Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1, 0484, Oslo, Norway.
Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive (0812), La Jolla, CA, 92093-0812, USA.
Adm Policy Ment Health. 2022 Sep;49(5):785-797. doi: 10.1007/s10488-022-01199-x. Epub 2022 May 18.
The Leadership and Organizational Change for Implementation (LOCI) strategy is a multifaceted implementation strategy that aims to support successful evidence-based practice (EBP) implementation by fostering effective general leadership, implementation leadership, and implementation climate. How implementation strategies are experienced by participants is important for their utilization and effectiveness in supporting EBP implementation. The current study is the first in-depth qualitative study exploring first-level leaders' experiences of participating in the LOCI strategy. Data were collected as part of a trial where Norwegian child and adult mental health outpatient clinics implemented EBPs for posttraumatic stress disorder (PTSD). Eleven first-level leaders from adult and child clinics participated in semi-structured interviews after completing the LOCI strategy. Data were analyzed through reflexive thematic analysis. The analysis generated four themes related to leaders' experiences of participating in the LOCI strategy: (1) structuring the EBP implementation, (2) taking responsibility for the EBP implementation, (3) interacting with others about the EBP implementation, and (4) becoming aware of EBP implementation and their own leadership. Most participants experienced the LOCI strategy as beneficial for implementing EBPs for PTSD in their clinic. The strategy succeeded in raising awareness of leadership for EBP implementation, and simultaneously provided participants with tools and support for leading the implementation in their clinic. Two participants experienced LOCI as less beneficial than the others. Our results support the strategy's potential to engage and empower first-level leaders to get involved in implementation processes and point to important challenges for future research on implementation strategies.
实施领导力与组织变革（LOCI）策略是一种多方面的实施策略，旨在通过培养有效的一般领导力、实施领导力和实施氛围，来支持成功的循证实践（EBP）实施。参与者对实施策略的体验对于他们在支持 EBP 实施中的利用和有效性非常重要。本研究是第一项深入的定性研究，探讨了一线领导者参与 LOCI 策略的经验。数据是作为一项试验的一部分收集的，该试验中挪威儿童和成人心理健康门诊诊所实施了创伤后应激障碍（PTSD）的 EBP。11 名来自成人和儿童诊所的一线领导者在完成 LOCI 策略后参加了半结构化访谈。通过反思性主题分析对数据进行了分析。分析生成了四个主题，涉及领导者参与 LOCI 策略的经验：（1） 构建 EBP 实施，（2） 对 EBP 实施负责，（3） 就 EBP 实施与他人互动，（4） 意识到 EBP 实施和自己的领导能力。大多数参与者认为 LOCI 策略对在其诊所实施 PTSD 的 EBP 有益。该策略成功地提高了对 EBP 实施领导力的认识，同时为参与者提供了在其诊所领导实施的工具和支持。两名参与者认为 LOCI 不如其他人有益。我们的研究结果支持该策略有潜力吸引和授权一线领导者参与实施过程，并为未来的实施策略研究指出了重要的挑战。
