title: Applying the Policy Ecology Framework to Philadelphia's Behavioral Health Transformation Efforts.
abstract: Raghavan et al. (Implement Sci 3(26):1-9, 2008) proposed that effective implementation of evidence-based practices requires implementation strategies deployed at multiple levels of the "policy ecology," including the organizational, regulatory or purchaser agency, political, and social levels. However, much of implementation research and practice targets providers without accounting for contextual factors that may influence provider behavior. This paper examines Philadelphia's efforts to work toward an evidence-based and recovery-oriented behavioral health system, and uses the policy ecology framework to illustrate how multifaceted, multilevel implementation strategies can facilitate the widespread implementation of evidence-based practices. Ongoing challenges and implications for research and practice are discussed.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105C McGavran-Greenberg Hall, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA. bjpowell@unc.edu.|Department of Psychiatry, Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA, 19104, USA. bjpowell@unc.edu.
authors.forename: Byron J
authors.initials: BJ
authors.lastname: Powell
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA, 19104, USA.
authors.forename: Rinad S
authors.initials: RS
authors.lastname: Beidas
authors.affiliation: Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA.
authors.forename: Ronnie M
authors.initials: RM
authors.lastname: Rubin
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA, 19104, USA.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Stewart
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA, 19104, USA.
authors.forename: Courtney Benjamin
authors.initials: CB
authors.lastname: Wolk
authors.affiliation: Thomas Scattergood Behavioral Health Foundation, Philadelphia, PA, USA.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Matlin
authors.affiliation: Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA.
authors.forename: Shawna
authors.initials: S
authors.lastname: Weaver
authors.affiliation: Community Care Behavioral Health Organization, Philadelphia, PA, USA.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Hurford
authors.affiliation: Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA.
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Evans
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA, 19104, USA.
authors.forename: Trevor R
authors.initials: TR
authors.lastname: Hadley
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA, 19104, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Mandell
mesh_terms: D003156:Community Mental Health Services; D055317:Evidence-Based Practice; D006291:Health Policy; D006801:Humans; D015143:Philadelphia; D012931:Social Environment
keywords: Behavioral health systems; Evidence-based practices; Implementation strategies; Policy