Fuller Bret E, Rieckmann Traci, Nunes Edward V, Miller Michael, Arfken Cynthia, Edmundson Eldon, McCarty Dennis
Oregon Health and Science University, Portland, OR 97239, USA.
J Subst Abuse Treat. 2007 Sep;33(2):183-92. doi: 10.1016/j.jsat.2006.12.026. Epub 2007 Apr 16.
Program administrators and staff in treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network completed surveys to characterize participating programs and practitioners. A two-level random-effects regression model assessed the influence of Organizational Readiness for Change (ORC) and organizational attributes on opinions toward the use of four evidence-based practices (manualized treatments, medication, integrated mental health services, and motivational incentives) and practices with less empirical support (confrontation and noncompliance discharge). The ORC scales suggested greater support for evidence-based practices in programs where staff perceived more program need for improvement, better Internet access, higher levels of peer influence, more opportunities for professional growth, a stronger sense of organizational mission, and more organizational stress. Support for confrontation and noncompliance discharge, in contrast, was strong when staff saw less opportunity for professional growth, weaker peer influence, less Internet access, and perceived less organizational stress. The analysis provides evidence of the ORC's utility in assessing agency strengths and needs during the implementation of evidence-based practices.
参与国家药物滥用治疗临床试验网络的治疗项目中的项目管理人员和工作人员完成了调查,以描述参与项目和从业者的特征。一个两级随机效应回归模型评估了组织变革准备度(ORC)和组织属性对使用四种循证实践(手册化治疗、药物治疗、综合心理健康服务和动机激励)以及实证支持较少的实践(对抗和违规出院)的意见的影响。ORC量表表明,在工作人员认为项目更需要改进、互联网接入更好、同伴影响水平更高、职业发展机会更多、组织使命感更强以及组织压力更大的项目中,对循证实践的支持更大。相比之下,当工作人员认为职业发展机会较少、同伴影响较弱、互联网接入较少且组织压力较小时,对对抗和违规出院的支持较强。该分析提供了证据,证明ORC在评估循证实践实施过程中的机构优势和需求方面具有实用性。