Symposia
Dissemination & Implementation Science
Rafaella Sale, Ph.D.
Virginia Commonwealth University
Richmond, Virginia
Gabriela Aisenberg, PhD
Research Assistant
Virginia Commonwealth University
Richmond, Virginia
Natalie Finn, M.S.
Research Assistant
Virginia Commonwealth University
Richmond, Virginia
Michael A. Southam-Gerow, Ph.D.
Faculty
Virginia Commonwealth University
Richmond, Virginia
Implementation and dissemination science has in more recent years shifted its focus from deploying treatment packages developed for efficacy to prioritizing the context and its capacity for systems change. Context involves the service system, equipped with various stakeholders and goals. Community mental health practitioners typically hold bachelor or master-level degrees and provide services according to policies decided by the operations above them. This service layer of administrators and agency directors must navigate funding stipulations and performance indicators. Coordinated strategic action is a framework within implementation science that recognizes the bidirectional impact that service system layers have on each other which then influence the accessibility, feasibility, and fit of the services families receive. The current study presents a mixed methods approach to characterizing service gaps and organizational readiness for a multi-governmental agency initiative, designed in response to stakeholders’ request to rollout seven commercialized evidence-based programs (EBPs) statewide. A stakeholder survey (n = 177) assessed organizational readiness for EBP implementation, familiarity and knowledge of EBPs, and services currently present in the state. Individual, in-depth interviews (n = 40) were also conducted with a separate sample of state and local government employees. Lastly, a series of listening forums were held to collect additional qualitative information from local service referral brokers, local agency leaders and corporate interest, caseworkers, supervisors, and community members (n = 176). Design of all three studies included attention to participant selection, such as stakeholder position, geographic representation, and local decision-making power. Six themes emerged and were shared by both qualitative analyses, revealing significant barriers to EBP adoption at the service layer including a fractured system for referrals and severe workforce capacity concerns. Survey data demonstrated operational leader confidence and high level of EBP implementation readiness. Differing ways to measure EBP readiness that penetrate the various layers of a service system enable access to crucial information for sustaining high-quality interventions. Findings were presented to stakeholders and feedback was incorporated into a final strategic plan to guide the subsequent phase of implementation.