Evidence-based practices (EBPs) are increasingly being implemented in public service sectors with little systemic knowledge about what factors facilitate or limit their sustainment. Adding to the need for research on sustainment is the fact that many implementation efforts are not sustained after initial grant funding ends. There is evidence that leadership, policies, resource availability, collaboration, and organizational infrastructure may be key determinants of long-term sustainment, however, little empirical work has been conducted to systematically examine factors that either facilitate or limit sustainment so that the maximum public health impact of EBPs can be realized. This project will use mixed-methods (qualitative and quantitative) to examine factors that either support or limit sustainment of an evidence-based child neglect intervention in a large statewide public service system. We will conduct document analysis and interviews to examine leadership, policy, and contracting factors associated with sustainment. We will examine the degree to which public-academic collaborations impact EBP sustainment. We will conduct surveys of all service providers and supervisors in the service system to examine leadership, organizational factors, and organizational climate for sustainment of evidence-based practice. The main outcomes of interest include the sustained reach/penetration of the EBP in the service system, the fidelity with which the EBP is delivered, and the extent to which provider organizations have developed an organizational climate conducive to EBP sustainment. Finally, stakeholders involved in the study will work collaboratively to develop a comprehensive theoretical model of sustainment in public service sectors that can guide future research and implementation practice.

Public Health Relevance

While there is growing interest in improving implementation of evidence-based practices, many implementation efforts fail, thus limiting the potential public health impact of effective interventions and treatments. We will identify factors that either facilitate or limit effective sustainment of evidence-based practice in a statewide public sector service setting and begin to develop strategies to capitalize on facilitators and improve barriers be tested in future implementation studies. The ultimate goal is develop a comprehensive theory driven model of sustainment to improve the uptake and long-term sustainment of evidence-based practices.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
Project #
Application #
Study Section
Dissemination and Implementation Research in Health Study Section (DIRH)
Program Officer
Chambers, David A
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Diego
Schools of Medicine
La Jolla
United States
Zip Code
Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R et al. (2014) Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation. Annu Rev Public Health 35:255-74
Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R (2014) The Implementation Leadership Scale (ILS): development of a brief measure of unit level implementation leadership. Implement Sci 9:45
Aarons, Gregory A; Fettes, Danielle L; Hurlburt, Michael S et al. (2014) Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice. J Clin Child Adolesc Psychol 43:915-28
Green, Amy E; Albanese, Brian J; Shapiro, Nicole M et al. (2014) The roles of individual and organizational factors in burnout among community-based mental health service providers. Psychol Serv 11:41-9
Willging, Cathleen E; Sommerfeld, David H; Aarons, Gregory A et al. (2014) The effects of behavioral health reform on safety-net institutions: a mixed-method assessment in a rural state. Adm Policy Ment Health 41:276-91
Yeh, May; Aarons, Gregory A; Ho, Judy et al. (2014) Parental etiological explanations and longitudinal medication use for youths with attention deficit hyperactivity disorder. Adm Policy Ment Health 41:401-9
Green, Amy E; Miller, Elizabeth A; Aarons, Gregory A (2013) Transformational leadership moderates the relationship between emotional exhaustion and turnover intention among community mental health providers. Community Ment Health J 49:373-9
Novins, Douglas K; Green, Amy E; Legha, Rupinder K et al. (2013) Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review. J Am Acad Child Adolesc Psychiatry 52:1009-1025.e18
Fettes, Danielle L; Aarons, Gregory A; Green, Amy E (2013) Higher rates of adolescent substance use in child welfare versus community populations in the United States. J Stud Alcohol Drugs 74:825-34
Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H et al. (2012) Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services. Child Maltreat 17:67-79

Showing the most recent 10 out of 30 publications