Abstract
BackgroundOne critical factor in the implementation of evidence-based practice (EBP) in substance use disorder treatment organizations is an inner organizational context that clearly supports implementation efforts. The Implementation Climate Scale (ICS) has been developed to allow researchers and organizations to assess climate for EBP implementation in health and allied health service organizations. The ICS consists of 18 items and measures six dimensions of implementation climate: focus on EBP, educational support for EBP, recognition for EBP, rewards for EBP, selection for EBP, and selection for openness. The ICS was initially developed in a mental health context; thus, the goal of this study was to provide initial validation of the ICS in substance use disorder (SUD) treatment settings.MethodsConfirmatory factor analysis (CFA) was used to assess the psychometric functioning of the ICS using survey data from 326 providers in 65 teams in SUD treatment programs. Cronbach’s alpha was examined to assess internal consistency of the ICS, and individual and team level construct-based validity was examined by comparing its correlations with service climate, molar climate, and organizational change.ResultsWe found evidence for the reliability, factor structure, and validity of the ICS in SUD services. The psychometric functioning of the ICS in SUD treatment settings was comparable to that found in mental health contexts.ConclusionsThe ICS is a brief and pragmatic tool for researchers to better understand a critical antecedent for implementation effectiveness in SUD treatment and for organizational leaders in SUD treatment organizations to evaluate the extent to which providers perceive that their organization supports EBP implementation.
Highlights
One critical factor in the implementation of evidence-based practice (EBP) in substance use disorder treatment organizations is an inner organizational context that clearly supports implementation efforts
The Implementation Climate Scale (ICS) range of means for subscales was 1.86 to 2.63 on the 0–4 response scale, with the exception of Rewards for EBP, which was notably lower at .64. This pattern was similar to that reported by Ehrhart, Aarons, and Farahnak [43] with the biggest difference being for the Focus on EBP dimension, which had a mean of 2.63 in this sample versus 2.28 in a mental health sample
These findings suggest that substance use disorder (SUD) organizations who make EBP implementation a priority emphasize giving high quality service to clients, providing performance feedback to providers, involving employees in decision making, making sure work is done efficiently, and planning for organizational change while reducing uncertainty around change
Summary
One critical factor in the implementation of evidence-based practice (EBP) in substance use disorder treatment organizations is an inner organizational context that clearly supports implementation efforts. Implementation of evidence-based practices (EBPs) is critical for improving care in the public health and allied health sectors such as substance use disorder (SUD) treatment settings. EBPs are known to researchers as efficacious practices supported by research evidence, there is still a discrepancy between the knowledge that EBPs are available and the usage of EBPs by providers (i.e., clinicians) with their clients [1,2,3] This discrepancy is apparent in SUD services, and can be Overall, implementation of EBPs for SUD has received less attention than for mental health [7,8,9,10,11,12,13]. SUD treatment practices continued to be influenced by the experiences of people in recovery, primarily through Alcoholics Anonymous and related 12-step programs [10]
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