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Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health

BACKGROUND: Organizational readiness for implementation (ORI) is a barrier to disseminating recovery-oriented evidence-based practices for people with severe mental illnesses. However, there is a knowledge gap regarding implementation strategies and specific actions related to those strategies that...

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Autores principales: Vax, Sigal, Gidugu, Vasudha, Farkas, Marianne, Drainoni, Mari-Lynn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978613/
https://www.ncbi.nlm.nih.gov/pubmed/37090001
http://dx.doi.org/10.1177/2633489520988254
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author Vax, Sigal
Gidugu, Vasudha
Farkas, Marianne
Drainoni, Mari-Lynn
author_facet Vax, Sigal
Gidugu, Vasudha
Farkas, Marianne
Drainoni, Mari-Lynn
author_sort Vax, Sigal
collection PubMed
description BACKGROUND: Organizational readiness for implementation (ORI) is a barrier to disseminating recovery-oriented evidence-based practices for people with severe mental illnesses. However, there is a knowledge gap regarding implementation strategies and specific actions related to those strategies that may enhance ORI across organizations. The Transtheoretical Model (TTM) is a well-established stage-based model used to support organizational change. In TTM, the first three stages—Pre-contemplation, Contemplation, and Preparation—represent the pre-implementation phase, during which ORI should be developed. This study explored ORI enhancement strategies reported as useful by different stakeholders in the field of community mental health (CMH) and tested the applicability of the TTM readiness stages as an organizing framework to direct ORI development. METHODS: The study included the following two phases: (1) a qualitative exploration of ORI enhancement actions reported by various stakeholders in the CMH field (N = 16) based on their experience in successful implementation projects and (2) a consolidation process performed by the research team to create coherent groups of actions and their overarching implementation strategies per readiness stage. RESULTS: A comprehensive list of strategies and related actions was created. The strategies and actions correspond with each of the first three stages of the TTM. Stakeholders differed in their methods of facilitating engagement across the organization and in their level of involvement in developing ORI. CONCLUSIONS: This study is a first step in conceptualizing a systematic process for developing ORI using the TTM as a theoretical framework. Future studies should test the transferability and effectiveness of this repository to other implementation efforts, expend the lists per stage, and further explore differences between stakeholders’ role in ORI development. PLAIN LANGUAGE ABSTRACT: Interventions that were proven effective in supporting the recovery of people with mental illnesses are not sufficiently available in the field of community mental health. One barrier to getting those interventions implemented is the lack of willingness and preparedness of organizations to change their practice, also referred to as organizational readiness for implementation (ORI). Little is known about how to enhance ORI to increase the availability of interventions. This study explored actions used to enhance ORI by people in different roles who successfully implemented new recovery-oriented interventions in community mental health settings. The actions were organized into three stages of readiness development based on the Transtheoretical Model (TTM) of behavioral change. Differences were found between administrators, consultants, supervisors, and providers in the type and number of strategies they described. The results show the applicability of the TTM as an organizing framework for ORI development and provide sets of strategies and specific actions to support different readiness needs across the organization.
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spelling pubmed-99786132023-04-20 Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health Vax, Sigal Gidugu, Vasudha Farkas, Marianne Drainoni, Mari-Lynn Implement Res Pract Original Empirical Research BACKGROUND: Organizational readiness for implementation (ORI) is a barrier to disseminating recovery-oriented evidence-based practices for people with severe mental illnesses. However, there is a knowledge gap regarding implementation strategies and specific actions related to those strategies that may enhance ORI across organizations. The Transtheoretical Model (TTM) is a well-established stage-based model used to support organizational change. In TTM, the first three stages—Pre-contemplation, Contemplation, and Preparation—represent the pre-implementation phase, during which ORI should be developed. This study explored ORI enhancement strategies reported as useful by different stakeholders in the field of community mental health (CMH) and tested the applicability of the TTM readiness stages as an organizing framework to direct ORI development. METHODS: The study included the following two phases: (1) a qualitative exploration of ORI enhancement actions reported by various stakeholders in the CMH field (N = 16) based on their experience in successful implementation projects and (2) a consolidation process performed by the research team to create coherent groups of actions and their overarching implementation strategies per readiness stage. RESULTS: A comprehensive list of strategies and related actions was created. The strategies and actions correspond with each of the first three stages of the TTM. Stakeholders differed in their methods of facilitating engagement across the organization and in their level of involvement in developing ORI. CONCLUSIONS: This study is a first step in conceptualizing a systematic process for developing ORI using the TTM as a theoretical framework. Future studies should test the transferability and effectiveness of this repository to other implementation efforts, expend the lists per stage, and further explore differences between stakeholders’ role in ORI development. PLAIN LANGUAGE ABSTRACT: Interventions that were proven effective in supporting the recovery of people with mental illnesses are not sufficiently available in the field of community mental health. One barrier to getting those interventions implemented is the lack of willingness and preparedness of organizations to change their practice, also referred to as organizational readiness for implementation (ORI). Little is known about how to enhance ORI to increase the availability of interventions. This study explored actions used to enhance ORI by people in different roles who successfully implemented new recovery-oriented interventions in community mental health settings. The actions were organized into three stages of readiness development based on the Transtheoretical Model (TTM) of behavioral change. Differences were found between administrators, consultants, supervisors, and providers in the type and number of strategies they described. The results show the applicability of the TTM as an organizing framework for ORI development and provide sets of strategies and specific actions to support different readiness needs across the organization. SAGE Publications 2021-02-23 /pmc/articles/PMC9978613/ /pubmed/37090001 http://dx.doi.org/10.1177/2633489520988254 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Empirical Research
Vax, Sigal
Gidugu, Vasudha
Farkas, Marianne
Drainoni, Mari-Lynn
Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health
title Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health
title_full Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health
title_fullStr Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health
title_full_unstemmed Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health
title_short Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health
title_sort ready to roll: strategies and actions to enhance organizational readiness for implementation in community mental health
topic Original Empirical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978613/
https://www.ncbi.nlm.nih.gov/pubmed/37090001
http://dx.doi.org/10.1177/2633489520988254
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