Abstract

BackgroundImproving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care. It is likely that efforts to identify, develop, and refine implementation strategies will be more successful if they are informed by relevant stakeholders and are responsive to the strengths and limitations of the contexts and implementation processes identified in usual care settings. This study will describe: the types of implementation strategies used; how organizational leaders make decisions about what to implement and how to approach the implementation process; organizational stakeholders’ perceptions of different implementation strategies; and the potential influence of organizational culture and climate on implementation strategy selection, implementation decision-making, and stakeholders’ perceptions of implementation strategies.Methods/designThis study is a mixed methods multiple case study of seven children’s social service organizations in one Midwestern city in the United States that compose the control group of a larger randomized controlled trial. Qualitative data will include semi-structured interviews with organizational leaders (e.g., CEOs/directors, clinical directors, program managers) and a review of documents (e.g., implementation and quality improvement plans, program manuals, etc.) that will shed light on implementation decision-making and specific implementation strategies that are used to implement new programs and practices. Additionally, focus groups with clinicians will explore their perceptions of a range of implementation strategies. This qualitative work will inform the development of a Web-based survey that will assess the perceived effectiveness, relative importance, acceptability, feasibility, and appropriateness of implementation strategies from the perspective of both clinicians and organizational leaders. Finally, the Organizational Social Context measure will be used to assess organizational culture and climate. Qualitative, quantitative, and mixed methods data will be analyzed and interpreted at the case level as well as across cases in order to highlight meaningful similarities, differences, and site-specific experiences.DiscussionThis study is designed to inform efforts to develop more effective implementation strategies by fully describing the implementation experiences of a sample of community-based organizations that provide mental health services to youth in one Midwestern city.

Highlights

  • Improving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations into routine care

  • There are a number of strategies that extend beyond the provider level [9]; in social services research, there are very few randomized studies that test the effectiveness of multilevel implementation strategies

  • The resulting organizational profiles can be compared to norms from a nationwide sample of 1,154 clinicians in 100 mental health clinics, which affords the opportunity to determine the generalizability of study findings beyond the selected sites

Read more

Summary

Introduction

Improving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care. To improve the quality of care for children, EBTs will need to be complemented by evidence-based approaches to implementation [6]. Most strategies deliver only modest effect sizes [10], and are effective under some, but not all, conditions [14] Passive strategies, such as disseminating educational materials and continuing education courses, may be useful in increasing knowledge, but are generally not sufficient to change provider behavior [15,16,17,18]. More research is needed to develop effective ways of tailoring strategies to target implementation barriers [29] and to develop innovative strategies that are efficient, cost-effective, and robust or readily adaptable [30]

Methods
Results
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.