Evidence map›Paper›PMID 27439504›Full record

ArticleAdministration and policy in mental health2016

The Roles of System and Organizational Leadership in System-Wide Evidence-Based Intervention Sustainment: A Mixed-Method Study.

Gregory A Aarons, Amy E Green, Elise Trott, Cathleen E Willging, Elisa M Torres, Mark G Ehrhart, Scott C Roesch

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Administration and policy in mental health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04356274 (Participatory System Dynamics vs Audit and Feedback), which is not on this map. Cited by 128 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
128citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04356274 naenrolling by invitationnot on this mapstarted 2019, after this paper: background citation

Participatory System Dynamics vs Audit and Feedback: A Cluster Randomized Trial of Mechanisms of Implementation Change to Expand Reach of Evidence-based Addiction and Mental Health Care

TypeinterventionalSponsorPalo Alto Veterans Institute for ResearchRan2019 to 2027Enrolled720ConditionsPTSD, Depression, Alcohol Use Disorder, Opioid Use DisorderArmsParticipatory System Dynamics (PSD), Audit and Feedback (AF)
3 · Its place in the literature

Who cites it

128 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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68 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Gregory A AaronsDepartment of Psychiatry, University of California, San Diego, 9500 Gilman Drive (8012), La Jolla, CA, 92093-0812, USA. gaarons@ucsd.edu.
Amy E GreenDepartment of Psychiatry, University of California, San Diego, 9500 Gilman Drive (8012), La Jolla, CA, 92093-0812, USA.
Elise TrottPacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, Albuquerque, NM, 87102, USA.
Cathleen E WillgingPacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, Albuquerque, NM, 87102, USA.
Elisa M TorresDepartment of Psychiatry, University of California, San Diego, 9500 Gilman Drive (8012), La Jolla, CA, 92093-0812, USA.
Mark G EhrhartDepartment of Psychology, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4611, USA.
Scott C RoeschChild and Adolescent Services Research Center, San Diego, CA, 92123, USA.

Funding

Mixed-Methods Study of EBP Sustainment in a Statewide Service SystemR01MH072961 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI AARONS, GREGORY · 2005 to 2016
$5.8M
Interagency Collaborative Teams to Scale-up Evidence Based PracticeR01MH092950 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI AARONS, GREGORY, HURLBURT, MICHAEL SCOTT · 2011 to 2015
$3.2M
Testing the Leadership and Organizational Change for Implementation (LOCI) Intervention in Substance Abuse Treatment ProgramsR01DA038466 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI AARONS, GREGORY · 2015 to 2019
$3.0M
Dynamic Adaptation to Implement an Evidence-based Child Maltreatment InterventionR01CE001556 · CE · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI AARONS, GREGORY · 2009 to 2011
$1.2M
NCIPC CDC HHS R01 CE001556NIDA NIH HHS R01 DA038466NIMH NIH HHS R01 MH072961NIMH NIH HHS R01 MH092950
6 · The paper itself

Abstract

If evidence-based interventions (EBIs) are not sustained, investments are wasted and public health impact is limited. Leadership has been suggested as a key determinant of implementation and sustainment; however, little empirical work has examined this factor. This mixed-methods study framed using the Exploration, Preparation, Implementation, Sustainment (EPIS) conceptual framework examines leadership in both the outer service system context and inner organizational context in eleven system-wide implementations of the same EBI across two U.S. states and 87 counties. Quantitative data at the outer context (i.e., system) and inner context (i.e., team) levels demonstrated that leadership predicted future sustainment and differentiated between sites with full, partial, or no sustainment. In the outer context positive sustainment leadership was characterized as establishing a project's mission and vision, early and continued planning for sustainment, realistic project plans, and having alternative strategies for project survival. Inner context frontline transformational leadership predicted sustainment while passive-avoidant leadership predicted non-sustainment. Qualitative results found that sustainment was associated with outer context leadership characterized by engagement in ongoing supportive EBI championing, marketing to stakeholders; persevering in these activities; taking action to institutionalize the EBI with funding, contracting, and system improvement plans; and fostering ongoing collaboration between stakeholders at state and county, and community stakeholder levels. For frontline leadership the most important activities included championing the EBI and providing practical support for service providers. There was both convergence and expansion that identified unique contributions of the quantitative and qualitative methods. Greater attention to leadership in both the outer system and inner organizational contexts is warranted to enhance EBI implementation and sustainment.

Indexed as

Attitude of Health PersonnelChild WelfareEvidence-Based PracticeLeadershipMental Health ServicesPublic HealthCaliforniaCaregiversChild AbuseChild Health ServicesChild, PreschoolFocus GroupsHealth PersonnelHumansInfantInfant, NewbornEPISEvidence-based practiceHealthcareLeadershipMixed-methodsSustainability

Identifiers

PMID27439504
PMCPMC5494253

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.