title: A Multi-Level Examination of Stakeholder Perspectives of Implementation of Evidence-Based Practices in a Large Urban Publicly-Funded Mental Health System.
abstract: Our goal was to identify barriers and facilitators to the implementation of evidence-based practices from the perspectives of multiple stakeholders in a large publicly funded mental health system. We completed 56 interviews with three stakeholder groups: treatment developers (n = 7), agency administrators (n = 33), and system leadership (n = 16). The three stakeholder groups converged on the importance of inner (e.g., agency competing resources and demands, therapist educational background) and outer context (e.g., funding) factors as barriers to implementation. Potential threats to implementation and sustainability included the fiscal landscape of community mental health clinics and an evolving workforce. Intervention characteristics were rarely endorsed as barriers. Inner context, outer context, and intervention characteristics were all seen as important facilitators. All stakeholders endorsed the importance of coordinated collaboration across stakeholder groups within the system to successfully implement evidence-based practices.
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA. rbeidas@upenn.edu.
authors.forename: Rinad S
authors.initials: RS
authors.lastname: Beidas
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Stewart
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Danielle R
authors.initials: DR
authors.lastname: Adams
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Tara
authors.initials: T
authors.lastname: Fernandez
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Susanna
authors.initials: S
authors.lastname: Lustbader
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Byron J
authors.initials: BJ
authors.lastname: Powell
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Aarons
authors.affiliation: Department of Psychiatry, New York University, New York, USA.
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Hoagwood
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.|Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, USA.
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Evans
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.|Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, USA.|Community Behavioral Health, Philadelphia, USA.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Hurford
authors.affiliation: Community Behavioral Health, Philadelphia, USA.
authors.forename: Ronnie
authors.initials: R
authors.lastname: Rubin
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Trevor
authors.initials: T
authors.lastname: Hadley
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Mandell
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
authors.forename: Frances K
authors.initials: FK
authors.lastname: Barg
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration*; D055317:Evidence-Based Practice / Q000458:organization & administration*; D005260:Female; D006307:Health Systems Agencies / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D008297:Male; D055361:Multilevel Analysis; D015143:Philadelphia; D036301:Qualitative Research; D014505:Urban Population
keywords: Evidence-based practices; Implementation; Policy