Training in Implementation Practice Leadership (TRIPLE): evaluation of a novel practice change strategy in behavioral health organizations

Abstract

Background Effective leadership for organizational change is critical to the implementation of evidence-based practices (EBPs). As organizational leaders in behavioral health organizations often are promoted from within the agency for their long-standing, effective work as counselors, they may lack formal training in leadership, management, or practice change. This study assesses a novel implementation leadership training designed to promote leadership skills and successful organizational change specific to EBP implementation. Methods We conducted a pre-post outcome evaluation of the Training in Implementation Practice Leadership (TRIPLE), delivered via three in-person, half-day training sessions, with interim coaching and technical support. Sixteen mid-level leaders (75% female, 94% Caucasian, mean age 37 years) from 8 substance abuse treatment agencies participated. Professional roles included clinical managers, quality improvement coordinators, and program directors. Participants completed surveys prior to the first and following the final session. At both time points, measures included the Implementation Leadership Scale, Implementation Climate Scale, and Organizational Readiness for Implementing Change Scale. At post-test, we added the Training Acceptability and Appropriateness Scale (TAAS), assessing participant satisfaction with the training. Qualitative interviews were conducted 6 to 8 months after the training. Results Most participants (86% and 79%, respectively) reported increased implementation leadership skills and implementation climate; paired samples t tests indicated these pre-post increases were statistically significant. Implementation leadership scores improved most markedly on the Proactive and Knowledgeable subscales. For implementation climate, participants reported the greatest increases in educational support and recognition for using EBP. Post-test scores on the TAAS also indicated that participants found the training program to be highly acceptable and appropriate for their needs. Qualitative results supported positive outcomes of training that resulted in both increased organizational implementation as well as leadership skills of participants. Conclusions This training program represents an innovative, effective, and well-received implementation strategy for emerging behavioral healthcare leaders seeking to adopt or improve the delivery of EBPs. Reported implementation leadership skills and implementation climate improved following the training program, suggesting that TRIPLE may have helped fulfill a critical need for emerging behavioral healthcare leaders. Electronic supplementary material The online version of this article (10.1186/s13012-019-0906-2) contains supplementary material, which is available to authorized users.

Building capacity in dissemination and implementation science: a systematic review of the academic literature on teaching and training initiatives

“…Of the 41 D&I CBIs identified, a range of ‘types’ of training (as defined by the authors of each of the included articles) were reported including training Institutes ( N = 4) [ 18 a , 48 , 57 , 92 , 103 , 106 , 107 , 109 , 110 c ] or courses that were part of training programmes ( N = 2) [ 18 b , 98 , 100 ] or training initiatives ( N = 1) [ 99 ]; workshops ( N = 4) [ 49 , 93 , 95 , 111 ], seminars ( N = 3) [ 90 a , 110 a,b ], clerkships ( N = 1) [ 88 ], mentorship programmes ( N = 1) [ 90 b ], graduate certificates ( N = 1) [ 89 ], webinars ( N = 1) [ 90 c ], fellowship programmes ( N = 1) [ 97 ], master’s programmes ( N = 1) [ 102 ] or modules that have been integrated in master’s programmes—including clinical research ( N = 1) [ 104 a ] primary health care ( N = 1) [ 105 ] and public health ( N = 1) [ 62 ]; or PhD programmes ( N = 1) [ 94 ] or modules that are integrated as part of a Doctors of Nursing programme ( N = 2) [ 101 , 108 ]. The 15 remaining CBIs were termed by the authors as ‘courses’ relating (in part or in full) to D&I science [ 18 c,d , 47 , 58 , 91 , 96 , 104 b,c , 110 d-k ].…”

“…Fourteen CBIs were delivered face-face [ 47 – 49 , 88 , 91 , 95 , 100 – 104 a , 106 , 107 , 110 a-c,i,k , 111 ], 7 were delivered remotely (either online, over the phone or through video-conferencing) [ 62 , 90 a-c , 105 , 110 a,b ], 8 were blended—employing F-F and remoted-based methods [ 18 a,b , 57 , 58 , 89 , 92 , 96 – 98 , 108 , 109 ], 4 were delivered either F-F or remotely (i.e. individuals picked one mode of delivery) [ 93 , 110 e,f,h ] and for the remainder, it was not reported/not clear ( N = 8) [ 18 c,d , 94 , 104 b,c , 110 d,g,j ].…”

“…CBI also discussed in Baumann, 2019, Brownson, 2017A and Luke, 2016. Doct Proctor, 2019 [ 100 ] Washington University, USA 27. Training in Implementation Practice Leadership (TRIPLE) Training programme/F-F c CBI Comprises lectures, group exercises and reading and involved optional conference calls for more in-depth coaching and mentoring.…”

“…CBI also discussed in Baumann, 2019, Brownson, 2017A and Luke, 2016. Proctor, 2019 [ 100 ] Behavioural health/multiple Description in text and table on curriculum 27. Training in Implementation Practice Leadership (TRIPLE) Sixteen mid-level leaders were enrolled in the training.…”

Leadership Approaches to Developing an Effective Drug Treatment System

“…As this treatment system must withstand funding uncertainty, limited technical resources and workforce development needs [1, 5,6], program managers require unique leadership approaches. Training managers to develop their leadership capacity to help their staff implement EBPs with fidelity has become a unique feature to improve effectiveness needs in this system [53].…”