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The Journal of Behavioral Health Services & Research

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01-10-2016

Knowledge, Attitudes, Social Desirability, and Organizational Characteristics in Youth Mental Health Services

Authors: Sonia C. Izmirian, MA, Brad J. Nakamura, PhD

Published in: The Journal of Behavioral Health Services & Research | Issue 4/2016

Abstract

This project investigated the extent to which knowledge of evidence-based practices (EBPs) and organizational characteristics predicted attitudes toward EBPs, while controlling for social desirability and organization membership. Participants were 167 public sector youth practitioners. Hierarchical multiple regression analyses were conducted to determine which factors significantly predicted EBP attitudes. Findings suggested that social desirability, organization membership, and various organizational characteristics predicted EBP attitudes. Results are discussed as they relate to the importance of including social desirability in future research and identifying different factors that influence EBP attitudes across various organizations.

From this point forward, EBP-related constructs will refer to evidence-based treatment practices, rather than evidence-based assessment strategies.

In Hawaii’s public sector system, therapists are not required to have a license if they are supervised by a licensed mental health professional. In addition, the difference between licensed and unlicensed therapists on EBP attitudes was not significant (F(1, 164) = 2.216, p = 0.139).

A multilevel regression analysis was considered but decided against. While the participants were part of the same larger organizations that set the guidelines for which they work (e.g., CAMHD and DOE), they each came from various agencies or schools nested within those departments. The sample size of each agency or school was between 1 and 15, which is too small to conduct a multilevel model.

The use of the word “predictor” was chosen due to the conventional use of this term in multiple regression analyses. It should be noted that the use of “predictor” refers to the independent variables of this cross-sectional study.

A moderation analysis was conducted by creating interaction terms between the dummy coded variable of organization membership and the predictor variables. Each interaction was checked one by one and found to be non-significant in predicting the dependent variable. Thus, none of the interaction terms were retained in the main analyses.

Supplemental analyses were conducted with the original MPAS instead of the Aggregated EBP Attitudes score. A majority of the findings were maintained (i.e., variables that significantly predicted positive EBP attitudes included organizational membership and stress and the variables that approached significance included social desirability and cohesion).

Children’s health topics: Behavioral and mental health. American Academy of Pediatrics. Available online at http://www.aap.org/healthtopics/behavmenthlth.cfm. Accessed 2011.

Chorpita BF, Daleiden EL, Weisz JR. Identifying and selecting the common elements of evidence-based interventions: A distillation and matching model. Mental Health Services Research. 2005; 7: 5–20. doi: 10.1007/s11020-005-1962-6.CrossRefPubMed

Lonigan CJ, Elbert JC, Johnson S. Empirically supported psychosocial interventions for children: An overview. Journal of Clinical Child and Adolescent Psychology. 1998; 27: 138–145. doi:10.1207/s15374424jccp2702_1.CrossRef

Silverman WK, Hinshaw SP. The second special issue on evidence-based psychosocial treatments for children and adolescents: A 10-year update. Journal of Clinical Child and Adolescent Psychology. 2008; 37(1): 1–7. doi:10.1080/15374410701817725 CrossRef

Weisz JR, Hawley KM, Doss AJ. Empirically tested psychotherapies for youth internalizing and externalizing problems and disorders. Child and Adolescent Psychiatric Clinics of North America. Special Issue: Evidence-Based Practice, Part I: Research Update. 2004; 13(4): 729–815. doi:10.1016/j.chc.2004.05.006.

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): 1–15. doi:10.1186/1748-5908-4-50.

Fixsen DL, Naoom SF, Blase KA, et al. Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Research Institute, The National Implementation Research Network; 2005.

Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991; 50: 179–211. doi: 10.1016/0749-5978(91)90020-T.CrossRef

Cote F, Gagnon J, Houme PK, et al. Using the Theory of Planned Behaviour to predict nurses’ intention to integrate research evidence into clinical decision-making. Journal of Advanced Nursing. 2012; 68(10): 2289–2298. doi: 10.1111/j.1365-2648.2011.05922.x CrossRefPubMed

10.

Kelly PJ, Deane FP, Lovett MJ. Using the theory of planned behavior to examine residential substance abuse workers intention to use evidence-based practices. Psychology of Addictive Behaviors. 2012; 26(3): 661–664. doi: 10.1037/a0027887.CrossRefPubMed

11.

Walker A, Watson M, Grimshaw J, et al. Applying the theory of planned behaviour to pharmacists’ beliefs and intentions about the treatment of vaginal candidiasis with non-prescription medicines. Family Practice. 2004; 21: 670–676. doi: 10.1093/fampra/cmh615.CrossRefPubMed

12.

Rogers EM. Diffusion of Innovations. 5th ed. New York, NY: Free Press; 2004.

13.

Lim A, Nakamura BJ, Higa-McMillan C, et al. Effects of workshop trainings on evidence-based practice knowledge and attitudes among youth community mental health providers. Behaviour Research and Therapy. 2012; 50: 397–406. doi: 10.1016/j.brat.2012.03.008.CrossRefPubMed

14.

Nakamura BJ, Higa-McMillan C, Okamura K, et al. Knowledge of and attitudes towards evidence-based practices in community child mental health practitioners. Administration and Policy in Mental Health and Mental Health Services Research. 2011; 38(4): 287–300. doi: 10.1007/s10488-011-0351-2.CrossRefPubMed

15.

Jensen-Doss A, Hawley KM. Understanding barriers to evidence-based assessment: Clinician attitudes toward standardized assessment tools. Journal of Clinical Child and Adolescent Psychology. 2010; 39(6): 885–896. doi: 10.1080/15374416.2010.517169.CrossRefPubMedPubMedCentral

16.

Jensen-Doss A, Hawley KM. Understanding clinicians’ diagnostic practices: Attitudes toward the utility of diagnosis and standardized diagnostic tools. Administration and Policy in Mental Health and Mental Health Services Research. 2011; 38: 476–487. doi: 10.1007/s10488-011-0334-3.CrossRefPubMed

17.

Becker EM, Smith AM, Jensen-Doss A. Who’s using treatment manuals? A national survey of practicing therapists. Behaviour Research and Therapy. 2013; 51: 706–710. doi: 10.1016/j.brat.2013.07.008.CrossRefPubMed

18.

Kolko D, Cohen JA, Mannarino AP, et al. Community treatment of child sexual abuse: A survey of practitioners in the National Child Traumatic Stress Network. Administration and Policy in Mental Health and Mental Health Services Research. 2009; 36(1): 37–49. doi: 10.1007/s10488-008-0180-0.CrossRefPubMed

19.

Beidas RS, Kendall PC. Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice. 2010; 17(1): 1–30. doi: 10.1111/j.1468-2850.2009.01187.x.

20.

Stumpf RE, Higa-McMillan CK, Chorpita BF. Implementation of evidence-based services for youth: Assessing provider knowledge. Behavior Modification. 2009; 33: 48–65. doi:10.1177/0145445508322625.CrossRefPubMed

21.

Melas CD, Zampetakis LA, Dimopoulou A, et al. Evaluating the properties of the Evidence-Based Practice Attitude Scale (EBPAS) in health care. Psychological Assessment. 2012; 24(4): 867–876. doi: 10.1037/a0027445.CrossRefPubMed

22.

Hartzler B, Baer JS, Dunn C, et al. What is seen through the looking glass: The impact of training on practitioner self-rating of motivational interviewing skills. Behavioural and Cognitive Psychotherapy. 2007; 35(4): 431–445. doi: 10.1017/S1352465807003712.CrossRef

23.

Manuel JK, Hagedorn HJ, Finney JW. Implementing evidence-based psychosocial treatment in specialty substance use disorder care. Psychology of Addictive Behaviors. 2011; 25(2): 225–237. doi: 10.1037/a0022398.CrossRefPubMedPubMedCentral

24.

Crowne DP, Marlowe D. A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology. 1960; 24: 349–354. doi: 10.1037/h0047358 CrossRefPubMed

25.

Croucher SM, Kassing JW, Diers-Lawson AR. Accuracy, coherence, and discrepancy in self- and other-reports: moving toward an interactive perspective of organization dissent. Management Communication Quarterly. 2013; 27: 425–442. doi: 10.1177/0893318913476142.CrossRef

26.

Edwards AL. The relationship between the judged desirability of a trait and the probability that the trait will be endorsed. The Journal of Applied Psychology. 1953; 37(2): 90–93. doi: 10.1037/h0058073.CrossRef

27.

Pedregon CA, Farley RL, Davis A, et al. Social Desirability, personality questionnaires, and the “better than average” effect. Personality and Individual Difference. 2012; 52: 213–217. doi: 10.1016/j.paid.2011.10.022.CrossRef

28.

Kowalska J., Winnicka J. Attitudes of undergraduate students towards persons with disabilities; the role of the need for social approval. Polish Psychological Bulletin. 2013; 44(1): 40–49. doi: 10.2478/ppb-2013-0005.CrossRef

29.

Fu W, Deshpande SP, Zhao X. The impact of ethical behavior and facets of job satisfaction on organizational commitment of Chinese Employees. Journal of Business Ethics. 2011; 104: 537–543. doi: 10.1007/s10551-011-0928-4.CrossRef

30.

Carels RA, Cacciapaglis HM, Rydin S, et al. Can social desirability interfere with success in a behavioral weight loss program? Psychology and Health. 2006; 21(1): 65–78. doi: 10.1080/14768320500102277.CrossRef

31.

Aarons GA, Glisson C, Green PD, et al. The organizational social context of mental health services and clinician attitudes toward evidence-based practice: A United States national study. Implementation Science. 2012; 7(56): 1–28. doi: 10.1186/1748-5908-7-56.

32.

Aarons GA, Sawitzky AC. Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychological Services. 2006; 3(1): 61–72. doi: 10.1037/1541-1559.3.1.61.CrossRefPubMedPubMedCentral

33.

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(4): 423–431. doi: 10.1016/j.jaac.2012.01.018.CrossRefPubMed

34.

Glisson C, Green P, Williams NJ. Assessing the organizational social context (OSC) of child welfare systems: Implications for research and practice. Child Abuse & Neglect. 2012; 36: 621– 632. doi: 10.1016/j.chiabu.2012.06.002.CrossRef

35.

Glisson C, Williams NJ, Green P, et al. The organizational social context of mental health medicaid waiver programs with family support services: Implications for research and practice. Administration and Policy in Mental Health and Mental Health Services. 2013; 41(1): 32–42. doi: 10.1007/s10488-013-0517-1.CrossRef

36.

Aarons GA, Sommerfeld DH, Walrath-Greene CM. Evidence-based practice implementation: The impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice. Implementation Science. 2009; 4(83): 1–13. doi:10.1186/1748-5908-4-83.

37.

Sinkowitz-Cochran RL, Burkitt KH, Cuerdon T, et al. The associations between organizational culture and knowledge, attitudes, and practices in a multicenter Veterans Affairs quality improvement initiative to prevent methicillin-resistant Staphylococcus aureus. American Journal of Infection Control. 2012; 40: 138–143. doi:10.1016/j.ajic.2011.04.332.CrossRefPubMed

38.

Glisson C. The organizational context of children’s mental health services. Clinical Child and Family Psychology Review. 2002; 5(4): 233–253. doi: 10.1023/A:1020972906177.CrossRefPubMed

39.

Wisdom JP, Chor KHB, Hoagwood KE, et al. Innovation adoption: A review of theories and constructs. Administration and Policy in Mental Health and Mental Health Related Services. 2014; 41: 480–502. doi: 10.1007/s10488-013-0486-4.CrossRef

40.

Frambach RT, Schillewaert N. Organizational innovation adoption: A multi-level framework of determinants and opportunities for future research. Journal of Business Research. 2002; 55(2): 163–176. doi:10.1016/S0148-2963(00)00152-1.CrossRef

41.

State of Hawaii Department of Education Office of Curriculum, Instruction and Student Support and Department of Health Child & Adolescent Mental Health Division. Interagency Performance Standards and Practice Guidelines. State of Hawaii Publication No. 06–310, Honolulu, HI: Hawaii State Department of Health, 2006.

42.

Nakamura BJ, Selbo-Bruns A, Okamura K, et al. Developing a systematic evaluation approach for training programs within a train-the-trainer model for youth cognitive behavior therapy. Behavior Research and Therapy. 2014; 53: 10–19. doi: 10.1016/j.brat.2013.12.001.CrossRef

43.

Ebesutani C, Bernstein A, Nakamura B, et al. A psychometric analysis of the revised child anxiety and depression scale – parent version in a clinical sample. Journal of Abnormal Child Psychology. 2010; 38(2): 249–260. doi: 10.1007/s10802-009-9363-8.CrossRefPubMed

44.

Aarons GA. Mental health provider attitudes toward adoption of evidence-based practice: The Evidence-Based Practice Attitude Scale (EBPAS). Mental Health Services Research. 2004; 6: 61–74. doi:10.1023/B:MHSR.0000024351.12294.65.CrossRefPubMedPubMedCentral

45.

Aarons GA, Glisson C, Hoagwood K, et al. Psychometric properties and U.S. National norms of the Evidence-Based Practice Attitude Scale (EBPAS). Psychological Assessment. 2010; 22(2): 356–365. doi: 10.1037/a0019188.CrossRefPubMed

46.

Chorpita BF, Daleiden E. Evidence-based services committee - Biennial report – Effective psychological interventions for youth with behavioral and emotional needs. Honolulu, HI: Hawaii Department of Health Child and Adolescent Mental Health Division; 2009.

47.

Okamura KH, Nakamura BJ, Mueller C, et al. An exploratory factor analysis of the knowledge of evidence-based services questionnaire. Journal of Behavioral Health Services & Research. 2014; 1–18. doi:10.1007/s11414-013-9384-5.

48.

Weist M, Lever N, Stephan S, et al. Formative evaluation of a framework for high quality, evidence-based services in school mental health. School Mental Health. 2009; 1(4): 196–211. doi: 10.1007/s12310-009-9018-5.CrossRef

49.

Reynolds WM. Development of reliable and valid short forms of the Marlowe-Crowne Social Desirability Scale. Journal of Clinical Psychology. 1982; 38: 119 –125. doi: 10.1002/1097-4679(198201)38:1<119::AID-JCLP2270380118>3.0.CO;2-I.CrossRef

50.

Borntrager CF, Chorpita BF, Higa-McMillan CK, et al. Provider attitudes toward evidence-based practices: Are the concerns with the evidence or with the manuals? Psychiatric Services. 2009; 60: 677–681. doi: 10.1176/appi.ps.60.5.677.CrossRefPubMed

51.

Haynes SN, Yoshioka DT. Clinical assessment applications of ambulatory biosensors. Psychological Assessment. 2007; 19(1): 44–57. doi: 10.1037/1040-3590.19.1.44.CrossRefPubMed

52.

Keaweaimoku Kaholokula J, Haynes SN, Grandinetti A, et al. Biological, psychosocial, and sociodemographic variables associated with depressive symptoms in persons with Type 2 Diabetes. Journal of Behavioral Medicine. 2003; 26(5): 435–458. doi: 10.1023/A:1025772001665.CrossRefPubMed

53.

Haynes SN, Smith G, Hunsley JR. Scientific Foundations of Clinical Assessment. New York, NY: Taylor and Francis/Routledge; 2011.

54.

Lehman WEK, Greener JM, Simpson D. Assessing organizational readiness for change. Journal of Substance Abuse Treatment. 2002; 22: 197–209. doi: 10.1016/S0740-5472(02)00233-7.CrossRefPubMed

55.

Henggeler SW, Chapman JE, Rowland MD, et al. Statewide adoption and initial implementation of contingency management for substance-abusing adolescents. Journal of Consulting and Clinical Psychology. 2008; 76(4): 556–567. doi: 10.1037/0022-006X.76.4.556.CrossRefPubMedPubMedCentral

56.

Henggeler SW, Chapman JE, Rowland MD, et al. If you build it, they will come: Statewide practitioner interest in contingency management for youths. Journal of Substance Abuse Treatment. 2007; 32: 121–131. doi:10.1016/j.jsat.2006.07.006.CrossRefPubMed

57.

Saldana L, Chapman JE, Henggeler SW, et al. The organizational readiness for change scale in adolescent programs: Criterion validity. Journal of Substance Abuse Treatment. 2007; 33: 159 – 169. doi:10.1016/j.jsat.2006.12.029.CrossRefPubMedPubMedCentral

58.

Barwick MA, Peters J, Boydell K. Getting to uptake: Do communities of practice support the implementation of evidence-based practice? Journal of the Canadian Academy of Children and Adolescent Psychiatry. 2009; 18(1): 16–29.

59.

Hamilton AB, Cohen AN, Young AS. Organizational readiness in specialty mental health care. Journal of General Internal Medicine. 2009; 25(Suppl 1): 27–31. doi: 10.1007/s11606-009-1133-3.

60.

Schurer J, Kohl PL, Bellamy JL. Organizational context and readiness for change: A study of community-based parenting programs in one Midwestern city. Administration in Social Work. 2010; 34: 178–195. doi:10.1080/03643101003609487.CrossRef

61.

Simpson DD. Organizational readiness for stage-based dynamics of innovation implementation. Research on Social Work Practice. 2009; 19(5): 541–551. doi: 10.1177/1049731509335589.CrossRef

62.

Beidas RS, Mychailyszyn MP, Edmunds JM, et al. Training school mental health providers to delivers cognitive-behavioral therapy. School Mental Health. 2012; 1: 1–12. doi: 10.1007/s12310-012-9074-0.

63.

Statistical Package for the Social Sciences, Inc. S.P.S.S. 15.0 base user's guide. Prentice Hall; 2006.

64.

Little RJA, Rubin DB. Statistical Analysis with Missing Data. New York, NY: John Wiley & Sons; 1987.

65.

Shapiro SS, Wilk MB. An analysis of variance test for normality (complete samples). Biometrika. 1965; 52: 591–611. doi: 10.1093/biomet/52.3-4.591.CrossRef

66.

Tabachnick BG, Fidell LS. Using Multivariate Statistics. 5th ed. Upper Saddle River, NJ: Allyn & Bacon; 2007.

67.

Faul F, Erdfelder E, Lang A, et al. G*Power 3. Heinrich Heine Universitat Dusseldorf. Available online at http://www.psycho.uni-duesseldorf.de/abteilungen/aap/gpower3/. Accessed September, 16, 2013.

68.

Green SB, Salkind NJ. Using SPSS for Windows and Macintosh: Analyzing and understanding data. 4th ed. NJ: Pearson Education, Inc.; 2005.

69.

Brown CE, Wickline MA, Ecoff L, et al. Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center. Journal of Advanced Nursing. 2008; 65(2): 371–381. doi: 10.1111/j.1365-2648.2008.04878.x.CrossRefPubMed

70.

Chau JPC, Lopez V, Thompson DR. A survey of Hong Kong nurses' perceptions of barriers to and facilitators of research utilization. Research in Nursing & Health. 2008; 31(6): 640–649. doi: 10.1002/nur.20289.CrossRef

71.

Cummings GG, Estabrooks CA, Midodzi WK, et al. Influence of organizational characteristics and context on research utilization. Nursing Research. 2007; 54(4s): s24-s39. doi: 10.1097/01.NNR.0000280629.63654.95.CrossRef

72.

Egerod I, Hansen GM. Evidence-based practice among Danish cardiac nurses: A national survey. Journal of Advanced Nursing. 2004; 51(5): 465 – 473. doi: 10.1111/j.1365-2648.2005.03525.x.CrossRef

73.

Estrada N. Exploring perceptions of a learning organization by RNs and relationship to EBP beliefs and implementation in the acute care setting. Worldviews on Evidence-Based Nursing. 2009; 6(4): 200–209. doi: 10.1111/j.1741-6787.2009.00161.x.CrossRefPubMed

74.

Beidas RS, Marcus S, Aarons GA, et al. Predictors of community therapists’ use of therapy techniques in a large public mental health system. Journal of the American Medical Association Pediatrics. 2015; E1 – E9. doi: 10.1001/jamapediatrics.2014.3736.

75.

Henggeler SW, Borduin CM. Family therapy and beyond: A multisystemic approach to treating the behavior problems of children and adolescents. Pacific Grove, CA: Brooks/Cole; 1990.

76.

Alexander JF, & Parsons, B. V. Short-term behavioral intervention with delinquent families: Impact on family process and recidivism. Journal of Abnormal Psychology. 1973; 81(3): 219– 225. doi:10.1037/h0034537.CrossRefPubMed

77.

Child and Adolescent Mental Health Division. Instructions and codebook for provider monthly summaries. Honolulu, HI: Hawaii Department of Health Child and Adolescent Mental Health Division; 2003.

78.

Higa-McMillan CK, Powell CKK, Daleiden EL, et al. Pursuing an evidence-based culture through contextualized feedback: Aligning youth outcome and practices. Professional Psychology: Research and Practice. 2011; 42(2): 137–144. doi: 10.1037/a0022139.CrossRef

Title: Knowledge, Attitudes, Social Desirability, and Organizational Characteristics in Youth Mental Health Services
Authors: Sonia C. Izmirian, MA
Brad J. Nakamura, PhD
Publication date: 01-10-2016
Publisher: Springer US
Published in: The Journal of Behavioral Health Services & Research / Issue 4/2016
Print ISSN: 1094-3412
Electronic ISSN: 2168-6793
DOI: https://doi.org/10.1007/s11414-015-9491-6

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Knowledge, Attitudes, Social Desirability, and Organizational Characteristics in Youth Mental Health Services

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