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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH072961-08
Application #
8662085
Study Section
Dissemination and Implementation Research in Health Study Section (DIRH)
Program Officer
Chambers, David A
Project Start
2004-09-01
Project End
2017-04-30
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
8
Fiscal Year
2014
Total Cost
$655,786
Indirect Cost
$151,150
Name
University of California San Diego
Department
Psychiatry
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
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Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R et al. (2015) Discrepancies in Leader and Follower Ratings of Transformational Leadership: Relationship with Organizational Culture in Mental Health. Adm Policy Ment Health :
Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R et al. (2015) Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation. Implement Sci 10:11
Cafri, Guy; Hedeker, Donald; Aarons, Gregory A (2015) An introduction and integration of cross-classified, multiple membership, and dynamic group random-effects models. Psychol Methods 20:407-21

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