School of Social Work, Boise State University, 1910 University Drive, Boise, ID, 83625, USA.
Department of Psychology, Temple University, 1701 N 13th St., Philadelphia, PA, 19122, USA.
Implement Sci. 2019 Feb 12;14(1):15. doi: 10.1186/s13012-019-0863-9.
Implementation researchers have typically studied organizational culture and climate by testing whether individual dimensions are linked to the implementation of evidence-based practices (EBPs) rather than examining how the overarching social context influences implementation. This approach may limit implementation theory and strategy development to the extent that individual dimensions of culture and climate interact, mutually reinforce or counteract one another, or exhibit non-linear relationships. This study tests whether empirically identifiable culture and climate profiles emerge in a sample of organizations and examines how these profiles relate to EBP fidelity and work attitudes that support EBP sustainment, focusing on three EBPs for youth with autism delivered in schools as an example.
The study included 65 elementary schools in the U.S. that implemented three EBPs-discrete trial training, pivotal response training, and visual schedules-for youth with autism. Organizational culture and climate and work attitudes were assessed using the Organizational Social Context measure at the beginning of the school year. Observations of EBP fidelity occurred mid school-year. We used bias-adjusted stepwise latent profile modeling to (1) identify subpopulations of schools that share similar culture and climate profiles, and (2) test for mean differences across profiles in observed EBP fidelity and teacher and staff work attitudes.
Controlling for region, four profiles best characterized the organizational cultures and climates of schools. Teachers and staff in schools with a comprehensive profile (high proficiency culture, positive climate) exhibited higher fidelity to two of three EBPs (d's = .95 to 1.64) and reported superior work attitudes (d's = .71 to 1.93) than teachers and staff in all other schools. Teachers and staff in supportive schools (low rigidity culture, positive climate) had better work attitudes, but not better fidelity, than those in schools with indifferent (low culture/climate, elevated stress) and constrained (high rigidity and resistance, high stress) profiles.
Organizational culture and climate profiles are a strong predictor of EBP fidelity and work attitudes that support EBP sustainment, highlighting the importance of an organization's overarching social context when developing implementation theory and strategies. Strategies that foster a comprehensive profile may improve EBP implementation.
实施研究人员通常通过测试个别维度是否与实施基于证据的实践(EBP)相关联,而不是检查总体社会环境如何影响实施,来研究组织文化和氛围。这种方法可能会限制实施理论和策略的发展,因为文化和氛围的个别维度相互作用、相互加强或相互抵消,或者表现出非线性关系。本研究检验了在一个组织样本中是否出现可识别的文化和氛围特征,并研究了这些特征与 EBP 保真度以及支持 EBP 维持的工作态度之间的关系,重点关注在学校中为自闭症儿童提供的三种 EBP——离散试训、关键反应训练和视觉时间表。
该研究包括美国的 65 所小学,这些学校为自闭症儿童实施了三种 EBP——离散试训、关键反应训练和视觉时间表。在学年开始时,使用组织社会背景量表评估组织文化和氛围以及工作态度。在学年中期进行 EBP 保真度观察。我们使用偏差调整的逐步潜在剖面建模来(1)确定具有相似文化和氛围特征的学校亚群体,以及(2)测试在观察到的 EBP 保真度以及教师和员工工作态度方面,不同剖面之间的均值差异。
控制区域因素后,有四个剖面最能描述学校的组织文化和氛围。具有全面特征(高熟练度文化、积极氛围)的教师和员工在三种 EBP 中的两种(d 值为.95 到 1.64)表现出更高的保真度,并且报告了更好的工作态度(d 值为.71 到 1.93),而其他所有学校的教师和员工则表现出更好的工作态度。具有支持性的学校(低僵化文化、积极氛围)的教师和员工工作态度较好,但 EBP 保真度不如冷漠(低文化/氛围、压力升高)和受限(高僵化和阻力、高压力)的学校。
组织文化和氛围特征是 EBP 保真度和支持 EBP 维持的工作态度的有力预测因素,突出了在制定实施理论和策略时考虑组织总体社会环境的重要性。培养全面特征的策略可能会提高 EBP 的实施效果。