Building organizational readiness: initial field testing of an expert-informed typology of implementation strategies

Sigal Vax; Marianne Farkas; Kim T Mueser; Mari-Lynn Drainoni; Zlatka Russinova

doi:10.1186/s43058-022-00257-7

Building organizational readiness: initial field testing of an expert-informed typology of implementation strategies

Implement Sci Commun. 2022 Mar 2;3(1):22. doi: 10.1186/s43058-022-00257-7.

Authors

Sigal Vax^{1

2}, Marianne Farkas³, Kim T Mueser³, Mari-Lynn Drainoni^{4

5}, Zlatka Russinova³

Affiliations

¹ Rehabilitation Sciences Program, College of Health & Rehabilitation: Sargent College, Boston University, Boston, USA. sigalvax@gmail.com.
² Center for Psychiatric Rehabilitation, College of Health & Rehabilitation: Sargent College, Boston University, 940 Commonwealth Ave W, Boston, MA, 02215, USA. sigalvax@gmail.com.
³ Center for Psychiatric Rehabilitation, College of Health & Rehabilitation: Sargent College, Boston University, 940 Commonwealth Ave W, Boston, MA, 02215, USA.
⁴ Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, USA.
⁵ Department of Health Law Policy & Management, Boston University School of Public Health, Boston, USA.

Abstract

Background: Organizational readiness is a known barrier to implementing evidence-based practices (EBPs) in community mental health services. A robust methodology for enhancing organizational readiness for implementation (ORI) has the potential to improve implementation outcomes of EBPs and ensure better services for people with a psychiatric disability. Prior work established a framework of implementation strategies targeting ORI enhancement by asking a group of implementation experts from various fields to categorize strategies from the "Expert Recommendations for Implementing Change" (ERIC) Project into three readiness stages, consistent with the pre-action stages of the Transtheoretical Model of behavioral change: Pre-contemplation, Contemplation, and Preparation. The current study provides initial confirmation and refinement to this expert-driven typology based on community mental health field experiences.

Methods: We conducted in-depth interviews with stakeholders involved in a recent EBP implementation project. Participants included staff (n=9) from four community mental health agencies and the implementation team who facilitated the project (n=3). Their pre-implementation experiences were compared with the experts' typology to identify consistencies and discrepancies.

Results: The participants' experiences were congruent with two thirds of the strategies identified by the experts for specific ORI stages. The refinements included 12 strategies used in additional stages beyond the experts' classification, four strategies from the ERIC list that were not included in the ORI typology, and five new strategies.

Conclusions: This study provides initial confirmation and refinements to the previously published ORI typology. The results offer guidance as to how ORI could be enhanced in the community mental health field.

Keywords: Community mental health; Employment services; Evidence-based practices; Implementation strategies; Organizational readiness for change; Pre-implementation; Psychiatric rehabilitation; Psychosocial interventions; Transtheoretical model.

Abstract

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