Testing an Organizational Implementation Process Model Related to Teachers' Implementation-Related Attitudes and Behaviors: a Multilevel Mediation Analysis.

The effectiveness of school-based universal prevention programs is frequently diminished due to low-quality implementation. Organizational factors support high-quality implementation because of their broad influence across implementers. Conceptually, implementation leadership (i.

Symphony of Success: Leader-Practitioner Reciprocity during Evidence-Based Practice Implementation.

This study aimed to explore the reciprocal relationships between implementation leadership and practitioner implementation citizenship behavior during the implementation of evidence-based practices (EBPs). Data were collected at two timepoints with a time lag of six months during a national implementation of evidence-based treatment for post-traumatic stress disorder in Norwegian mental health clinics. Data from 72 leaders and 346 practitioners were analyzed with a two-wave cross-lagged panel model, accounting for the nested structure and adjusting for demographic variables.

Randomized trial of the leadership and organizational change for implementation (LOCI) strategy in substance use treatment clinics.

Introduction: Evidence-based practice (EBP) implementation represents a strategic change that requires alignment of leadership and support throughout organizations. Leadership and Organizational Change for Implementation (LOCI) is a multifaceted implementation strategy that aims to improve implementation leadership and climate within organizations through iterative cycles of leadership and climate assessment and feedback, leadership training and coaching, and strategic planning with upper-level leaders. This study tested the effects of LOCI on transformational and implementation leadership, implementation climate, implementation citizenship behavior, and EBP reach.

Utility of the Leadership and Organizational Change for Implementation-Systems Level (LOCI-SL) strategy for a statewide substance use treatment implementation effort.

Introduction: Multi-level and cross-context implementation strategies are needed to support health systems, healthcare delivery organizations, and providers to adopt evidence-based practice (EBP) for substance use disorder (SUD) treatment. However, misalignment between state oversight agencies and healthcare organizations about which services to prioritize and which outcomes are reasonable to expect can hinder implementation success and widespread access to high-quality care. This study investigated the utility of the Leadership and Organizational Change for Implementation-System Level (LOCI-SL) strategy for supporting statewide EBP implementation for SUD treatment.

Inter-organizational alignment and implementation outcomes in integrated mental healthcare for children and adolescents: a cross-sectional observational study.

Background: Integrated care involves care provided by a team of professionals, often in non-traditional settings. A common example worldwide is integrated school-based mental health (SBMH), which involves externally employed clinicians providing care at schools. Integrated mental healthcare can improve the accessibility and efficiency of evidence-based practices (EBPs) for vulnerable populations suffering from fragmented traditional care.

Helping Educational Leaders Mobilize Evidence (HELM): The iterative redesign of the Leadership and Organizational Change for Implementation (LOCI) intervention for use in schools.

Background: Few "intervention agnostic" strategies have been developed that can be applied to the broad array of evidence-based practices (EBPs) in schools. This paper describes two studies that reflect the initial iterative redesign phases of an effective leadership-focused implementation strategy-Leadership and Organizational Change for Implementation (LOCI)-to ensure its acceptability, feasibility, contextual appropriateness, and usability when used in elementary schools. Our redesigned strategy-Helping Educational Leaders Mobilize Evidence (HELM)-is designed to improve principals' use of strategic implementation leadership to support the adoption and high-fidelity delivery of a universal EBP to improve student outcomes.

Implementation leadership and implementation climate in context: A single organization intrinsic case study for implementation of digital measurement-based care.

Background: Although studies have demonstrated that implementation leadership and climate are important constructs in predicting evidence-based practice (EBP) implementation, concrete descriptions of how they operate during organizational implementation efforts are lacking. This case study fills that gap through an in-depth description of an organization with effective implementation leadership that successfully built a strong implementation climate. This case study provides an illustration of implementation leadership and climate in tangible, replicable terms to assist managers, practitioners, and researchers in addressing the organizational context in their own implementation projects.

Improving measurement-based care implementation in youth mental health through organizational leadership and climate: a mechanistic analysis within a randomized trial.

Background: Theory and correlational research indicate organizational leadership and climate are important for successful implementation of evidence-based practices (EBPs) in healthcare settings; however, experimental evidence is lacking. We addressed this gap using data from the WISDOM (Working to Implement and Sustain Digital Outcome Measures) hybrid type III effectiveness-implementation trial. Primary outcomes from WISDOM indicated the Leadership and Organizational Change for Implementation (LOCI) strategy improved fidelity to measurement-based care (MBC) in youth mental health services.

Inter-Organizational Alignment and Implementation Outcomes in Integrated Mental Healthcare for Children and Adolescents: A Cross-Sectional Observational Study.

Background: Integrated care involves care provided by a team of professionals, often in non-traditional settings. A common example worldwide is integrated school-based mental health (SBMH), which involves externally employed clinicians providing care at schools. Integrated mental healthcare can improve the accessibility and efficiency of evidence-based practices (EBPs) for vulnerable populations suffering from fragmented traditional care.

Randomized Trial of an Organizational Implementation Strategy to Improve Measurement-Based Care Fidelity and Youth Outcomes in Community Mental Health.

Objective: Measurement-based care (MBC), which collects session-by-session symptom data from patients and provides clinicians with feedback on treatment response, is a highly generalizable evidence-based practice with significant potential to improve the outcomes of mental health treatment in youth when implemented with fidelity; however, it is rarely used in community settings. This study tested whether an implementation strategy targeting organizational leadership and organizational implementation climate could improve MBC fidelity and clinical outcomes for youth in outpatient mental health clinics.

Method: In a cluster randomized trial, 21 clinics were assigned to the Leadership and Organizational Change for Implementation strategy plus training and technical assistance in MBC (k = 11, n = 117) or training and technical assistance only (k = 10, n = 117).

Eight characteristics of rigorous multilevel implementation research: a step-by-step guide.

Background: Although healthcare is delivered in inherently multilevel contexts, implementation science has no widely endorsed methodological standards defining the characteristics of rigorous, multilevel implementation research. We identify and describe eight characteristics of high-quality, multilevel implementation research to encourage discussion, spur debate, and guide decision-making around study design and methodological issues.

Recommendations: Implementation researchers who conduct rigorous multilevel implementation research demonstrate the following eight characteristics.

The incremental association of implementation leadership and school personnel burnout beyond transformational leadership.

Successful implementation of school-wide interventions (i.e., delivered to all students by a wide array of school personnel) is key to promoting students' academic achievement and psychosocial development.

Teacher attitudes toward evidence-based practices: Exploratory and confirmatory analyses of the school-adapted evidence-based practice attitude scale.

Background: The Evidence-Based Practice Attitudes Scale (EBPAS) is widely used in implementation research, but it has not been adapted and validated for use among general education teachers, who are most likely to deliver evidence-based prevention programs in schools, the most common setting where youth access social, emotional, and behavioral health services.

Method: School-based stakeholders and a research team comprised of experts in the implementation of evidence-based practices in schools adapted the EBPAS for teachers (the S-EBPAS). The adapted instrument was administered to a representative sample ( = 441) of general education teachers (grades K-5) to assess the reliability and internal consistency via factor analyses.

Construct validity of the school-implementation climate scale.

Background: Implementation climate is an organizational construct theorized to facilitate the adoption and delivery of evidence-based practices. Within schools, teachers often are tasked with implementing universal prevention programs. Therefore, they are ideal informants when assessing school implementation climate for initial and continuous implementation improvement efforts.

Climate for evidence-based mental health care implementation in Germany: psychometric investigation of the Implementation Climate Scale (ICS).

Organizational implementation climate is an important construct in implementation research to describe to what extent implementation is expected, supported, and rewarded. Efforts in bridging the research-practice gap by implementing evidence-based practice (EBP) can benefit from consideration of implementation climate. The Implementation Climate Scale (ICS) is a psychometrically strong measure assessing employees' perceptions of the implementation climate.

Perceptual differences in nursing implementation leadership and climate: a cross-sectional study.

Background: The literature on perceptual differences between managers and staff regarding social dynamic factors (e.g., leadership, climate) in nursing settings is sparse.

Leading the charge in the education sector: development and validation of the School Implementation Leadership Scale (SILS).

Background: Strategic implementation leadership is a critical determinant of successful implementation, hypothesized to create a more supportive implementation climate conducive to the adoption and use of evidence-based practices. Implementation leadership behaviors may vary significantly across contexts, necessitating studies that examine the validity of established measurement tools in novel health service delivery sectors. The education sector is the most common site for delivering mental health services to children and adolescents in the USA, but research focused on implementation leadership in schools is in the early phases, and there is a need for adaptation and expansion of instruments in order to tailor to the school context.

"Change Doesn't Happen by Itself": A Thematic Analysis of First-Level Leaders' Experiences Participating in the Leadership and Organizational Change for Implementation (LOCI) Strategy.

The Leadership and Organizational Change for Implementation (LOCI) strategy is a multifaceted implementation strategy that aims to support successful evidence-based practice (EBP) implementation by fostering effective general leadership, implementation leadership, and implementation climate. How implementation strategies are experienced by participants is important for their utilization and effectiveness in supporting EBP implementation. The current study is the first in-depth qualitative study exploring first-level leaders' experiences of participating in the LOCI strategy.

A stepped-wedge randomized trial investigating the effect of the Leadership and Organizational Change for Implementation (LOCI) intervention on implementation and transformational leadership, and implementation climate.

Background: This study evaluates the Leadership and Organizational Change for Implementation (LOCI) strategy and its effect on implementation leadership, transformational leadership, and implementation climate.

Methods: A stepped wedge cluster randomized study design enrolling 47 first-level leaders from child- and adult-specialized mental health clinics within Norwegian health trusts across three cohorts. All therapists (n = 790) received training in screening of trauma exposure and posttraumatic stress, and a subgroup of therapists (n = 248) received training in evidence-based treatment methods for posttraumatic stress disorder (PTSD).

Barriers to Implementing Motivational Interviewing in Addiction Treatment: A Nominal Group Technique Process Evaluation.

Background: The successful implementation of evidence-based practices (EBPs) in real-world settings requires an adaptive approach and ongoing process evaluation and tailoring. Although conducting a needs assessment during the preparation phase of implementation is beneficial, it is challenging to predict all barriers to EBP implementation that may arise over the course of implementation and sustainment. This article describes a process evaluation that identified emergent and persistent barriers that impacted the implementation of an EBP across multiple behavioral health organizations and clinics.

Provider REport of Sustainment Scale (PRESS): development and validation of a brief measure of inner context sustainment.

Background: Implementation scientists and practitioners often rely on frontline providers for reporting on implementation outcomes. Furthermore, measures of sustainment are few, and available sustainment measures are mainly setting or evidenced-based practice (EBP) specific, require organizational and system-level knowledge to complete, and often lack psychometric rigor. The aim of this study was to develop a brief, pragmatic, and generalizable measure for completion by frontline service providers of the implementation outcome, sustainment.

Measures of organizational culture, organizational climate, and implementation climate in behavioral health: A systematic review.

Background: Organizational culture, organizational climate, and implementation climate are key organizational constructs that influence the implementation of evidence-based practices. However, there has been little systematic investigation of the availability of psychometrically strong measures that can be used to assess these constructs in behavioral health. This systematic review identified and assessed the psychometric properties of measures of organizational culture, organizational climate, implementation climate, and related subconstructs as defined by the Consolidated Framework for Implementation Research (CFIR) and Ehrhart and colleagues.

COVID-related work changes, burnout, and turnover intentions in mental health providers: A moderated mediation analysis.

The novel coronavirus disease (COVID-19) has drastically impacted the provision of mental health services. Changes required of providers were substantial and could lead to increased burnout and, subsequently, increased turnover intentions. This study examined burnout experienced by mental health services providers in the context of COVID-19 and through the lens of the job demands-resources (JD-R) model.

Validating the Implementation Leadership Scale in Chinese nursing context: A cross-sectional study.

Aim: This study aimed to evaluate the validity, reliability and acceptability of the Implementation Leadership Scale in the Chinese nursing context.

Design: This study utilized a cross-sectional design.

Methods: This study was conducted in one general tertiary hospital with 234 nurses (85.