Trial reportImplementation science : IS2018
Organizational culture and climate as moderators of enhanced outreach for persons with serious mental illness: results from a cluster-randomized trial of adaptive implementation strategies.
Trial report in Implementation science : IS, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Comparative effectiveness of external vs blended facilitation on collaborative care model implementation in slow-implementer community practices.Health services research · 2020Trial
- Comparing the effectiveness of implementation strategies to improve liver and colon cancer screening for Veterans: protocol for a large cluster-randomized implementation study.Implementation science : IS · 2025Article
- Combined use of the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework with other implementation frameworks: a systematic review.Implementation science communications · 2025Review
- Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing.JAMA surgery · 2025Article
- How does facilitation in healthcare work? Using mechanism mapping to illuminate the black box of a meta-implementation strategy.Implementation science communications · 2023Article
- Repeated measures of implementation variables.Frontiers in health services · 2023Article
- Contextual factors and mechanisms that influence sustainability: a realist evaluation of two scaled, multi-component interventions.BMC health services research · 2021Article
- Effectiveness and Reach of the Primary Palliative Care for Emergency Medicine (PRIM-ER) Pilot Study: a Qualitative Analysis.Journal of general internal medicine · 2021Observational
- Association of Work Environment With Missed and Rushed Care Tasks Among Care Aides in Nursing Homes.JAMA network open · 2020Article
- RE-AIM Planning and Evaluation Framework: Adapting to New Science and Practice With a 20-Year Review.Frontiers in public health · 2019Review
- Association of organizational culture and climate with variation in the clinical outcomes of collaborative care for maternal depression in community health centers.Implementation research and practiceArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundOrganizational culture and climate are considered key factors in implementation efforts but have not been examined as moderators of implementation strategy comparative effectiveness. We investigated organizational culture and climate as moderators of comparative effectiveness of two sequences of implementation strategies (Immediate vs. Delayed Enhanced Replicating Effective Programs [REP]) combining Standard REP and REP enhanced with facilitation on implementation of an outreach program for Veterans with serious mental illness lost to care at Veterans Health Administration (VA) facilities nationwide.
methodsThis study is a secondary analysis of the cluster-randomized Re-Engage implementation trial that assigned 3075 patients at 89 VA facilities to either the Immediate or Delayed Enhanced REP sequences. We hypothesized that sites with stronger entrepreneurial culture, task, or relational climate would benefit more from Enhanced REP than Standard REP. Veteran- and site-level data from the Re-Engage trial were combined with site-aggregated measures of entrepreneurial culture and task and relational climate from the 2012 VA All Employee Survey. Longitudinal mixed-effects logistic models examined whether the comparative effectiveness of the Immediate vs. Delayed Enhanced REP sequences were moderated by culture or climate measures at 6 and 12 months post-randomization. Three Veteran-level outcomes related to the engagement with the VA system were assessed: updated documentation, attempted contact by coordinator, and completed contact.
resultsFor updated documentation and attempted contact, Veterans at sites with higher entrepreneurial culture and task climate scores benefitted more from Enhanced REP compared to Standard REP than Veterans at sites with lower scores. Few culture or climate moderation effects were detected for the comparative effectiveness of the full sequences of implementation strategies.
conclusionsImplementation strategy effectiveness is highly intertwined with contextual factors, and implementation practitioners may use knowledge of contextual moderation to tailor strategy deployment. We found that facilitation strategies provided with Enhanced REP were more effective at improving uptake of a mental health outreach program at sites with stronger entrepreneurial culture and task climate; Veterans at sites with lower levels of these measures saw more similar improvement under Standard and Enhanced REP. Within resource-constrained systems, practitioners may choose to target more intensive implementation strategies to sites that will most benefit from them.
trial registrationISRCTN: ISRCTN21059161 . Date registered: April 11, 2013.
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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.