Providers' perspectives of factors influencing implementation of evidence-based treatments in a community mental health setting: A qualitative investigation of the training-practice gap.
This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 28 semistructured interviews that were conducted with providers during the pre-implementation phase of a larger implementation study for cognitive processing therapy for posttraumatic stress disorder (Resick et al., 2008). Our findings extend the existing literature by also presenting provider-identified client-level factors that contribute to providers' positive and negative attitudes toward EBTs. Provider-identified client-level factors include the following: client motivation to engage in treatment, client openness to EBTs, support networks of family and friends, client use of community and government resources, the connection and relationship with their therapist, client treatment adherence, client immediate needs or crises, low literacy or illiteracy, low levels of education, client cognitive limitations, and misconceptions about therapy. These results highlight the relations between provider perceptions of their clients, provider engagement in EBT training, and subsequent adoption of EBTs. We present suggestions for future implementation research in this area. (PsycINFO Database Record
Department of Psychiatry, Massachusetts General Hospital.
Luana
L
Marques
Department of Psychology, University of California, Los Angeles.
Louise
L
Dixon
Department of Psychiatry, Massachusetts General Hospital.
Sarah E
SE
Valentine
Department of Psychiatry, Massachusetts General Hospital.
Christina P C
CP
Borba
Department of Psychiatry, Massachusetts General Hospital.
Naomi M
NM
Simon
Dissemination and Training Division, National Center for PTSD.
Shannon
S
Wiltsey Stirman
D000328:Adult; D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy / Q000193:education; D003156:Community Mental Health Services / Q000458:organization & administration*; D018864:Cultural Diversity; D055317:Evidence-Based Practice / Q000458:organization & administration*; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration*; D006302:Health Services Research / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010349:Patient Compliance / Q000208:ethnology / Q000523:psychology; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology* / Q000628:therapy*