) encountered challenges with both the external and internal organization, including issues with financial resources and formal agreements, resulting in the lowest implementation level. Subgroup C (Limited implementation issues, 9.4%) demonstrated relatively high ratings across determinants, achieving the highest implementation level. CPs in subgroup D (CP-client interaction issues, 37.7%) encountered challenges specifically in CP-client interaction. CPs in subgroup E (Indifferent attitudes towards implementation, 36.1%) expressed low to average retings and was predominantly represented by CPs in aMHC settings. This subgroup also reported a low to average implementation level. Conclusions: This study highlights the importance of tailored implementation plans to address each subgroup's specific needs and challenges, instead of employing a one-size-fits-all approach. Latent Profile Analysis successfully revealed the variations in implementation determinants among CPs in aMHC and Forensic Care settings. Tailoring implementation strategies for these subgroups is key to successful guideline implementation and enhancing the well-being of vulnerable children and families.