(PS5-D80) The Role of Organizational Implementation Context on School Mental Health Providers’ Intentions to Use Evidence-based Practices

Dissemination and implementation (D&I) research for evidence-based practices (EBP) emphasizes the important role that  organizational context, in which D&I takes place, plays in facilitating successful adoption and implementation.  The organizational implementation context (OIC) refers to organizational characteristics identified as particularly relevant to EBP implementation. Specifically, (a) organizational leadership and (b) climate have consistently been shown to facilitate implementation efforts (Williams et al., 2022), whereas (c) citizenship behavior has been proposed as an important marker of employee engagement and positive peer influence toward EBP implementation (Ehrhart et al., 2015). Schools in Hawai‘i are a primary setting in which behavioral health services are delivered to children and adolescents. Thus, gaining a better understanding of OIC variables is critical in addressing barriers faced by mental health professionals in the implementation and use of EBP within a school-based behavioral health system.

This study evaluates elements of a Hawai'i Department of Education initiative to offer statewide training on the Managing and Adapting Practice (MAP; PracticeWise, LLC) system, a modular-based approach to evidence-based service delivery. Specifically, we will examine the intercorrelation of OIC variables and whether they are associated with the successful adoption of EBP in schools.

Evaluation data were collected from 60 school-based therapists who serve diverse youth attending a MAP training; with 41 identifying as school-based behavioral health providers (SBBH) and 17 as direct supervisors. They were approximately 42.49 (SD= 10.49) years in age, predominantly female (n=43, 78.2%), identified most as a cognitive or cognitive-behavioral orientation, and have worked in their current position for 7.87 (SD= 6.46) years. Participants were administered three OIC measures (Lyon et al., 2018) pre-training, including (a) the Implementation Leadership Scale (ILS), (b) the Implementation Climate Scale (ICS), and (c) the Implementation Citizenship Behavior Scale (ICBS). Participants were also administered the Therapist Behavioral Intention Survey (T-BIS; Hill et al., 2020), measuring provider’s intentions to use given practice elements derived from the evidence base (PDEB) for a hypothetical youth client presenting with a single problem area (i.e., anxiety or disruptive behavior). Trainees were administered the T-BIS before and after a 5-day MAP training; scores were calculated as the sum of all correctly endorsed and omitted PDEBs for each problem area.
Preliminary analyses showed that the ILS, ICS, and ICBS scores are highly correlated to each other; and ILS Supportive score was positively correlated with increased T-BIS scores for disruptive behaviors post-training.  Additionally, results indicated significant differences on subscales of the OIC measures based on provider role (supervisor vs. SBBH). Further analyses will explore the relationship between the OIC variables separately for supervisors vs. SBBH; and how they may differentially predict changes in T-BIS scores. These findings have the potential to inform efforts to improve adoption of EBP for school mental health initiatives.