Skip to main content

Advertisement

SpringerLink
Log in

The Effect of a Change Agent on Use of Evidence-Based Mental Health Practices

  • Original Article
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

A Correction to this article was published on 24 February 2018

This article has been updated

Abstract

Children’s service systems are faced with a critical need to disseminate evidence-based mental health interventions. Despite the proliferation of comprehensive implementation models, little is known about the key active processes in effective implementation strategies. This proof of concept study focused on the effect of change agent interactions as conceptualized by Rogers’ diffusion of innovation theory on providers’ (N = 57) use of a behavioral intervention in a child welfare agency. An experimental design compared use for providers randomized to training as usual or training as usual supplemented by change agent interactions after the training. Results indicate that the enhanced condition increased use of the intervention, supporting the positive effect of change agent interactions on use of new practices. Change agent types of interaction may be a key active process in implementation strategies following training.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Change history

  • 24 February 2018

    The original version of this article unfortunately contained a mistake.

References

  • Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy In Mental Health, 38, 4–23. doi:10.1007/s10488-010-0327-7.

    Article  PubMed  Google Scholar 

  • Aarons, G. A., & Palinkas, L. A. (2007). Implementation of evidence-based practice in child welfare: Service provider perspectives. Administration and Policy in Mental Health and Mental Health Services Research, 34, 411–419.

    Article  PubMed  Google Scholar 

  • Aarons, G. A., & Sawitzky, A. C. (2006). Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 33, 289–301.

    Article  PubMed  PubMed Central  Google Scholar 

  • Abry, T., Hulleman, C. S., & Rimm-Kaufman, S. (2015). Using indices of fidelity to intervention core components to identify program active ingredients. American Journal of Evaluation, 36, 320–338.

    Article  Google Scholar 

  • Antle, B. F., Barbee, A. P., & van Zyl, M. A. (2008). A comprehensive model for child welfare training evaluation. Children and Youth Services Review, 30, 1063–1080.

    Article  Google Scholar 

  • Atkins, M. S., Frazier, S. L., Leathers, S. J., Graczyk, P. A., Talbott, E., Jakobsons, L., et al. (2008). Teacher key opinion leaders and mental health consultation in low-income urban schools. Journal of Consulting and Clinical Psychology, 76, 905–908.

    Article  PubMed  Google Scholar 

  • Balas, E. A., & Boren, S. A. (2000). Managing clinical knowledge for health care improvement. In J. Bemmel & A. T., McCray (Eds.), Yearbook of medical informatics 2000: Patient-centered systems (pp. 65–70). Stuttgard: Schattauer Verlagsgesellschaft mbH.

  • Barbee, A. P., Christensen, D., Antle, B., Wandersman, A., & Cahn, K. (2011). Successful adoption and implementation of a comprehensive casework practice model in a public child welfare agency: Application of the getting to outcomes (GTO) model. Children and Youth Services Review, 33, 622–633.

    Article  Google Scholar 

  • Beidas, R. S., Edmunds, J. M., Cannuscio, C. C., Gallagher, M., Downey, M. M., & Kendall, P. C. (2013). Therapists perspectives on the effective elements of consultation following training. Administration and Policy in Mental Health and Mental Health Services Research, 40, 507–517.

    Article  PubMed  PubMed Central  Google Scholar 

  • Beidas, R. S., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17, 1–30.

    Google Scholar 

  • Blase, K., & Fixsen, D. (2013). Core intervention components: Identifying and operationalizing what makes programs work (ASPE Research Brief). Washington, DC: OHSP, US Department of Health and Human Services. Retrieved from http://aspe.hhs.gov/hsp/13/KeyIssuesforChildrenYouth/CoreIntervention/rb_CoreIntervention.cfm

  • Chamberlain, P., Price, J., Leve, L., Laurent, H., Landsverk, J. A., & Reid, J. B. (2008). Prevention of behavior problems for children in foster care: outcomes and mediation effects. Prevention Science, 9, 17–27.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chamberlain, P., Roberts, R., Jones, H., Marsenich, L., Sosna, T., & Price, J. M. (2012). Three collaborative models for scaling up evidence-based practices. Administration and Policy in Mental Health and Mental Health Services Research, 39, 278–290.

    Article  PubMed  PubMed Central  Google Scholar 

  • Collins, M. E., Amodeo, M., & Clay, C. (2007). Training as a factor in plicy implementation: Lessons from a national evaluation of child welfare training. Children and Youth Services Review, 29, 1487–1502.

    Article  Google Scholar 

  • Damanpour, F., & Schneider, M. (2009). Characteristics of innovation and innovation adoption in public organizations: Assessing the role of managers. Journal of Public Administration Research and Theory, 19, 495–522.

    Article  Google Scholar 

  • Deane, F. P., Andresen, R., Crowe, T. P., Oades, L. G., Ciarrochi, J., & Williams, V. (2014). A comparison of two coaching approaches to enhance implementation of a recovery-oriented service model. Administration and Policy in Mental Health and Mental Health Services Research, 41, 660–667.

    Article  PubMed  Google Scholar 

  • Dingfelder, H. E., & Mandell, D. S. (2011). Bridging the research-to-practice gap in autism intervention: An application of diffusion of innovation theory. Journal of Autism and Developmental Disorders, 5, 597–609.

    Article  Google Scholar 

  • Edmunds, J. M., Beidas, R. S., & Kendall, P. C. (2013). Dissemination and implementation of evidence-based practices: Training and consultation as implementation strategies. Clinical Psychology: Science and Practice, 20, 152–165.

    Google Scholar 

  • Fixsen, D. L., Blase, K. A., Naoom, S. F., & Wallace, F. (2009). Core implementation components. Research on Social Work Practice, 19, 531–540.

    Article  Google Scholar 

  • Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).

  • Gingiss, P. L., Gottlieb, N. H., & Brink, S. G. (1994). Measuring cognitive characteristics associated with adoption and implementation of health innovations in schools. American Journal of Health Promotion, 8, 294–301.

    Article  Google Scholar 

  • Glisson, C., Dukes, D., & Green, P. (2011). The effects of the ARC organizational intervention on caseworker turnover, climate, and culture in children’s service systems. Child Abuse and Neglect, 30, 855–880.

    Article  Google Scholar 

  • Glisson, C., & Green, P. (2011). Organizational climate, services, and outcomes in child welfare systems. Child Abuse and Neglect, 35, 582–591.

    Article  PubMed  Google Scholar 

  • Golden, O. (2009). Reforming child welfare. The Urban Institute: Washington, DC.

    Google Scholar 

  • Gustafson, D. H., Quanbeck, A. R., Robinson, J. M., Ford, J. H, I. I., Pulvermacher, A., French, M. T., et al. (2013). Which elements of improvement collaboratives are most effective? A cluster-randomized trial. Addiction, 108, 1145–1157.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hedeker, D., & Gibbons, R. D. (2006). Longitudinal data analysis. Wiley Series in probability and statistics. Hoboken, NJ: Wiley-Interscience.

    Google Scholar 

  • Hedeker, D., Gibbons, R. D., & Flay, B. R. (1994). Random-effects regression models for clustered data with an example from smoking prevention research. Journal of Consulting and Clinical Psychology, 62, 757–765.

    Article  CAS  PubMed  Google Scholar 

  • Henggeler, S., & Lee, T. (2002). What happens after the innovation is identified? Clinical Psychology: Science and Practice, 9, 191–194.

    Google Scholar 

  • Herschell, A. D., McNeil, C. B., Urquiza, A. J., McGrath, J. M., Zebell, N. M., Timmer, S. G., et al. (2009). Evaluation of a treatment manual and workshops for disseminating parent–child interaction therapy. Administration and Policy in Mental Health and Mental Health Services Research, 36, 63–81.

    Article  PubMed  Google Scholar 

  • Hurlburt, M. S., Garland, A. F., Nguyen, K., & Brookman-Frazee, L. (2010). Child and family therapy process: Concordance of therapist and observational perspectives. Administration and Policy in Mental Health and Mental Health Services Research, 37, 230–244.

    Article  PubMed  Google Scholar 

  • Kolko, D. J., Baumann, B. L., Herschell, A. D., Hart, J. A., Holden, E. A., & Wisniewski, S. R. (2012). Implementation of AF-CBT by community practitioners serving child welfare and mental health: A randomized trial. Child Maltreatment, 17, 32–46.

    Article  PubMed  Google Scholar 

  • Kolko, D., Cohen, J., Mannarino, A., Baumann, B., & Knudsen, K. (2009). Community treatment of child sexual abuse: A survey of practitioners in the National Child Stress Network. Administration and Policy in Mental Health and Mental Health Services, 36, 37–49.

    Article  Google Scholar 

  • Leathers, S. J., Atkins, M. S., Spielfogel, J. E., McMeel, L. S., Wesley, J. M., & Davis, R. (2009). Context-specific mental health services for children in foster care. Children and Youth Services Review, 31, 1289–1297.

    Article  PubMed  PubMed Central  Google Scholar 

  • Leathers, S. J., Spielfogel, J. E., McMeel, L. S., & Atkins, M. S. (2011). Use of a parent management training intervention with urban foster parents: A pilot study. Children and Youth Services Review, 33, 1270–1279.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee, A. H., Wang, K., Scott, J. A., Yau, K. K. W., & McLachlan, G. J. (2006). Multi-level zero-inflated Poisson regression modelling of correlated count data with excess zeros. Statistical Methods in Medical Research, 15, 47–61.

    Article  PubMed  Google Scholar 

  • Lipsky, M. (1980). Street-level bureaucracy: Dilemmas of the individual in public services. New York: Russell Sage Foundation.

    Google Scholar 

  • Miller, W. R., Yahne, C. E., Moyers, T. B., Martinez, J., & Pirritano, M. (2004). A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting and Clinical Psychology, 72, 1050–1062.

    Article  PubMed  Google Scholar 

  • Milne, D. (2007). An empirical definition of clinical supervision. British Journal of Clinical Psychology, 46, 437–447.

    Article  PubMed  Google Scholar 

  • Moore, K. A., Peters, R. H., Hills, H. A., LaVasseur, J. B., Rich, A. R., Hunt, W. M., et al. (2004). Characteristics of opinion leaders in substance abuse treatment agencies. American Journal of Drug and Alcohol Abuse, 30, 187–203.

    Article  PubMed  Google Scholar 

  • Nadeem, E., Gleacher, A., & Beidas, R. S. (2013a). Consultation as an implementation strategy for evidence-based practices across multiple contexts: Unpacking the black box. Administration and Policy in Mental Health and Mental Health Services Research, 40, 439–540.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nadeem, E., Olin, S. S., Hill, L. C., Hoagwood, K. E., & Horwitz, S. M. (2013b). Understanding the components of quality improvement collaboratives: A systemic literature review. The Milbank Quarterly, 91, 354–394.

    Article  PubMed  PubMed Central  Google Scholar 

  • Novins, D. K., Green, A. E., Legha, R. K., & Aarons, G. A. (2013). Dissemination and implementation of evidence-based practices for child and adolescent mental health: A systematic review. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 1009–1025.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pacifici, C., Chamberlain, P., & White, L. (2002). Off road parenting. Oregon: Northwest Media Inc.

    Google Scholar 

  • Palinkas, L., Schoenwald, S., Hoagwood, K., Landsverk, J., Chorpita, B., & Weisz, J. (2008). An ethnographic study of implementation of evidence-based treatments in child mental health: First steps. Psychiatric Services, 59, 738–746.

    Article  PubMed  Google Scholar 

  • Patterson Silver Wolf (Adelv unegv Waya), D. A., Dulmus, C. N., & Maguin, E. (2013). Is openness to using empirically supported treatments related to organizational culture and climate? Journal of Social Service Research, 39, 562–571.

  • Powell, B. J., Proctor, E. K., & Glass, J. E. (2014). A systematic review of strategies for implementing empirically supported mental health interventions. Research on Social Work Practice, 24, 192–212.

    Article  PubMed  Google Scholar 

  • Price, J. M., Chamberlain, P., Landsverk, J., & Reid, J. (2009). KEEP foster-parent training intervention: Model description and effectiveness. Child & Family Social Work, 14, 233–242.

    Article  Google Scholar 

  • Proctor, E. (2012). Implementation science and child maltreatment: Methodological advances. Child Maltreatment, 17, 107–112.

    Article  PubMed  Google Scholar 

  • Proctor, E. K., Knudsen, K. J., Fedoravicius, N., Hovmand, P., Rosen, A., & Perron, B. (2007). Implementation of evidence-based practice in community behavioral health: Agency director perspectives. Administration and Policy in Mental Health and Mental Health Services Research, 34, 479–488.

    Article  PubMed  Google Scholar 

  • Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy In Mental Health, 36, 24–34.

    Article  PubMed  Google Scholar 

  • Riemer, M., Rosof-Williams, J., & Bickman, L. (2005). Theories related to changing clinician practice. Child and Adolescent Psychiatric Clinics of North America, 14, 241–254.

    Article  PubMed  Google Scholar 

  • Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: Simon & Schuster.

    Google Scholar 

  • Schoenwald, S. K., Sheidow, A. J., & Chapman, J. E. (2009). Clinical supervision in treatment transport: Effects on adherence and outcomes. Journal of Consulting and Clinical Psychology, 77, 410–421.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sholomskas, D. E., Syracuse-Siewart, G., Rounsaville, B. J., Ball, S. A., Nuro, K. F., & Carroll, K. M. (2005). We don’t train in vain: A dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 73(1), 106–115.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tabak, R. G., Khoong, E. C., Chambers, D. A., & Brownson, R. C. (2012). Bridging research and practice: Models for dissemination and implementation research. American Journal of Preventive Medicine, 43, 337–350.

    Article  PubMed  PubMed Central  Google Scholar 

  • Torrey, W. C., & Gorman, P. G. (2005). Closing the gap between what services are and what they could be. In R. Drake, M. Merrens, & D. Lynde (Eds.), Evidence-based mental health practice (pp. 167–188). New York: Norton and Co.

    Google Scholar 

  • van den Hombergh, P., Grol, R., van den Hoogen, H., & van den Bosch, W. (1999). Practice visits as a tool in quality improvement: mutual visits and feedback by peers compared with visits and feedback by non-physician observers. Quality and Safety in Health Care, 8, 161–166.

    Article  Google Scholar 

  • Walker, H. M. (2004). Commentary: Use of evidence-based interventions in schools: Where we’ve been, where we are, and where we need to go. School Psychology Review, 33, 398–407.

    Google Scholar 

  • Weisz, J. R., Chu, B. C., & Polo, A. J. (2004). Treatment dissemination and evidence-based practice: Strengthening intervention through clinician-research collaboration. Clinical Psychology: Science and Practice, 11, 300–307.

    Google Scholar 

  • Wulczyn, F., Barth, R. P., Yuan, Y. T., Harden, B. J., & Landsverk, J. (2008). Beyond common sense: Child welfare, child wellbeing, and the evidence for policy reform. Aldine Transaction: Piscataway, NJ.

    Google Scholar 

Download references

Acknowledgments

This research was supported by a Grant from the National Institute for Mental Health (RC1 MH088732). The views expressed in this paper solely reflect the views of the authors and do not necessarily reflect the views of the National Institutes of Health.

Author information

Author notes

  1. Jill E. Spielfogel

    Present address: School of Social Service Administration, University of Chicago, Chicago, IL, USA

  2. Joan Blakey

    Present address: Helen Bader School of Social Welfare, University of Wisconsin at Milwaukee, Milwaukee, WI, USA

  3. Errick Christian

    Present address: Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USA

Authors and Affiliations

  1. Jane Addams College of Social Work, University of Illinois at Chicago, 1040 W. Harrison St., Chicago, IL, 60607-7134, USA

    Sonya J. Leathers, Jill E. Spielfogel, Joan Blakey & Errick Christian

  2. Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA

    Marc S. Atkins

Authors
  1. Sonya J. Leathers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jill E. Spielfogel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joan Blakey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Errick Christian
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marc S. Atkins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sonya J. Leathers.

Additional information

A correction to this article is available online at https://doi.org/10.1007/s10488-018-0859-9.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Leathers, S.J., Spielfogel, J.E., Blakey, J. et al. The Effect of a Change Agent on Use of Evidence-Based Mental Health Practices. Adm Policy Ment Health 43, 768–782 (2016). https://doi.org/10.1007/s10488-015-0694-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-015-0694-1

Keywords

Search

Navigation