Systems Antecedents for Dissemination and Implementation

Emmons, Karen M.; Weiner, Bryan J.; Fernández, María E.; Tu, Shin Ping

doi:10.1177/1090198111409748

Cited by 66 publications

(74 citation statements)

References 72 publications

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“…Moreover, several have unreported or poorly reported psychometric properties or have been applied in just a single study (25,31,100). Emmons et al (25) found highly variable and poor score reliabilities across studies (i.e., α < 0.70), factor structures that were unique to each study, use of a single rater to assess an organization's culture and climate, and inappropriate composition models for constructing items and aggregating individual-level responses.…”

Section: Assessing Organizational Culture and Climate In Mental Healtmentioning

confidence: 99%

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

Glisson

Williams

2015

Annu. Rev. Public Health

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Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness.

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Section: Assessing Organizational Culture and Climate In Mental Healtmentioning

confidence: 99%

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

Glisson

Williams

2015

Annu. Rev. Public Health

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“…The CFIR framework posits that the implementation process can be organized into five core domains: outer setting, inner setting, intervention characteristics, characteristics of individuals, and process planning. We further refined the surveys and interview guides by reviewing relevant literature and consulting experts in the areas of clinic readiness, adaptive reserve, implementation climate, and community health center settings [10][11][12]. The pre-and 1-year post-implementation assessments included an organizational survey, an in-depth leadership interview, and a provider survey.…”

Section: Emr Toolsmentioning

confidence: 99%

Implementation successes and challenges in participating in a pragmatic study to improve colon cancer screening: perspectives of health center leaders

Coronado

Schneider

Petrik

et al. 2017

Behav. Med. Pract. Policy Res.

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Little is known about the challenges faced by community clinics who must address clinical priorities first when participating in pragmatic studies. We report on implementation challenges faced by the eight community health centers that participated in Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), a large comparative effectiveness cluster-randomized trial to evaluate a directmail program to increase the rate of colorectal cancer (CRC) screening. We conducted interviews, at the onset of implementation and 1 year later, with center leaders to identify challenges with implementing and sustaining an electronic medical record (EMR)-driven mailed program to increase CRC screening rates. We used the Consolidated Framework for Implementation Research to thematically analyze the content of meeting discussions and identify anticipated and experienced challenges. Common early concerns were patients' access to colonoscopy, patients' low awareness of CRC screening, time burden on clinic staff to carry out the STOP CRC program, inability to accurately identify eligible patients, and incompatibility of the program's approach with the patient population or organizational culture. Once the program was rolled out, time burden remained a primary concern and new organizational capacity and EMR issues were raised (e.g., EMR staffing resources and turnover in key leadership positions). Cited program successes were improved CRC screening processes and rates, more patients reached, reduced costs, and improved patient awareness, engagement, or satisfaction. These findings may inform any clinic considering mailed fecal testing programs and future pragmatic research efforts in community health centers.

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“…A further difficulty is in measuring the components of the available models. Measurement allows implementation leaders to identify barriers, and then to monitor progress in reducing these during a change project (Gagnon et al 2011;Emmons et al 2012;Finch et al 2012) but available survey tools have limited testing and unclear links with published change models (Scott et al 2003;Weiner et al 2008;Finch et al 2012 ).…”

Section: Practice Change and Implementation Sciencementioning

confidence: 99%

Changing practice to support self-management and recovery in mental illness: application of an implementation model

Harris

Jones²,

Heartfield

et al. 2015

Aust. J. Prim. Health

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Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model; and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.

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Systems Antecedents for Dissemination and Implementation

Cited by 66 publications

References 72 publications

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

Implementation successes and challenges in participating in a pragmatic study to improve colon cancer screening: perspectives of health center leaders

Changing practice to support self-management and recovery in mental illness: application of an implementation model

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