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Can Learning Collaboratives Support Implementation by Rewiring Professional Networks?

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Abstract

This study examined how a learning collaborative focusing on trauma-focused CBT (TF-CBT) impacted advice-seeking patterns between clinicians and three key learning sources: (1) training experts who share technical knowledge about TF-CBT, (2) peers from other participating organizations who share their implementation experiences, and (3) colleagues from their own agency who provide social and professional support. Based on surveys administered to 132 clinicians from 32 agencies, participants’ professional networks changed slightly over time by forming new advice-seeking relationships with training experts. While small, these changes at the clinician-level yielded substantial changes in the structure of the regional advice network.

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References

  • Aarons, G. A., Sommerfeld, D., Hecht, D. B., Silovsky, J. F., & Chaffin, M. J. (2009). The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: Evidence for a protective effect. Journal of Consulting and Clinical Psychology, 77(2), 270–280. doi:10.1037/a0013223.

    Article  PubMed  PubMed Central  Google Scholar 

  • Allen, I. J. D., Linnan, L. A., & Emmons, K. M. (2012). Fidelity and its relationship to implementation effectiveness, adaptation, and dissemination. In R. C. Brownson, G. A. Colditz, & E. K. Proctor (Eds.), Dissemination and implementation research in health: Translating science to practice (p. 281). New York: Oxford University Press.

    Chapter  Google Scholar 

  • Beidas, R. S., Edmunds, J. M., Marcus, S. C., & Kendall, P. C. (2012). Training and consultation to promote implementation of an empirically supported treatment: A randomized trial. Psychiatric Services, 63(7), 660–665. doi:10.1176/appi.ps.201100401.

    Article  PubMed  PubMed Central  Google Scholar 

  • Borgatti, S. P., & Cross, R. (2003). A relational view of information seeking and learning in social networks. Management Science, 49(4), 432–445. doi:10.1287/mnsc.49.4.432.14428.

    Article  Google Scholar 

  • Butts, C. T. (2014). sna: Tools for social network analysis. R package version 2.3-2. Retrieved from http://cran.r-project.org/package=sna. Accessed 18 Aug 2014.

  • Cane, J., O’Connor, D., & Michie, S. (2012). Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science, 7(37), 1–17. doi:10.1186/1748-5908-7-37.

    Google Scholar 

  • Carter, P., Ozieranski, P., McNicol, S., Power, M., & Dixon-Woods, M. (2014). How collaborative are quality improvement collaboratives: A qualitative study in stroke care. Implementation Science, 9(1), 32. doi:10.1186/1748-5908-9-32.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cary, C. E., & McMillen, J. C. (2012). The data behind the dissemination: A systematic review of trauma-focused cognitive behavioral therapy for use with children and youth. Children and Youth Services Review, 34(4), 748–757.

    Article  Google Scholar 

  • Clarke, N. (2005). Transorganization development for network building. The Journal of Applied Behavioral Science, 41(1), 30–46. doi:10.1177/0021886304272655.

    Article  Google Scholar 

  • Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents (p. 256). New York: Guilford Press.

    Google Scholar 

  • Cretin, S., Shortell, S. M., & Keeler, E. B. (2004). An evaluation of collaborative interventions to improve chronic illness care. Framework and study design. Evaluation Review, 28(1), 28–51. doi:10.1177/0193841X03256298.

    Article  PubMed  Google Scholar 

  • Csardi, G., & Nepusz, T. (2006). The igraph software package for complex network research. InterJournal. Complex Systems. Retrieved from http://igraph.org. Accessed 18 Aug 2014.

  • Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(50), 1–15.

    Google Scholar 

  • Dückers, M., Spreeuwenberg, P., Wagner, C., & Groenewegen, P. P. (2009). Exploring the black box of quality improvement collaboratives: Modelling relations between conditions, applied changes and outcomes. Implementation Science, 4(1), 74. doi:10.1186/1748-5908-4-74.

    Article  PubMed  PubMed Central  Google Scholar 

  • Durlak, J. A., & DuPre, E. P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41, 327–350. doi:10.1007/s10464-008-9165-0.

    Article  PubMed  Google Scholar 

  • Ebert, L., Amaya-Jackson, L., Markiewicz, J. M., & Fairbank, J. A. (2012). Development and application of the NCCTS learning collaborative model for the implementation of evidence-based child trauma treatment. In R. K. McHugh & D. H. Barlow (Eds.), Dissemination and implementation of evidence-based psychological interventions. New York: Oxford University Press.

    Google Scholar 

  • Ebert, L., Amaya-Jackson, L., Markiewicz, J. M., Kisiel, C., & Fairbank, J. A. (2011). Use of the breakthrough series collaborative to support broad and sustained use of evidence-based trauma treatment for children in community practice settings. Administration and Policy in Mental Health,. doi:10.1007/s10488-011-0347-y.

    Google Scholar 

  • Farmer, A. P., Légaré, F., Turcot, L., Grimshaw, J. M., Harvey, E., McGowan, J., & Wolf, F. M. (2011). Printed educational materials: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews,. doi:10.1002/14651858.CD004398.pub2.

    Google Scholar 

  • Garcia, S. K. (2007). Developing social network propositions to explain large-group intervention theory and practice. Advances in Developing Human Resources, 9(3), 341–358. doi:10.1177/1523422307304100.

    Article  Google Scholar 

  • Gesell, S. B., Barkin, S. L., & Valente, T. W. (2013). Social network diagnostics: A tool for monitoring group interventions. Implementation Science, 8(1), 116. doi:10.1186/1748-5908-8-116.

    Article  PubMed  PubMed Central  Google Scholar 

  • Glisson, C., & Schoenwald, S. K. (2005). The ARC organizational and community intervention strategy for implementing evidence-based children’s mental health treatments. Mental Health Services Research, 7(4), 243–259. doi:10.1007/s11020-005-7456-1.

    Article  PubMed  Google Scholar 

  • Gustafson, D. H., Quanbeck, A. R., Robinson, J. M., Ford, J. H., Pulvermacher, A., French, M. T., et al. (2013). Which elements of improvement collaboratives are most effective? A cluster-randomized trial. Addiction, 108(6), 1145–1157. doi:10.1111/add.12117.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hanf, K., & O’Toole, L. J. (1992). Revisiting old friends: Networks, implementation structures and the management of inter-organizational relations. European Journal of Political Research, 21(1–2), 163–180. doi:10.1111/j.1475-6765.1992.tb00293.x.

    Article  Google Scholar 

  • Herschell, A. D., Kolko, D. J., Baumann, B. L., & Davis, A. C. (2010). The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations. Clinical Psychology Review, 30(4), 448–466. doi:10.1016/j.cpr.2010.02.005.

    Article  PubMed  PubMed Central  Google Scholar 

  • IHI. (2003). The breakthrough series: IHI’s collaborative model for achieving breakthrough improvement. Cambridge, MA. Retrieved from http://www.ihi.org/IHI/Results/WhitePapers/. Accessed 03 Oct 2011.

  • Kilo, C. M. (1998). A framework for collaborative improvement: Lessons from the Institute for Healthcare Improvement’s breakthrough series. Quality Management in Health care, 8(4), 1–13.

    Article  Google Scholar 

  • Kossinets, G. (2006). Effects of missing data in social networks. Social Networks, 28(3), 247–268. doi:10.1016/j.socnet.2005.07.002.

    Article  Google Scholar 

  • Langley, A. K., Nadeem, E., Kataoka, S. H., Stein, B. D., & Jaycox, L. H. (2010). Evidence-based mental health programs in schools: Barriers and facilitators of successful implementation. School Mental Health, 2(3), 105–113. doi:10.1007/s12310-010-9038-1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meyers, P. W., Sivakumar, K., & Nakata, C. (1999). Implementation of industrial process innovations: Factors, effects, and marketing implications. Journal of Product Innovation Management, 16(3), 295–311. doi:10.1111/1540-5885.1630295.

    Article  Google Scholar 

  • Mittman, B. S. (2004). Creating the evidence base for quality improvement collaboratives. Annals of Internal Medicine, 140(11), 897–901.

    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, 40(6), 439–450. doi:10.1007/s10488-013-0502-8.

    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 systematic literature review. The Milbank Quarterly, 91(2), 354–394. doi:10.1111/milq.12016.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nembhard, I. M. (2009). Learning and improving in quality improvement collaboratives: Which collaborative features do participants value most? Health Services Research, 44(2 Pt 1), 359–378. doi:10.1111/j.1475-6773.2008.00923.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nembhard, I. M. (2011). All teach, all learn, all improve? The role of interorganizational learning in quality improvement collaboratives. Health Care Management Review,. doi:10.1097/HMR.0b013e31822af831.

    Google Scholar 

  • Ovretveit, J. (2002). Quality collaboratives: Lessons from research. Quality and Safety in Health Care, 11(4), 345–351. doi:10.1136/qhc.11.4.345.

    Article  PubMed  CAS  Google Scholar 

  • Palinkas, L. A., Fuentes, D., Finno, M., Garcia, A. R., Holloway, I. W., & Chamberlain, P. (2014). Inter-organizational collaboration in the implementation of evidence-based practices among public agencies serving abused and neglected youth. Administration and Policy in Mental Health and Mental Health Services Research, 41, 74–85. doi:10.1007/s10488-012-0437-5.

    Article  PubMed  Google Scholar 

  • Palinkas, L. A., Holloway, I. W., Rice, E., Brown, C. H., Valente, T. W., & Chamberlain, P. (2013). Influence network linkages across implementation strategy conditions in a randomized controlled trial of two strategies for scaling up evidence-based practices in public youth-serving systems. Implementation Science, 8(133), 1–11. doi:10.1186/1748-5908-8-133.

    Google Scholar 

  • Palinkas, L. A., Holloway, I. W., Rice, E., Fuentes, D., Wu, Q., & Chamberlain, P. C. (2011). Social networks and implementation of evidence-based practices in public youth-serving systems: A mixed-methods study. Implement Science,. doi:10.1186/1748-5908-6-113.

    Google Scholar 

  • Proctor, E. K., Powell, B. J., & McMillen, J. C. (2013). Implementation strategies: Recommendations for specifying and reporting. Implementation Science, 8, 139. doi:10.1186/1748-5908-8-139.

    Article  PubMed  PubMed Central  Google Scholar 

  • Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., et al. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health, 38(2), 65–76. doi:10.1007/s10488-010-0319-7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Saunders, B. E., & Hanson, R. F. (2014). Innovative methods for implementing evidence-supported interventions for mental health treatment of child and adolescent victims of violence. In R. Reece, R. F. Hanson, & J. Sargent (Eds.), Treatment of child abuse: Common ground for mental health, medical, and legal practitioners (2nd ed.). Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  • Schoenwald, S. K., Sheidow, A. J., & Letourneau, E. J. (2004). Toward effective quality assurance in evidence-based practice: Links between expert consultation, therapist fidelity, and child outcomes. Journal of Clinical Child and Adolescent Psychology, 33(1), 94–104. doi:10.1207/S15374424JCCP3301_10.

    Article  PubMed  Google Scholar 

  • Schouten, L., Hulscher, M., van Everdingen, J., Huijsman, R., & Grol, R. (2008). Evidence for the impact of quality improvement collaboratives: Systematic review. BMJ (Clinical Research Ed.), 336(7659), 1491–1494. doi:10.1136/bmj.39570.749884.BE.

    Article  Google Scholar 

  • StataCorp. (2013). Stata statistical software: Release 13. College Station, TX: StataCorp LP.

    Google Scholar 

  • Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014). Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ Quality & Safety, 23(4), 290–298. doi:10.1136/bmjqs-2013-001862.

    Article  Google Scholar 

  • Tenkasi, R. V., & Chesmore, M. C. (2003). Social networks and planned organizational change: The impact of strong network ties on effective change implementation and use. Journal of Applied Behavioral Science, 39(3), 281–300. doi:10.1177/0021886303258338.

    Article  Google Scholar 

  • Valente, T. W. (2010). Social networks and health: Models, methods, and applications. Oxford: Oxford University Press.

    Book  Google Scholar 

  • Valente, T. W., Chou, C. P., & Pentz, M. A. (2007). Community coalitions as a system: Effects of network change on adoption of evidence-based substance abuse prevention. American Journal of Public Health, 97(5), 880–886. doi:10.2105/AJPH.2005.063644.

    Article  PubMed  PubMed Central  Google Scholar 

  • Valente, T. W., & Davis, R. L. (1999). Accelerating the diffusion of innovations using opinion leaders. The ANNALS of the American Academy of Political and Social Science, 566(1), 55–67. doi:10.1177/000271629956600105.

    Article  Google Scholar 

  • Wasserman, S., & Faust, K. (1994). Social network analysis: Methods and applications. New York: Cambridge University Press.

    Book  Google Scholar 

  • West, E., Barron, D., Dowsett, J., & Newton, J. (1999). Hierarchies and cliques in the social networks of health care professionals: Implications for the design of dissemination strategies. Social Science and Medicine, 48(5), 633–646. doi:10.1016/S0277-9536(98)00361-X.

    Article  PubMed  CAS  Google Scholar 

  • Yousefi-Nooraie, R., Dobbins, M., & Marin, A. (2014). Social and organizational factors affecting implementation of evidence-informed practice in a public health department in Ontario: A network modelling approach. Implementation Science, 9(1), 29. doi:10.1186/1748-5908-9-29.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

This research was supported in part by a National Research Service Award Postdoctoral Traineeship (T32 MH019117) (AB), Individual Predoctoral Fellowship (F31MH098478) (BP) from the National Institute of Mental Health, and a Doris Duke Fellowship for the Promotion of Child Well-Being (BP). The preparation of this article was supported in part by the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health (R25 MH080916-01A2) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative (QUERI) (AB and RH). The authors also appreciate the support and collaboration of their community partners, and the participating clinicians.

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Correspondence to Alicia C. Bunger.

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Bunger, A.C., Hanson, R.F., Doogan, N.J. et al. Can Learning Collaboratives Support Implementation by Rewiring Professional Networks?. Adm Policy Ment Health 43, 79–92 (2016). https://doi.org/10.1007/s10488-014-0621-x

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