The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study.
ABSTBACKGROUND: Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States.


METHODS
In-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics.


RESULTS
We found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice.


CONCLUSIONS
The findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes.
University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive (0812), La Jolla, CA 92093-0812, USA. gaarons@ucsd.edu
Gregory A
GA
Aarons
Charles
C
Glisson
Phillip D
PD
Green
Kimberly
K
Hoagwood
Kelly J
KJ
Kelleher
John A
JA
Landsverk
John R
JR
Weisz
Bruce
B
Chorpita
Robert
R
Gibbons
Charles
C
Glisson
Evelyn Polk
EP
Green
Kimberly
K
Hoagwood
Peter S
PS
Jensen
Kelly
K
Kelleher
John
J
Landsverk
Stephen
S
Mayberg
Jeanne
J
Miranda
Lawrence
L
Palinkas
Sonja
S
Schoenwald
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002648:Child; D003156:Community Mental Health Services; D004059:Diffusion of Innovation; D055317:Evidence-Based Practice; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016013:Likelihood Functions; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015279:Organizational Culture; D014481:United States