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基于社区的成瘾治疗项目的组织变革准备和实施循证实践的依从性:一项全国性研究。

Organizational readiness for change in community-based addiction treatment programs and adherence in implementing evidence-based practices: a national study.

机构信息

Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA 02215, USA.

出版信息

J Subst Abuse Treat. 2013 Nov-Dec;45(5):457-65. doi: 10.1016/j.jsat.2013.06.007. Epub 2013 Aug 6.

Abstract

UNLABELLED

Prior studies by the authors identified that clinical staff who reported that their treatment unit had lower levels of organizational readiness to change experienced higher levels of barriers in implementing an evidence-based practice (EBP). The current study examined whether clinical staff perceptions of their treatment unit's organizational readiness to change were also associated with their adherence to EBP protocols during EBP implementation. Adherence was examined through a variable measuring the extent to which staff modified EBP standards and manuals when implementing a new EBP. Multivariate regression analyses identified that clinical staff who had five or more years of addiction counseling experience, who rated staff in their organization as having higher levels of influence, who less frequently implemented new counseling interventions and who reported higher levels of barriers when implementing a newly funded EBP also reported that their program made more modifications to the EBP in the implementation process. Finally, staff who implemented MI compared to any other EBP reported lower levels of EBP modifications.

IMPLICATIONS

Continued federal funding is needed to enhance treatment unit organizational resources in order to reduce barriers and promote adherence to EBPs. Also, funders of treatment need to continue to provide ongoing technical assistance and training opportunities to promote implementation of EBPs with fidelity.

摘要

未加标签

作者先前的研究表明,报告其治疗单位组织变革准备程度较低的临床工作人员在实施循证实践(EBP)时遇到了更高水平的障碍。本研究探讨了临床工作人员对其治疗单位组织变革准备程度的看法是否也与其在实施 EBP 期间对 EBP 协议的依从性有关。通过衡量工作人员在实施新的 EBP 时修改 EBP 标准和手册的程度来评估依从性。多变量回归分析确定,具有五年或五年以上成瘾咨询经验的临床工作人员、评估其组织中员工影响力水平较高的工作人员、较少实施新咨询干预措施的工作人员以及在实施新资助的 EBP 时报告障碍水平较高的工作人员报告称,他们的方案在实施过程中对 EBP 进行了更多修改。最后,与实施任何其他 EBP 相比,实施 MI 的工作人员报告的 EBP 修改水平较低。

含义

需要继续为治疗单位提供联邦资金,以增强组织资源,以减少障碍并促进对 EBP 的依从性。此外,治疗的资助者需要继续提供持续的技术援助和培训机会,以促进 EBP 的忠实实施。

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