title: Increasing clinicians' EBT exploration and preparation behavior in youth mental health services by changing organizational culture with ARC.
abstract: OBJECTIVE
  Clinician EBT exploration and preparation behavior is essential to the ongoing implementation of new EBTs. This study examined the effect of the ARC organizational intervention on clinician EBT exploration and preparation behavior and assessed the mediating role of organizational culture as a linking mechanism.
  
  
  METHODS
  Fourteen community mental health agencies that serve youth in a major Midwestern metropolis along with 475 clinicians who worked in those agencies, were randomly assigned to either the three-year ARC intervention or control condition. Organizational culture was assessed with the Organizational Social Context (OSC) measure at baseline and follow-up. EBT exploration and preparation behavior was measured as clinician participation in nine separate community EBT workshops held over a three-year period.
  
  
  RESULTS
  There was 69 percent greater odds (OR = 1.69, p < .003) of clinicians in the ARC condition (versus control) attending each subsequent workshop. Workshop attendance in the control group remained under two percent and declined over three years while attendance in the ARC condition grew from 3.6 percent in the first workshop to 12 percent in the ninth and final workshop. Improvement in proficient organizational culture mediated the positive effect of the ARC intervention on clinicians' workshop attendance (a × b = .21; 95% CI:LL = .05, UL = .40).
  
  
  CONCLUSIONS
  Organizational interventions that create proficient mental health agency cultures can increase clinician EBT exploration and preparation behavior that is essential to the ongoing implementation of new EBTs in community youth mental health settings.
authors.affiliation: University of Tennessee, USA. Electronic address: cglisson@utk.edu.
authors.forename: Charles
authors.initials: C
authors.lastname: Glisson
authors.affiliation: Boise State University, USA.
authors.forename: Nathaniel J
authors.initials: NJ
authors.lastname: Williams
authors.affiliation: University of Tennessee, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Hemmelgarn
authors.affiliation: Washington University St. Louis, USA.
authors.forename: Enola
authors.initials: E
authors.lastname: Proctor
authors.affiliation: University of Tennessee, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Green
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003156:Community Mental Health Services / Q000379:methods / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008603:Mental Health / Q000193:education; D015279:Organizational Culture; D012947:Social Work / Q000379:methods / Q000458:organization & administration
keywords: ARC; EBT implementation; OSC; Organizational culture; Organizational intervention