Skip to main content
Top
Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Research article

Attitudes of mental health providers towards adoption of evidence-based interventions: relationship to workplace, staff roles and social and psychological factors at work

Authors: Marte Rye, Oddgeir Friborg, Ingunn Skre

Published in: BMC Health Services Research | Issue 1/2019

Login to get access

Abstract

Background

Gaining insight into factors influencing the adoption of evidence-based interventions (EBI) is essential to ensuring their sustainability in the mental healthcare setting. This article describes 1) differences between professional staff roles in attitudes towards EBI and 2) individual and organizational predictors of attitudes towards adopting EBI.

Methods

The participants were psychologists and psychiatric nurses (N = 792). Student t-tests were used to investigate group differences of global attitude scores on the Evidence-based Practice Attitude Scale-36 (EBPAS-36). A confirmatory factor analysis (CFA) of the EBPAS-36 measurement model, and a principal component analysis (PCA) of the factor scores were used to obtain attitudinal components for the subsequent hierarchical regression analyses.

Results

Three second-order attitudinal components were retained and named: professional concern, attitudes related to work conditions and requirements, and attitudes related to fit and preferences. Nurses’ global attitudinal scores were more positive than those of psychologists, while clinicians had less positive global attitudinal scores than non-clinicians. Hierarchical regression analysis showed that provider demographic, social and psychological factors in the workplace and staff role predicted attitudes towards adopting EBI, e.g. male gender, older age and working in private practice predicted more negative global attitudes, while working in academia, experiencing social support from colleagues and empowering leadership predicted more positive global attitudes to adopt EBI. The prediction outcomes for the specific attitudinal components are presented, as well.

Conclusion

The findings suggest that implementation efforts may benefit from being tailored to the different needs and values of the affected professionals, including the role of the context they operate within. Implications with a special emphasis on training efforts and organizational development are discussed.
Literature
1.
go back to reference Drake RE, et al. Implementing evidence-based practices in routine mental health service settings. Psychiatr Serv. 2001;52(2):179–82.PubMedCrossRef Drake RE, et al. Implementing evidence-based practices in routine mental health service settings. Psychiatr Serv. 2001;52(2):179–82.PubMedCrossRef
3.
go back to reference Balas EA, Boren SA. Managing clinical knowledge for health care improvement. Yearb Med Inf. 2000;2000:65–70. Balas EA, Boren SA. Managing clinical knowledge for health care improvement. Yearb Med Inf. 2000;2000:65–70.
4.
go back to reference Haines A, Kuruvilla S, Borchert M. Bridging the implementation gap between knowledge and action for health. Bull World Health Organ. 2004;82(10):724–31 discussion 732.PubMedPubMedCentral Haines A, Kuruvilla S, Borchert M. Bridging the implementation gap between knowledge and action for health. Bull World Health Organ. 2004;82(10):724–31 discussion 732.PubMedPubMedCentral
5.
go back to reference Waller G, Turner H. Therapist drift redux: why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track. Behav Res Ther. 2016;77:129–37.PubMedCrossRef Waller G, Turner H. Therapist drift redux: why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track. Behav Res Ther. 2016;77:129–37.PubMedCrossRef
6.
go back to reference Wisdom JP, et al. Innovation adoption: a review of theories and constructs. Admin Pol Ment Health. 2014;41(4):480–502.CrossRef Wisdom JP, et al. Innovation adoption: a review of theories and constructs. Admin Pol Ment Health. 2014;41(4):480–502.CrossRef
7.
go back to reference Powell BJ, et al. Are general and strategic measures of organizational context and leadership associated with knowledge and attitudes toward evidence-based practices in public behavioral health settings? A cross-sectional observational study. Implement Sci. 2017;12(1):64.PubMedPubMedCentralCrossRef Powell BJ, et al. Are general and strategic measures of organizational context and leadership associated with knowledge and attitudes toward evidence-based practices in public behavioral health settings? A cross-sectional observational study. Implement Sci. 2017;12(1):64.PubMedPubMedCentralCrossRef
8.
go back to reference Aarons GA, et al. Expanding the domains of attitudes towards evidence-based practice: the evidence based practice attitude scale-50. Admin Pol Ment Health. 2012;39(5):331–40.CrossRef Aarons GA, et al. Expanding the domains of attitudes towards evidence-based practice: the evidence based practice attitude scale-50. Admin Pol Ment Health. 2012;39(5):331–40.CrossRef
9.
go back to reference Rye M, et al. The evidence-based practice attitude Scale-36 (EBPAS-36): a brief and pragmatic measure of attitudes to evidence-based practice validated in US and Norwegian samples. Implement Sci. 2017;12(1):44.PubMedPubMedCentralCrossRef Rye M, et al. The evidence-based practice attitude Scale-36 (EBPAS-36): a brief and pragmatic measure of attitudes to evidence-based practice validated in US and Norwegian samples. Implement Sci. 2017;12(1):44.PubMedPubMedCentralCrossRef
10.
11.
go back to reference Lilienfeld SO, et al. Why many clinical psychologists are resistant to evidence-based practice: root causes and constructive remedies. Clin Psychol Rev. 2013;33(7):883–900.PubMedCrossRef Lilienfeld SO, et al. Why many clinical psychologists are resistant to evidence-based practice: root causes and constructive remedies. Clin Psychol Rev. 2013;33(7):883–900.PubMedCrossRef
12.
go back to reference Aarons GA. Measuring provider attitudes toward evidence-based practice: consideration of organizational context and individual differences. Child Adolesc Psychiatr Clin N Am. 2005;14(2):255–71 viii.PubMedPubMedCentralCrossRef Aarons GA. Measuring provider attitudes toward evidence-based practice: consideration of organizational context and individual differences. Child Adolesc Psychiatr Clin N Am. 2005;14(2):255–71 viii.PubMedPubMedCentralCrossRef
13.
go back to reference Beidas RS, et al. Predictors of community therapists' use of therapy techniques in a large public mental health system. JAMA Pediatr. 2015;169(4):374–82.PubMedPubMedCentralCrossRef Beidas RS, et al. Predictors of community therapists' use of therapy techniques in a large public mental health system. JAMA Pediatr. 2015;169(4):374–82.PubMedPubMedCentralCrossRef
14.
go back to reference Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Admin Pol Ment Health. 2011;38(1):4–23.CrossRef Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Admin Pol Ment Health. 2011;38(1):4–23.CrossRef
15.
go back to reference Damschroder LJ, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.PubMedPubMedCentralCrossRef Damschroder LJ, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.PubMedPubMedCentralCrossRef
16.
go back to reference Okamura KH, et al. Furthering our understanding of therapist knowledge and attitudinal measurement in youth community mental health. Admin Pol Ment Health. 2018;45(5):699–708. Okamura KH, et al. Furthering our understanding of therapist knowledge and attitudinal measurement in youth community mental health. Admin Pol Ment Health. 2018;45(5):699–708.
17.
go back to reference Cook JM, Biyanova T, Coyne JC. Barriers to adoption of new treatments: an internet study of practicing community psychotherapists. Admin Pol Ment Health. 2009;36(2):83–90.CrossRef Cook JM, Biyanova T, Coyne JC. Barriers to adoption of new treatments: an internet study of practicing community psychotherapists. Admin Pol Ment Health. 2009;36(2):83–90.CrossRef
18.
go back to reference Connors EH, et al. Factors associated with community-partnered school behavioral health Clinicians' adoption and implementation of evidence-based practices. Admin Pol Ment Health. 2018;46(1):91–104. Connors EH, et al. Factors associated with community-partnered school behavioral health Clinicians' adoption and implementation of evidence-based practices. Admin Pol Ment Health. 2018;46(1):91–104.
19.
go back to reference Aarons GA, et al. Psychometric properties and U.S. national norms of the evidence-based practice attitude scale (EBPAS). Psychol Assess. 2010;22(2):356–65.PubMedCrossRef Aarons GA, et al. Psychometric properties and U.S. national norms of the evidence-based practice attitude scale (EBPAS). Psychol Assess. 2010;22(2):356–65.PubMedCrossRef
20.
21.
go back to reference Stewart RE, Stirman SW, Chambless DL. A qualitative investigation of practicing psychologists' attitudes toward research-informed practice: implications for dissemination strategies. Prof Psychol Res Pract. 2012;43(2):100–9.CrossRef Stewart RE, Stirman SW, Chambless DL. A qualitative investigation of practicing psychologists' attitudes toward research-informed practice: implications for dissemination strategies. Prof Psychol Res Pract. 2012;43(2):100–9.CrossRef
22.
go back to reference Pagoto SL, et al. Barriers and facilitators of evidence-based practice perceived by behavioral science health professionals. J Clin Psychol. 2007;63(7):695–705.PubMedCrossRef Pagoto SL, et al. Barriers and facilitators of evidence-based practice perceived by behavioral science health professionals. J Clin Psychol. 2007;63(7):695–705.PubMedCrossRef
23.
go back to reference Nelson TD, Steele RG, Mize JA. Practitioner attitudes toward evidence-based practice: themes and challenges. Admin Pol Ment Health. 2006;33(3):398–409.CrossRef Nelson TD, Steele RG, Mize JA. Practitioner attitudes toward evidence-based practice: themes and challenges. Admin Pol Ment Health. 2006;33(3):398–409.CrossRef
24.
25.
go back to reference Aarons GA. Transformational and transactional leadership: association with attitudes toward evidence-based practice. Psychiatr Serv. 2006;57(8):1162–9.PubMedPubMedCentralCrossRef Aarons GA. Transformational and transactional leadership: association with attitudes toward evidence-based practice. Psychiatr Serv. 2006;57(8):1162–9.PubMedPubMedCentralCrossRef
26.
go back to reference Barnett M, et al. How intervention and implementation characteristics relate to community Therapists' attitudes toward evidence-based practices: a mixed methods study. Admin Pol Ment Health. 2017;44(6):824–37.CrossRef Barnett M, et al. How intervention and implementation characteristics relate to community Therapists' attitudes toward evidence-based practices: a mixed methods study. Admin Pol Ment Health. 2017;44(6):824–37.CrossRef
27.
go back to reference Aarons GA, Sawitzky AC. Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychol Serv. 2006;3(1):61–72.PubMedPubMedCentralCrossRef Aarons GA, Sawitzky AC. Organizational culture and climate and mental health provider attitudes toward evidence-based practice. Psychol Serv. 2006;3(1):61–72.PubMedPubMedCentralCrossRef
28.
go back to reference Arumugam V, et al. Attitudes, knowledge and behaviors related to evidence-based practice in health professionals involved in pain management. Int J Evid Based Healthc. 2018;16(2):107–18. Arumugam V, et al. Attitudes, knowledge and behaviors related to evidence-based practice in health professionals involved in pain management. Int J Evid Based Healthc. 2018;16(2):107–18.
29.
go back to reference Asadoorian J, et al. Evidence-based practice in healthcare: an exploratory cross-discipline comparison of enhancers and barriers. J Healthc Qual. 2010;32(3):15–22.PubMedCrossRef Asadoorian J, et al. Evidence-based practice in healthcare: an exploratory cross-discipline comparison of enhancers and barriers. J Healthc Qual. 2010;32(3):15–22.PubMedCrossRef
30.
go back to reference Beidas RS, et al. A multi-level examination of stakeholder perspectives of implementation of evidence-based practices in a large urban publicly-funded mental health system. Adm Policy Ment Health Ment Health Serv Res. 2016;43(6):893–908.CrossRef Beidas RS, et al. A multi-level examination of stakeholder perspectives of implementation of evidence-based practices in a large urban publicly-funded mental health system. Adm Policy Ment Health Ment Health Serv Res. 2016;43(6):893–908.CrossRef
31.
go back to reference Stadnick NA, et al. Comparing agency leader and therapist perspectives on evidence-based practices: associations with individual and organizational factors in a mental health system-driven implementation effort. Admin Pol Ment Health. 2017;45(3):447–61. Stadnick NA, et al. Comparing agency leader and therapist perspectives on evidence-based practices: associations with individual and organizational factors in a mental health system-driven implementation effort. Admin Pol Ment Health. 2017;45(3):447–61.
32.
go back to reference Green AE, Aarons GA. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping. Implement Sci. 2011;6:104.PubMedPubMedCentralCrossRef Green AE, Aarons GA. A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping. Implement Sci. 2011;6:104.PubMedPubMedCentralCrossRef
33.
go back to reference Aarons GA, et al. The humble leader: Association of Discrepancies in leader and follower ratings of implementation leadership with organizational climate in mental health. Psychiatr Serv. 2017;68(2):115–22.PubMedCrossRef Aarons GA, et al. The humble leader: Association of Discrepancies in leader and follower ratings of implementation leadership with organizational climate in mental health. Psychiatr Serv. 2017;68(2):115–22.PubMedCrossRef
34.
go back to reference Aarons GA, et al. Discrepancies in leader and follower ratings of transformational leadership: relationship with organizational culture in mental health. Admin Pol Ment Health. 2017;44(4):480–91.CrossRef Aarons GA, et al. Discrepancies in leader and follower ratings of transformational leadership: relationship with organizational culture in mental health. Admin Pol Ment Health. 2017;44(4):480–91.CrossRef
35.
go back to reference Aarons GA, et al. The roles of system and organizational leadership in system-wide evidence-based intervention sustainment: a mixed-method study. Admin Pol Ment Health. 2016;43(6):991–1008.CrossRef Aarons GA, et al. The roles of system and organizational leadership in system-wide evidence-based intervention sustainment: a mixed-method study. Admin Pol Ment Health. 2016;43(6):991–1008.CrossRef
36.
go back to reference Psykologforening N. Prinsipperklæring om evidensbasert psykologisk praksis. Tidsskrift for Norsk Psykologforening. 2007;9:1127–8. Psykologforening N. Prinsipperklæring om evidensbasert psykologisk praksis. Tidsskrift for Norsk Psykologforening. 2007;9:1127–8.
37.
go back to reference APA Presidental Task Force on Evidence-Based Practice. Evidence-based practice in psychology. Am Psychol. 2006;61(4):271–85.CrossRef APA Presidental Task Force on Evidence-Based Practice. Evidence-based practice in psychology. Am Psychol. 2006;61(4):271–85.CrossRef
38.
go back to reference Aarons GA. Mental health provider attitudes toward adoption of evidence-based practice: the evidence-based practice attitude scale (EBPAS). Ment Health Serv Res. 2004;6(2):61–74.PubMedPubMedCentralCrossRef Aarons GA. Mental health provider attitudes toward adoption of evidence-based practice: the evidence-based practice attitude scale (EBPAS). Ment Health Serv Res. 2004;6(2):61–74.PubMedPubMedCentralCrossRef
39.
go back to reference Skogstad A. STAMI-rapport; årgang 2, Brukerveiledning QPSNordic : generelt spørreskjema om psykologiske og sosiale faktorer i arbeidet, in STAMI-rapport. 2001, Statens arbeidsmiljøinstitutt. Skogstad A. STAMI-rapport; årgang 2, Brukerveiledning QPSNordic : generelt spørreskjema om psykologiske og sosiale faktorer i arbeidet, in STAMI-rapport. 2001, Statens arbeidsmiljøinstitutt.
40.
go back to reference Wannstrom I, et al. Psychometric properties of scales in the general Nordic questionnaire for psychological and social factors at work (QPS): confirmatory factor analysis and prediction of certified long-term sickness absence. Scand J Psychol. 2009;50(3):231–44.PubMedCrossRef Wannstrom I, et al. Psychometric properties of scales in the general Nordic questionnaire for psychological and social factors at work (QPS): confirmatory factor analysis and prediction of certified long-term sickness absence. Scand J Psychol. 2009;50(3):231–44.PubMedCrossRef
41.
go back to reference Wannstrom I, et al. Can scales assessing psychological and social factors at work be used across different occupations? Work. 2009;34(1):3–11.PubMedCrossRef Wannstrom I, et al. Can scales assessing psychological and social factors at work be used across different occupations? Work. 2009;34(1):3–11.PubMedCrossRef
42.
go back to reference Hu LB, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J. 1999;6(1):1–55.CrossRef Hu LB, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J. 1999;6(1):1–55.CrossRef
43.
go back to reference Park AL, et al. Unintended consequences of evidence-based treatment policy reform: is implementation the goal or the strategy for higher quality care? Admin Pol Ment Health. 2018;45(4):649–60.CrossRef Park AL, et al. Unintended consequences of evidence-based treatment policy reform: is implementation the goal or the strategy for higher quality care? Admin Pol Ment Health. 2018;45(4):649–60.CrossRef
44.
go back to reference Beidas RS, et al. Training research: practical recommendations for maximum impact. Admin Pol Ment Health. 2011;38(4):223–37.CrossRef Beidas RS, et al. Training research: practical recommendations for maximum impact. Admin Pol Ment Health. 2011;38(4):223–37.CrossRef
45.
go back to reference Lyon AR, et al. Using modular psychotherapy in school mental health: provider perspectives on intervention-setting fit. J Clin Child Adolesc Psychol. 2014;43(6):890–901.PubMedCrossRef Lyon AR, et al. Using modular psychotherapy in school mental health: provider perspectives on intervention-setting fit. J Clin Child Adolesc Psychol. 2014;43(6):890–901.PubMedCrossRef
46.
go back to reference McMillen JC, Hawley KM, Proctor EK. Mental health Clinicians' participation in web-based training for an evidence supported intervention: signs of encouragement and trouble ahead. Admin Pol Ment Health. 2016;43(4):592–603.CrossRef McMillen JC, Hawley KM, Proctor EK. Mental health Clinicians' participation in web-based training for an evidence supported intervention: signs of encouragement and trouble ahead. Admin Pol Ment Health. 2016;43(4):592–603.CrossRef
47.
go back to reference Van Horn PS, Green KE, Martinussen M. Survey response rates and survey Administration in Counseling and Clinical Psychology a Meta-Analysis. Educ Psychol Meas. 2009;69(3):389–403.CrossRef Van Horn PS, Green KE, Martinussen M. Survey response rates and survey Administration in Counseling and Clinical Psychology a Meta-Analysis. Educ Psychol Meas. 2009;69(3):389–403.CrossRef
48.
go back to reference Stormark KM, et al. Predicting nonresponse bias from teacher ratings of mental health problems in primary school children. J Abnorm Child Psychol. 2008;36(3):411–9.PubMedCrossRef Stormark KM, et al. Predicting nonresponse bias from teacher ratings of mental health problems in primary school children. J Abnorm Child Psychol. 2008;36(3):411–9.PubMedCrossRef
49.
50.
go back to reference Powell BJ, et al. Applying the policy ecology framework to Philadelphia's behavioral health transformation efforts. Admin Pol Ment Health. 2016;43(6):909–26.CrossRef Powell BJ, et al. Applying the policy ecology framework to Philadelphia's behavioral health transformation efforts. Admin Pol Ment Health. 2016;43(6):909–26.CrossRef
Metadata
Title
Attitudes of mental health providers towards adoption of evidence-based interventions: relationship to workplace, staff roles and social and psychological factors at work
Authors
Marte Rye
Oddgeir Friborg
Ingunn Skre
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-3933-4

Other articles of this Issue 1/2019

BMC Health Services Research 1/2019 Go to the issue