TY - JOUR
T1 - Implementation of evidence-based practices for children in four countries
T2 - A project of the World Psychiatric Association
AU - Hoagwood, Kimberly E.
AU - Kelleher, Kelly
AU - Murray, Laura K.
AU - Jensen, Peter S.
PY - 2006/3
Y1 - 2006/3
N2 - Objective: The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. Method: A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. Results: All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1) early adoption and guidance by innovative leaders (i.e., the Directors); 2) attention to the "fit" between the intervention model and local practices; 3) attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues); 4) attention to back-end processes early in the project (e.g., sustainability); and 5) establishing strong relationships with multiple stakeholders within the program setting. Conclusions: The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.
AB - Objective: The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. Method: A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. Results: All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1) early adoption and guidance by innovative leaders (i.e., the Directors); 2) attention to the "fit" between the intervention model and local practices; 3) attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues); 4) attention to back-end processes early in the project (e.g., sustainability); and 5) establishing strong relationships with multiple stakeholders within the program setting. Conclusions: The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.
KW - Behavior
KW - Child
KW - Cognitive therapy
KW - Evidence-based medicine
KW - Feasibility studies
UR - http://www.scopus.com/inward/record.url?scp=33645458384&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33645458384&partnerID=8YFLogxK
U2 - 10.1590/s1516-44462006000100012
DO - 10.1590/s1516-44462006000100012
M3 - Article
C2 - 16612492
AN - SCOPUS:33645458384
SN - 1516-4446
VL - 28
SP - 59
EP - 66
JO - Revista Brasileira de Psiquiatria
JF - Revista Brasileira de Psiquiatria
IS - 1
ER -