"Policy, Organizational, and Provider Factors in Sustainment of Evidence-Based Allied Health Care"

Abstract

Without effective sustainment of evidence-based interventions, investments in implementation are wasted and public health impact is limited. The United States National Institutes of Health (NIH), Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control (CDC) and other federal and state agencies and foundations are funding studies to facilitate more effective implementation of evidence-based practices and interventions, but there are few systematic studies of sustainment. Adding to the need for research on sustainment is the fact that many evidence-based interventions are not sustained after initial implementation or that key core elements linked to outcomes are not utilized. This symposium will present initial findings from three NIH funded studies examining sustainment of mental health and substance use disorder interventions. The studies examine sustainment across three very different contexts: 1) 82 SAMHSA funded substance abuse treatment programs across the United States, 2) Los Angeles County Department of Mental Health child/adolescent services including 120 agencies and 1500 service providers, and 3) child maltreatment prevention across two states and 87 counties. Mixed methods are utilized across the three studies and quantitative analyses include hierarchical linear and growth mixture modeling controlling for the nested data structures. Qualitative results indicate the critical role of policies and contracting procedures that can scuttle the institutionalization of evidence-based interventions, and quantitative analyses implicate the impact of organizational and provider characteristics, and variation in management practices that impact the quality of evidence-based interventions. Sustainment of Multiple EBP's Fiscally Mandated in Children's Mental Health Services Presenter: Lauren Brookman-Frazee; U. of California, San Diego Presenter: Anna Lau; U. of California, Los Angeles Presenter: Nicole Stadnick; U. of California, San Diego The Sustainment of Evidence Based Adolescent Substance Use Treatment in Community Settings Presenter: Sarah Hunter; RAND Corporation Presenter: Susan Godley; Chestnut Health Systems Presenter: Bryan Garner; RTI International Presenter: Bing Han; RAND Corporation Presenter: Lynsay Ayer; RAND Corporation Presenter: Mary Ellen Slaughter; RAND Corporation Presenter: Chau Pham; RAND Corporation