Attitudes of mental health providers towards adoption of evidence-based interventions: relationship to workplace, staff roles and social and psychological factors at work

Marte Rye,Oddgeir Friborg,Ingunn Skre

doi:10.1186/s12913-019-3933-4

Marte Rye, Oddgeir Friborg + Show 1 more

Open Access

https://doi.org/10.1186/s12913-019-3933-4

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Abstract

BackgroundGaining insight into factors influencing the adoption of evidence-based interventions (EBI) is essential to ensuring their sustainability in the mental healthcare setting. This article describes 1) differences between professional staff roles in attitudes towards EBI and 2) individual and organizational predictors of attitudes towards adopting EBI.MethodsThe participants were psychologists and psychiatric nurses (N = 792). Student t-tests were used to investigate group differences of global attitude scores on the Evidence-based Practice Attitude Scale-36 (EBPAS-36). A confirmatory factor analysis (CFA) of the EBPAS-36 measurement model, and a principal component analysis (PCA) of the factor scores were used to obtain attitudinal components for the subsequent hierarchical regression analyses.ResultsThree second-order attitudinal components were retained and named: professional concern, attitudes related to work conditions and requirements, and attitudes related to fit and preferences. Nurses’ global attitudinal scores were more positive than those of psychologists, while clinicians had less positive global attitudinal scores than non-clinicians. Hierarchical regression analysis showed that provider demographic, social and psychological factors in the workplace and staff role predicted attitudes towards adopting EBI, e.g. male gender, older age and working in private practice predicted more negative global attitudes, while working in academia, experiencing social support from colleagues and empowering leadership predicted more positive global attitudes to adopt EBI. The prediction outcomes for the specific attitudinal components are presented, as well.ConclusionThe findings suggest that implementation efforts may benefit from being tailored to the different needs and values of the affected professionals, including the role of the context they operate within. Implications with a special emphasis on training efforts and organizational development are discussed.

Highlights

Gaining insight into factors influencing the adoption of evidence-based interventions (EBI) is essential to ensuring their sustainability in the mental healthcare setting
The confirmatory factor analysis (CFA) factor scores were saved in Mplus and subjected to a principal component analysis (PCA) in SPSS, representing a second-order factor analysis
The second-order component was labelled attitudes related to work conditions and requirements, encompassing the time and administrative burdens of learning new interventions, job security and perceived organizational support and adoption of imposed evidence-based interventions

Summary

Introduction

Gaining insight into factors influencing the adoption of evidence-based interventions (EBI) is essential to ensuring their sustainability in the mental healthcare setting. Challenges in the early phase of implementation may substantially impact the subsequent implementation process by, e.g., hampering sustainability within the service setting or even lead to a de-implementation [6]. Both individual and organizational factors play a major role in implementation processes, but more knowledge is needed to understand the interplay between these factors [7,8,9]. Gaining insight into the role of individual professional provider characteristics and organizational context factors may provide a better understanding of how to overcome adoption obstacles; helping to tailor implementation strategies in order to anchor the implementation and increase the uptake of EBI

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