Department of Psychiatry, University of California, 9500 Gilman Drive #8012, San Diego, CA 92093-0812, USA.
Implement Sci. 2009 Dec 31;4:83. doi: 10.1186/1748-5908-4-83.
The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use.
Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use.
Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice.
This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings.
本研究旨在通过考察组织类型（公立与私立）和组织对循证实践（EBP）的支持对提供者对 EBP 的态度和 EBP 使用的影响，扩展 EBP 实施的研究。组织理论和创新理论以及 EBP 的个体采纳指导了本研究的方法和分析。我们预计私营部门组织将为 EBP 提供更多的组织支持，从而使提供者对 EBP 的态度更加积极，对 EBP 的使用也更多。我们还期望对 EBP 的态度能够调节组织支持和 EBP 使用之间的关系。
参与者是来自美国 16 个州 17 个社区的 170 名心理健康服务提供者。进行路径分析以比较组织类型对 EBP 组织支持的影响以及组织支持对提供者对 EBP 态度和 EBP 使用的影响的三种理论模型。
与我们的预测一致，私立机构为 EBP 的实施提供了更多的支持，并且在私立机构工作的员工对采用 EBP 的态度更为积极。EBP 的组织支持部分调节了组织类型对提供者对 EBP 态度的影响。EBP 的组织支持与提供者对 EBP 的态度以及实践中 EBP 的使用呈显著正相关。
本研究进一步支持了组织背景作为影响 EBP 组织支持和提供者对采用 EBP 的态度的重要因素。该研究展示了组织支持在提供者实际应用 EBP 中的作用。该研究还表明，创新的组织支持是支持 EBP 使用的一个可改变的因素。应更加关注能够促进 EBP 在社区环境中传播和实施的组织影响。
