Methodology

A longitudinal design is being utilized to follow the adoption and implementation processes as they occur. Data gathering will occur at six-month intervals. Data are and will continue to be collected from organizations that are at various states of adoption and implementation. This includes organizations that have decided to adopt an EBP, as well as organizations that have decided not to adopt an EBP and organizations that have decided that they may reconsider adopting the EBP in the future ("wait and see" group). Data will also be collected from organizations that have implemented the EBP and organizations that implemented the EBP and later decided to discontinue implementation ("de-adopters").

At each organization, data are being gathered from four or five key informants: one or two staff involved in the adoption decision (e.g., executive director, medical director, clinical supervisor); one or two staff involved in planning and implementing the EBP (e.g., case managers, supervisors, psychiatrists); and one or two administrative staff who can provide general information related to organizational structure and resources. Finally, representatives of the four CCOEs are providing data about the working relationship between the CCOE and the organization and about status and outcomes of implementation efforts.

Several data gathering approaches are being used to obtain quantitative and qualitative data. Interviews are conducted with key informants and representatives from each CCOE. These interviews include structured and open-ended questions. A "process reconstruction approach" adapted from Paul Nutt (1994) is being used to systematically track project planning and implementation processes through planning stages. Participants are asked to describe the steps taken from the point at which they initially heard about the CCOE to their current level of implementation. At each step, participants are asked to describe what took place, people involved, and how the work was carried out.

Surveys are being administered to key informants at each organization and to representatives from each CCOE to gather additional data related to variables in the adoption decision and implementation models. Archival data related to organizational structure, size and budget are obtained from administrative and fiscal staff.

Findings

Data gathering began in full at the beginning of the 2002 calendar year. Preliminary findings were reported to ODMH and CCOE principles in early summer and reflected responses from about 30 organizations and 80 individual respondents. Key linkages in the Phase I and Phase II models were supported at the bivariate level. In addition, specific linkages between antecedent variables and core predictors for the Level 1 model of the adoption decision-making also were supported.

Upcoming activities

An intensive effort to increase the size of the organizational sample will be launched this year. In addition, qualitative data analyses will be a key focus this year.

Implications for Policy and Action

There are numerous potential uses of formative and summative findings. Formative findings can be used to shape dissemination and implementation strategies within and across CCOE. In addition, findings will have implications for both "intervention" and "selection" strategies. In other words, with regard to the "intervention" approach, findings are expected to suggest specific ways that CCOEs and ODMH might "shape" or 'frame" information related to innovations that maximizes information value to potential organizational adopters (i.e., information that is more meaningful, accurate and action-oriented.) In contrast, findings that relate to a "selection" strategy will be those that profile characteristics of organizational settings and practices that are likely to support the implementation of innovative practices.

Summative findings will compare the effectiveness of innovations that are implemented according to prescriptions and those that are not. In addition, the relative weight of perceptual versus objective information about outcomes will be examined.

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