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.
Research
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