Abstract
Many efforts to implement evidence-based programs do not reach their full potential or fail due to the variety of challenges inherent in dissemination and implementation. This article describes the use of concept mapping—a mixed method strategy—to study implementation of behavioral health innovations and evidence‐based practice (EBP). The application of concept mapping to implementation research represents a practical and concise way to identify and quantify factors affecting implementation, develop conceptual models of implementation, target areas to address as part of implementation readiness and active implementation, and foster communication among stakeholders. Concept mapping is described and a case example is provided to illustrate its use in an implementation study. Implications for the use of concept mapping methods in both research and applied settings towards the dissemination and implementation of behavioral health services are discussed.
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Aarons GA. Measuring provider attitudes toward evidence-based practice: Consideration of organizational context and individual differences. Child and Adolescent Psychiatric Clinics of North America. 2005;14(2):255–271.
Greenhalgh T, Robert G, Macfarlane F, et al. Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quarterly. 2004;82(4):581–629.
Mendel P, Meredith L, Schoenbaum M, et al. Interventions in organizational and community context: A framework for building evidence on dissemination and implementation in health services research. Administration and Policy in Mental Health and Mental Health Services Research. 2008;35(1–2):21–37.
Raghavan R, Bright CL, Shadoin AL. Toward a policy ecology of implementation of evidence-based practices in public mental health settings. Implementation Science. 2008;3(26):3–26.
National Institute of Mental Health. 2008; National Institute of Mental Health Strategic Plan. Available at: http://www.nimh.nih.gov/about/strategic-planning-reports/index.shtml.
Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in child welfare. Administration and Policy in Mental Health and Mental Health Services Research. 2011;38(1):4–23.
Fixsen D, Blase K, Naoom S, et al. Core implementation components. Research on Social Work Practice. 2009;19(5):531.
Simpson DD. A conceptual framework for transferring research to practice. Journal of Substance Abuse Treatment. 2002;22(4):171–182.
Backer TE. Assessing and enhancing readiness for change: Implications for technology transfer. In: Backer TE, David SL, Soucy G, eds. Reviewing the behavioral science knowledge base on technology transfer. Vol NIDA Research Monograph 155. Rockville, MD: National Institute on Drug Abuse; 1995.
Damschroder L, Aron D, Keith R, et al. Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science. 2009;4:50.
Rogers EM. Diffusions of innovations. 4th ed. New York: The Free Press; 1995.
Ferlie EB, Shortell SM. Improving the quality of health care in the United Kingdom and the United States: a framework for change. Milbank Quarterly. 2001;79(2):281–315.
Glisson C, Schoenwald S. The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments. Mental Health Services Research. 2005;7(4):243–259.
Grimshaw J, Shirran L, Thomas R, et al. Changing provider behavior: an overview of systematic reviews of interventions. Medical Care. 2001;39(8): 2–45.
Grol R, Grimshaw J. Evidence-based implementation of evidence-based medicine. Journal on Ouality Improvement. 1999;25:503–513.
Aarons GA, Wells RS, Zagursky K, et al. Implementing evidence-based practice in community mental health agencies: A multiple stakeholder analysis. American Journal of Public Health. 2009;99(11):2087–2095.
Green AE, Aarons GA. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping. Implementation Science. 2011;6:104.
Trochim WM, Cook JA, Setze RJ. Using concept mapping to develop a conceptual framework of staff's views of a supported employment program for individuals with severe mental illness. Journal of Consulting and Clinical Psychology. 1994;62(4):766–775.
Trochim WMK. Concept mapping: Soft science or hard art? Evaluation and Program Planning. 1989;12:87–110.
Greene JC. Toward a methodology of mixed methods social inquiry. Research in the Schools. 2006;13(1):93–98.
Johnson RB, Onwuegbuzie JA, Turner LA. Toward a definition of mixed methods research. Journal of Mixed Methods Research. 2007;1(2):112–133.
Tashakkori A, Teddlie C. Issues and dilemmas in teaching research methods courses in social and behavioural sciences: US perspective. International Journal of Social Research Methodology: Theory & Practice. Jan–Mar 2003;6(1):61–77.
Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 2nd ed. Thousand Oaks, CA: Sage; 2011.
Robins CS, Ware NC, dosReis S, et al. Dialogues on mixed-methods and mental health services research: Anticipating challenges, building solutions. Psychiatric Services. 2008;59(7):727–731.
Aarons GA, Fettes DL, Sommerfeld DH, et al. Mixed Methods for Implementation Research Application to Evidence-Based Practice Implementation and Staff Turnover in Community-Based Organizations Providing Child Welfare Services. Child Maltreatment. 2012;17(1):67–79.
Emrick CD, Aarons GA. Program evaluation and treatment outcome: Contemporary developments. Annual Review of Addictions Research and Treatment. 1991;1:215–231.
Trochim WM. An introduction to concept mapping for planning and evaluation. Evaluation and Program Planning. 1989;12:1–16.
Naoom SF, Wallace F, Blase KA, et al. Implementation in the Real World-Taking Programs and Practice to Scale: Concept Mapping Report. Tampa, FL: Louis de la Parte Florida Mental Health Institute;2004.
Abrahams DA. Technology adoption in higher education: a framework for identifying and prioritising issues and barriers to adoption of instructional technology. Journal of Applied Research in Higher Education. 2010;2(2):34–49.
Graham AL, Kerner JF, Quinlan KM, et al. Translating cancer control research into primary care practice: a conceptual framework. American Journal of Lifestyle Medicine. 2008;2(3):241–249.
Arrington B, Kimmey J, Brewster M, et al. Building a local agenda for dissemination of research into practice. Journal of Public Health Management and Practice 2008 14(2): 185
Shern DL, Trochim WMK, LaComb CA. The use of concept mapping for assessing fidelity of model transfer: An example from psychiatric rehabilitation. Evaluation and program planning. 1995;18(2):143–153.
The Concept System software® [computer program]. Version 4.147. Ithaca, NY 2007.
Trochim W, Dumont J, Campbell J. A report for the state mental health agency profiling system: Mapping mental health outcomes from the perspective of consumers/survivors. Alexandria, Virginia1993.
Aarons GA, Green AE, Palinkas LA, et al. Dynamic adaptation process to implement an evidence-based child maltreatment intervention. Implementation Science. 2012; 7: 32.
Aarons, GA, Sommerfeld, DH. Leadership, innovation climate, and attitudes toward evidence-based practice during a statewide implementation. Journal of the American Academy of Child and Adolescent Psychiatry, 2012; 51: 423–431.
Stetler CB, Legro MW, Rycroft-Malone J, et al. Role of "external facilitation" in implementation of research findings: a qualitative evaluation of facilitation experiences in the Veterans Health Administration. Implementation Science. 2006; 1: 23.
Acknowledgments
This research was conducted with funding from the National Institute of Mental Health (R03MH070703, R01MH072961, P30MH074678, and R25MH080916). The authors wish to thank the study participants for the insights offered during the brainstorming and feedback sessions described in this article.
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The authors declare no conflicts of interest.
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Green, A.E., Fettes, D.L. & Aarons, G.A. A Concept Mapping Approach to Guide and Understand Dissemination and Implementation. J Behav Health Serv Res 39, 362–373 (2012). https://doi.org/10.1007/s11414-012-9291-1
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DOI: https://doi.org/10.1007/s11414-012-9291-1