title: Organizational determinants of boundary spanning activity in outpatient substance abuse treatment programmes.
abstract: OBJECTIVE
  Substance abuse treatment programmes depend on boundary spanning to identify opportunities and threats, and represent their interests to stakeholders such as licensing entities and regulators. This study sought to identify director, client, unit and market factors associated with active director boundary spanning.
  
  
  METHODS
  Using data from the 1995, 1999-2000 and 2005 waves of a national survey of outpatient substance abuse treatment units, generalized estimating equation regression models tested associations between predictors and five aspects of directors' self-reported boundary spanning.
  
  
  RESULTS
  Directors licensed as substance abuse treatment counsellors spent more time than average consulting with other treatment providers and making presentations in the community. Older directors spent less time consulting with other treatment providers, making community presentations and liaisoning with monitoring organizations. The few associations between client unemployment and director boundary spanning were positive; the two associations between the percentage of clients who were African-American and boundary spanning were negative. Private ownership and being based in larger organizations were negatively associated with some types of boundary spanning. Perceived competition for public support was positively associated with all measures of boundary spanning.
  
  
  CONCLUSIONS
  Directors of treatment organizations may improve treatment practices and political leverage by directly, but selectively, interacting with key external stakeholders.
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA. jalexand@umich.edu
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Alexander
authors.forename: Rebecca
authors.initials: R
authors.lastname: Wells
authors.forename: Lan
authors.initials: L
authors.lastname: Jiang
authors.forename: Harold
authors.initials: H
authors.lastname: Pollack
mesh_terms: D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D007373:Interinstitutional Relations; D008605:Mental Health Services / Q000458:organization & administration*; D012017:Referral and Consultation; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000628:therapy*