Decision-making processes for the uptake and implementation of family-based therapy by eating disorder treatment teams: a qualitative study.
OBJECTIVE
To explore the decision-making processes involved in the uptake and implementation of evidence-based treatments (EBTs), namely, family-based treatment (FBT), among therapists and their administrators within publically funded eating disorder treatment programs in Ontario, Canada.


METHODS
Fundamental qualitative description guided sampling, data collection, and analytic decisions. Forty therapists and 11 administrators belonging to a network of clinicians treating eating disorders completed an in-depth interview regarding the decision-making processes involved in EBT uptake and implementation within their organizations. Content analysis and the constant comparative technique were used to analyze interview transcripts, with 20% of the data independently double-coded by a second coder.


RESULTS
Therapists and their administrators identified the importance of an inclusive change culture in evidence-based practice (EBP) decision-making. Each group indicated reluctance to make EBP decisions in isolation from the other. Additionally, participants identified seven stages of decision-making involved in EBT adoption, beginning with exposure to the EBT model and ending with evaluating the impact of the EBT on patient outcomes. Support for a stage-based decision-making process was in participants' indication that the stages were needed to demonstrate that they considered the costs and benefits of making a practice change. Participants indicated that EBTs endorsed by the Provincial Network for Eating Disorders or the Academy for Eating Disorders would more likely be adopted.


CONCLUSIONS
Future work should focus on integrating the important decision-making processes identified in this study with known implementation models to increase the use of low-cost and effective treatments, such as FBT, within eating disorder treatment programs.
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Melissa
M
Kimber
Jennifer
J
Couturier
Susan
S
Jack
Alison
A
Niccols
Sherry
S
Van Blyderveen
Gail
G
McVey
D000288:Administrative Personnel / Q000523:psychology*; D000328:Adult; D003657:Decision Making; D055317:Evidence-Based Practice / Q000379:methods*; D005196:Family Therapy / Q000592:standards*; D001068:Feeding and Eating Disorders / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009864:Ontario; D015279:Organizational Culture; D010348:Patient Care Team; D036301:Qualitative Research; D000078329:Workforce
Family-Based Treatment; decision-making; evidence-based practice; evidence-based treatment; implementation science; knowledge translation