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. 2009 Dec 31:4:83.
doi: 10.1186/1748-5908-4-83.

Evidence-based practice implementation: the impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice

Gregory A Aarons  1 , David H Sommerfeld, Christine M Walrath-Greene
Affiliations

Evidence-based practice implementation: the impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice

Gregory A Aarons et al. Implement Sci. .

Abstract

Background: The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use.

Methods: Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use.

Results: Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice.

Conclusion: This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings.

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Figures

Figure 1
Figure 1
Path model with full mediation effects of agency type on organizational support for evidence-based practice, provider attitudes toward evidence-based practice, and provider use of evidence-based practice. N = 170; AIC = 2514.106, SBIC = 2513.678; *p < 0.05, **p < 0.01 (one-tailed).
Figure 2
Figure 2
Path model with partial mediation effects of agency type on organizational support for evidence-based practice and attitudes toward evidence-based practice, and effect of provider attitudes toward evidence-based practice on provider use of evidence-based practice. N = 170; AIC = 2512.035, SBIC = 2511.577; *p < 0.05 (one-tailed).
Figure 3
Figure 3
Path model of partial mediation effects of agency type on organizational support for evidence-based practice and attitudes toward evidence-based practice, effect of organizational support for evidence-based practice on provider attitudes toward evidence-based practice, and effect of organizational support for evidence-based practice on provider use of evidence-based practice. N = 170; AIC = 2437.127, SBIC = 2436.638; *p < 0.05, **p < 0.01 (one-tailed).
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