Journal article
Inter-organizational alignment and implementation outcomes in integrated mental healthcare for children and adolescents: a cross-sectional observational study
Implementation science : IS, Vol.19(1), 36
05/27/2024
DOI: 10.1186/s13012-024-01364-w
PMCID: PMC11129427
PMID: 38802827
Abstract
Background
Integrated care involves care provided by a team of professionals, often in non-traditional settings. A common example worldwide is integrated school-based mental health (SBMH), which involves externally employed clinicians providing care at schools. Integrated mental healthcare can improve the accessibility and efficiency of evidence-based practices (EBPs) for vulnerable populations suffering from fragmented traditional care. However, integration can complicate EBP implementation due to overlapping organizational contexts, diminishing the public health impact. Emerging literature suggests that EBP implementation may benefit from the similarities in the implementation context factors between the different organizations in integrated care, which we termed inter-organizational alignment (IOA). This study quantitatively explored whether and how IOA in general and implementation context factors are associated with implementation outcomes in integrated SBMH.
Methods
SBMH clinicians from community-based organizations (CBOs; nclinician = 27) and their proximal student-support school staff (nschool = 99) rated their schools and CBOs (clinician only) regarding general (organizational culture and molar climate) and implementation context factors (Implementation Climate and Leadership), and nine common implementation outcomes (e.g., treatment integrity, service access, acceptability). The levels of IOA were estimated by intra-class correlations (ICCs). We fitted multilevel models to estimate the standalone effects of context factors from CBOs and schools on implementation outcomes. We also estimated the 2-way interaction effects between CBO and school context factors (i.e., between-setting interdependence) on implementation outcomes.
Results
The IOA in general context factors exceeded those of implementation context factors. The standalone effects of implementation context factors on most implementation outcomes were larger than those of general context factors. Similarly, implementation context factors between CBOs and schools showed larger 2-way interaction effects on implementation outcomes than general context factors.
Conclusions
This study preliminarily supported the importance of IOA in context factors for integrated SBMH. The findings shed light on how IOA in implementation and general context factors may be differentially associated with implementation outcomes across a broad array of integrated mental healthcare settings.
Details
- Title: Subtitle
- Inter-organizational alignment and implementation outcomes in integrated mental healthcare for children and adolescents: a cross-sectional observational study
- Creators
- Yanchen Zhang - University of IowaMadeline Larson - University of MinnesotaMark G. Ehrhart - University of Central FloridaKevin King - University of WashingtonJill Locke - University of WashingtonClayton R. Cook - Minnesota Department of EducationAaron R. Lyon - University of Washington
- Resource Type
- Journal article
- Publication Details
- Implementation science : IS, Vol.19(1), 36
- Publisher
- BioMed Central
- DOI
- 10.1186/s13012-024-01364-w
- PMID
- 38802827
- PMCID
- PMC11129427
- ISSN
- 1748-5908
- eISSN
- 1748-5908
- Language
- English
- Date published
- 05/27/2024
- Academic Unit
- Psychological and Quantitative Foundations
- Record Identifier
- 9984630758702771
Metrics
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