title: Community characteristics and implementation factors associated with effective systems of care.
abstract: How are characteristics of communities associated with the implementation of the principles of systems of care (SOC)? This study uses multilevel modeling with a stratified random sample (N = 225) of US counties to explore community-level predictors of the implementation factors of the System of Care Implementation Survey. A model composed of community-level social indicators fits well with 5 of 14 factors identified as relevant for effective SOCs. As hypothesized, community disadvantage was negatively and residential stability positively associated with the implementation of SOC principles. Designation as a mental health professional shortage area was positively related to some implementation scores, as was the percentage of minority residents, while rurality was not significantly associated with any of the factors. Given the limitations of the study, the results should be interpreted with caution, but suggest that further research is merited to clarify these relationships that could inform efforts directed at promoting SOCs.
authors: Department of Human and Organizational Development, Peabody College, Vanderbilt University, 230 Appleton Place, Box #90 Peabody, Nashville, TN 37203, USA. laurel.m.lunn@vanderbilt.edu
authors: Laurel M
authors: LM
authors: Lunn
authors: Craig Anne
authors: CA
authors: Heflinger
authors: Wei
authors: W
authors: Wang
authors: Paul E
authors: PE
authors: Greenbaum
authors: Krista
authors: K
authors: Kutash
authors: Roger A
authors: RA
authors: Boothroyd
authors: Robert M
authors: RM
authors: Friedman
references: Am J Public Health. 2003 Jul;93(7):1144-8
references: 12835200
references: Eval Program Plann. 2010 Feb;33(1):4-10
references: 19631383
references: Soc Sci Med. 2008 Jun;66(11):2253-67
references: 18329148
references: Psychol Methods. 2002 Mar;7(1):64-82
references: 11928891
references: J Health Soc Behav. 2005 Mar;46(1):15-31
references: 15869118
references: J Am Acad Child Adolesc Psychiatry. 2007 Feb;46(2):284-99
references: 17242631
references: J Behav Health Serv Res. 2011 Jul;38(3):342-57
references: 21494921
references: Community Ment Health J. 1997 Jun;33(3):175-87
references: 9211038
references: J Behav Health Serv Res. 2011 Jul;38(3):288-302
references: 21590313
references: Am J Community Psychol. 2007 Dec;40(3-4):345-58
references: 17906925
references: Med Care. 2004 Jul;42(7):707-14
references: 15213496
references: Psychol Bull. 1990 Mar;107(2):238-46
references: 2320703
references: J Behav Health Serv Res. 2011 Jul;38(3):303-26
references: 21541820
references: Adm Policy Ment Health. 2009 Nov;36(6):361-73
references: 19641987
references: Health Serv Res. 1974 Fall;9(3):208-20
references: 4436074
references: Psychol Med. 2003 Nov;33(8):1341-55
references: 14672243
references: Health Serv Res. 2000 Apr;35(1 Pt 2):293-306
references: 10778816
references: Annu Rev Public Health. 2000;21:639-57
references: 10884968
references: Health Aff (Millwood). 2005 Jul-Aug;24(4):1128-39
references: 16012153
references: Med Care. 2005 Jun;43(6):531-40
references: 15908847