Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation

BMC Research Notes

David A Patterson Silver Wolf (Adelv unegv Waya)¹  Carissa van den Berk-Clark²  Alex T Ramsey¹ 

[1] Washington University Brown School of Social Work, Campus Box 1196, One Brookings Drive, St. Louis 63130, MO, USA;Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri, USA

关键词: Addiction services;    Substance abuse treatment agencies;    Person-environment fit;    Organizational climate;    Practitioner attitudes;    Evidence-based practice implementation;   

Others  :  1232461
DOI  :  10.1186/s13104-015-1110-3

 received in 2014-06-20, accepted in 2015-03-31,  发布年份 2015

【 摘 要 】

Background

Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation.

Methods

Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire “fit continuum”.

Results

Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use.

Conclusions

The current research benefits from a strong theoretical framework, consistent findings, and significant practical implications for substance abuse treatment agencies. Comprehensive attempts to strengthen outcomes related to EBP implementation must consider both provider- and agency-level characteristics regarding EBP use. Organizational efforts to more closely align provider attitudes and agency priorities will likely constitute a key strategy in fostering the implementation of EBPs in substance abuse treatment organizations.

【 授权许可】

   
2015 Ramsey and van den Berk-Clark; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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