This study will develop measures of organizational climate, leadership, and provider behaviors likely to impact the implementation of evidence-based practices. Despite significant investments in intervention development, there is a large gap between the development of effective interventions and effective implementation. Organizational context can be a critical barrier for effective implementation, and thus is an important target for developing and improving implementation strategies. However, there are few reliable and valid measures to assess the degree to which organizational context either supports or limits effective implementation. Although global measures of general organizational culture and climate are available, the focus of the proposed research is on strategic climate. Strategic climate involves the extent to which the policies, practices, procedures, and reward systems in an organization reinforce the prioritization of a specific goal. When applied to EBP implementation, an effective "implementation climate" captures the extent to which employees perceive that the implementation of an innovation, such as EBP, is valued, rewarded, and supported by the organization. When employees see that an organization values EBPs and their implementation, effective implementation outcomes are more likely to result. The organizational literature also suggests the importance of two closely related constructs, implementation leadership and implementation citizenship behavior. Mental health and social service managers play a critical role in the success of their teams, including motivating and supporting staff and supporting organizational change. In the same way that climates can be focused on specific strategic goals, leadership can also support specific strategic imperatives. When leaders communicate the priority of EBP implementation, their "implementation leadership" is a direct antecedent to the formation of an implementation climate. Another construct, "implementation citizenship behavior," represents employee efforts to go beyond required compliance to support EBP implementation. The proposed study will develop a suite of measures that can be used to assess implementation climate, implementation leadership, and implementation citizenship behavior. The proposed measures would advance implementation science by providing reliable and valid measures to assess implementation climate, implementation leadership, and implementation citizenship behavior, constructs likely to impact effective EBP implementation and sustainment. The measures also support implementation practice by providing a pre-assessment of organizational context and enabling the development of strategies to accelerate effective implementation. This study will assess the factor structure, reliability, and construct ad criterion-related validity of the measures, and then assess generalizability by validating the factor structure across three public sector service settings: mental health, child welfare, and alcohol/drug services.

Public Health Relevance

The proposed study will develop measures of organizational factors likely to impact the implementation of evidence-based practices (EBPs) in organizations. Providing quantitative measures of implementation climate, implementation leadership, and implementation citizenship behavior will advance implementation science by providing metrics to better understand the role of organizational context in implementation theory and measurement. Additionally, such measures will assist researchers and agencies to more effectively evaluate organizational preparedness for EBP implementation.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21MH098124-01A1
Application #
8511011
Study Section
Dissemination and Implementation Research in Health Study Section (DIRH)
Program Officer
Chambers, David A
Project Start
2013-06-24
Project End
2015-05-31
Budget Start
2013-06-24
Budget End
2014-05-31
Support Year
1
Fiscal Year
2013
Total Cost
$239,496
Indirect Cost
$60,785
Name
San Diego State University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
073371346
City
San Diego
State
CA
Country
United States
Zip Code
92182
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