Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study
Abstract Background Behavioral health organizations are characterized by multiple organizational climates, including molar climate, which encompasses clinicians’ shared perceptions of how the work environment impacts their personal well-being, and strategic implementation climate, which includes cli...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | Implementation Science |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13012-018-0781-2 |
| _version_ | 1818311887947825152 |
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| author | Nathaniel J. Williams Mark G. Ehrhart Gregory A. Aarons Steven C. Marcus Rinad S. Beidas |
| author_facet | Nathaniel J. Williams Mark G. Ehrhart Gregory A. Aarons Steven C. Marcus Rinad S. Beidas |
| author_sort | Nathaniel J. Williams |
| collection | DOAJ |
| description | Abstract Background Behavioral health organizations are characterized by multiple organizational climates, including molar climate, which encompasses clinicians’ shared perceptions of how the work environment impacts their personal well-being, and strategic implementation climate, which includes clinicians’ shared perceptions of the extent to which evidence-based practice implementation is expected, supported, and rewarded by the organization. Theory suggests these climates have joint, cross-level effects on clinicians’ implementation of evidence-based practice and that these effects may be long term (i.e., up to 2 years); however, no empirical studies have tested these relationships. We hypothesize that molar climate moderates implementation climate’s concurrent and long-term relationships with clinicians’ use of evidence-based practice such that strategic implementation climate will have its most positive effects when it is accompanied by a positive molar climate. Methods Hypotheses were tested using data collected from 235 clinicians in 20 behavioral health organizations. At baseline, clinicians reported on molar climate and implementation climate. At baseline and at a 2-year follow-up, all clinicians who were present in the organizations reported on their use of cognitive-behavioral psychotherapy techniques, an evidence-based practice for youth psychiatric disorders. Two-level mixed-effects regression models tested whether baseline molar climate and implementation climate interacted in predicting clinicians’ evidence-based practice use at baseline and at 2-year follow-up. Results In organizations with more positive molar climates at baseline, higher levels of implementation climate predicted increased evidence-based practice use among clinicians who were present at baseline and among clinicians who were present in the organizations at 2-year follow-up; however, in organizations with less positive molar climates, implementation climate was not related to clinicians’ use of evidence-based practice at either time point. Conclusions Optimizing clinicians’ implementation of evidence-based practice in behavioral health requires attention to both molar climate and strategic implementation climate. Strategies that focus exclusively on implementation climate may not be effective levers for behavior change if the organization does not also engender a positive molar climate. These findings have implications for the development of implementation theory and effective implementation strategies. |
| first_indexed | 2024-12-13T08:09:06Z |
| format | Article |
| id | doaj.art-8f6d514d800841ee859827812d8f7d30 |
| institution | Directory Open Access Journal |
| issn | 1748-5908 |
| language | English |
| last_indexed | 2024-12-13T08:09:06Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science |
| spelling | doaj.art-8f6d514d800841ee859827812d8f7d302022-12-21T23:54:15ZengBMCImplementation Science1748-59082018-06-0113111310.1186/s13012-018-0781-2Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational studyNathaniel J. Williams0Mark G. Ehrhart1Gregory A. Aarons2Steven C. Marcus3Rinad S. Beidas4School of Social Work, Boise State UniversityDepartment of Psychology, University of Central FloridaDepartment of Psychiatry, University of CaliforniaSchool of Social Policy and Practice, University of PennsylvaniaDepartment of Psychiatry, University of PennsylvaniaAbstract Background Behavioral health organizations are characterized by multiple organizational climates, including molar climate, which encompasses clinicians’ shared perceptions of how the work environment impacts their personal well-being, and strategic implementation climate, which includes clinicians’ shared perceptions of the extent to which evidence-based practice implementation is expected, supported, and rewarded by the organization. Theory suggests these climates have joint, cross-level effects on clinicians’ implementation of evidence-based practice and that these effects may be long term (i.e., up to 2 years); however, no empirical studies have tested these relationships. We hypothesize that molar climate moderates implementation climate’s concurrent and long-term relationships with clinicians’ use of evidence-based practice such that strategic implementation climate will have its most positive effects when it is accompanied by a positive molar climate. Methods Hypotheses were tested using data collected from 235 clinicians in 20 behavioral health organizations. At baseline, clinicians reported on molar climate and implementation climate. At baseline and at a 2-year follow-up, all clinicians who were present in the organizations reported on their use of cognitive-behavioral psychotherapy techniques, an evidence-based practice for youth psychiatric disorders. Two-level mixed-effects regression models tested whether baseline molar climate and implementation climate interacted in predicting clinicians’ evidence-based practice use at baseline and at 2-year follow-up. Results In organizations with more positive molar climates at baseline, higher levels of implementation climate predicted increased evidence-based practice use among clinicians who were present at baseline and among clinicians who were present in the organizations at 2-year follow-up; however, in organizations with less positive molar climates, implementation climate was not related to clinicians’ use of evidence-based practice at either time point. Conclusions Optimizing clinicians’ implementation of evidence-based practice in behavioral health requires attention to both molar climate and strategic implementation climate. Strategies that focus exclusively on implementation climate may not be effective levers for behavior change if the organization does not also engender a positive molar climate. These findings have implications for the development of implementation theory and effective implementation strategies.http://link.springer.com/article/10.1186/s13012-018-0781-2Implementation climateMolar climateOrganizational climateCognitive behavioral therapyBehavioral healthEvidence-based practice |
| spellingShingle | Nathaniel J. Williams Mark G. Ehrhart Gregory A. Aarons Steven C. Marcus Rinad S. Beidas Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study Implementation Science Implementation climate Molar climate Organizational climate Cognitive behavioral therapy Behavioral health Evidence-based practice |
| title | Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study |
| title_full | Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study |
| title_fullStr | Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study |
| title_full_unstemmed | Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study |
| title_short | Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study |
| title_sort | linking molar organizational climate and strategic implementation climate to clinicians use of evidence based psychotherapy techniques cross sectional and lagged analyses from a 2 year observational study |
| topic | Implementation climate Molar climate Organizational climate Cognitive behavioral therapy Behavioral health Evidence-based practice |
| url | http://link.springer.com/article/10.1186/s13012-018-0781-2 |
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