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Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings

BACKGROUND: This study examines sustainment of an EBI implemented in 11 United States service systems across two states, and delivered in 87 counties. The aims are to 1) determine the impact of state and county policies and contracting on EBI provision and sustainment; 2) investigate the role of pub...

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Autores principales: Aarons, Gregory A, Green, Amy E, Willging, Cathleen E, Ehrhart, Mark G, Roesch, Scott C, Hecht, Debra B, Chaffin, Mark J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272775/
https://www.ncbi.nlm.nih.gov/pubmed/25490886
http://dx.doi.org/10.1186/s13012-014-0183-z
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author Aarons, Gregory A
Green, Amy E
Willging, Cathleen E
Ehrhart, Mark G
Roesch, Scott C
Hecht, Debra B
Chaffin, Mark J
author_facet Aarons, Gregory A
Green, Amy E
Willging, Cathleen E
Ehrhart, Mark G
Roesch, Scott C
Hecht, Debra B
Chaffin, Mark J
author_sort Aarons, Gregory A
collection PubMed
description BACKGROUND: This study examines sustainment of an EBI implemented in 11 United States service systems across two states, and delivered in 87 counties. The aims are to 1) determine the impact of state and county policies and contracting on EBI provision and sustainment; 2) investigate the role of public, private, and academic relationships and collaboration in long-term EBI sustainment; 3) assess organizational and provider factors that affect EBI reach/penetration, fidelity, and organizational sustainment climate; and 4) integrate findings through a collaborative process involving the investigative team, consultants, and system and community-based organization (CBO) stakeholders in order to further develop and refine a conceptual model of sustainment to guide future research and provide a resource for service systems to prepare for sustainment as the ultimate goal of the implementation process. METHODS: A mixed-method prospective and retrospective design will be used. Semi-structured individual and group interviews will be used to collect information regarding influences on EBI sustainment including policies, attitudes, and practices; organizational factors and external policies affecting model implementation; involvement of or collaboration with other stakeholders; and outer- and inner-contextual supports that facilitate ongoing EBI sustainment. Document review (e.g., legislation, executive orders, regulations, monitoring data, annual reports, agendas and meeting minutes) will be used to examine the roles of state, county, and local policies in EBI sustainment. Quantitative measures will be collected via administrative data and web surveys to assess EBI reach/penetration, staff turnover, EBI model fidelity, organizational culture and climate, work attitudes, implementation leadership, sustainment climate, attitudes toward EBIs, program sustainment, and level of institutionalization. Hierarchical linear modeling will be used for quantitative analyses. Qualitative analyses will be tailored to each of the qualitative methods (e.g., document review, interviews). Qualitative and quantitative approaches will be integrated through an inclusive process that values stakeholder perspectives. DISCUSSION: The study of sustainment is critical to capitalizing on and benefiting from the time and fiscal investments in EBI implementation. Sustainment is also critical to realizing broad public health impact of EBI implementation. The present study takes a comprehensive mixed-method approach to understanding sustainment and refining a conceptual model of sustainment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13012-014-0183-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-42727752014-12-22 Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings Aarons, Gregory A Green, Amy E Willging, Cathleen E Ehrhart, Mark G Roesch, Scott C Hecht, Debra B Chaffin, Mark J Implement Sci Study Protocol BACKGROUND: This study examines sustainment of an EBI implemented in 11 United States service systems across two states, and delivered in 87 counties. The aims are to 1) determine the impact of state and county policies and contracting on EBI provision and sustainment; 2) investigate the role of public, private, and academic relationships and collaboration in long-term EBI sustainment; 3) assess organizational and provider factors that affect EBI reach/penetration, fidelity, and organizational sustainment climate; and 4) integrate findings through a collaborative process involving the investigative team, consultants, and system and community-based organization (CBO) stakeholders in order to further develop and refine a conceptual model of sustainment to guide future research and provide a resource for service systems to prepare for sustainment as the ultimate goal of the implementation process. METHODS: A mixed-method prospective and retrospective design will be used. Semi-structured individual and group interviews will be used to collect information regarding influences on EBI sustainment including policies, attitudes, and practices; organizational factors and external policies affecting model implementation; involvement of or collaboration with other stakeholders; and outer- and inner-contextual supports that facilitate ongoing EBI sustainment. Document review (e.g., legislation, executive orders, regulations, monitoring data, annual reports, agendas and meeting minutes) will be used to examine the roles of state, county, and local policies in EBI sustainment. Quantitative measures will be collected via administrative data and web surveys to assess EBI reach/penetration, staff turnover, EBI model fidelity, organizational culture and climate, work attitudes, implementation leadership, sustainment climate, attitudes toward EBIs, program sustainment, and level of institutionalization. Hierarchical linear modeling will be used for quantitative analyses. Qualitative analyses will be tailored to each of the qualitative methods (e.g., document review, interviews). Qualitative and quantitative approaches will be integrated through an inclusive process that values stakeholder perspectives. DISCUSSION: The study of sustainment is critical to capitalizing on and benefiting from the time and fiscal investments in EBI implementation. Sustainment is also critical to realizing broad public health impact of EBI implementation. The present study takes a comprehensive mixed-method approach to understanding sustainment and refining a conceptual model of sustainment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13012-014-0183-z) contains supplementary material, which is available to authorized users. BioMed Central 2014-12-10 /pmc/articles/PMC4272775/ /pubmed/25490886 http://dx.doi.org/10.1186/s13012-014-0183-z Text en © Aarons et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Aarons, Gregory A
Green, Amy E
Willging, Cathleen E
Ehrhart, Mark G
Roesch, Scott C
Hecht, Debra B
Chaffin, Mark J
Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings
title Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings
title_full Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings
title_fullStr Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings
title_full_unstemmed Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings
title_short Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings
title_sort mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272775/
https://www.ncbi.nlm.nih.gov/pubmed/25490886
http://dx.doi.org/10.1186/s13012-014-0183-z
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