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. 2022 Sep;49(5):785-797.
doi: 10.1007/s10488-022-01199-x. Epub 2022 May 18.

"Change Doesn't Happen by Itself": A Thematic Analysis of First-Level Leaders' Experiences Participating in the Leadership and Organizational Change for Implementation (LOCI) Strategy

Randi Hovden Borge  1 , Karina M Egeland  2 , Gregory A Aarons  3   4   5 , Mark G Ehrhart  6 , Marisa Sklar  3   4   5 , Ane-Marthe Solheim Skar  2
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"Change Doesn't Happen by Itself": A Thematic Analysis of First-Level Leaders' Experiences Participating in the Leadership and Organizational Change for Implementation (LOCI) Strategy

Randi Hovden Borge et al. Adm Policy Ment Health. 2022 Sep.

Abstract

The Leadership and Organizational Change for Implementation (LOCI) strategy is a multifaceted implementation strategy that aims to support successful evidence-based practice (EBP) implementation by fostering effective general leadership, implementation leadership, and implementation climate. How implementation strategies are experienced by participants is important for their utilization and effectiveness in supporting EBP implementation. The current study is the first in-depth qualitative study exploring first-level leaders' experiences of participating in the LOCI strategy. Data were collected as part of a trial where Norwegian child and adult mental health outpatient clinics implemented EBPs for posttraumatic stress disorder (PTSD). Eleven first-level leaders from adult and child clinics participated in semi-structured interviews after completing the LOCI strategy. Data were analyzed through reflexive thematic analysis. The analysis generated four themes related to leaders' experiences of participating in the LOCI strategy: (1) structuring the EBP implementation, (2) taking responsibility for the EBP implementation, (3) interacting with others about the EBP implementation, and (4) becoming aware of EBP implementation and their own leadership. Most participants experienced the LOCI strategy as beneficial for implementing EBPs for PTSD in their clinic. The strategy succeeded in raising awareness of leadership for EBP implementation, and simultaneously provided participants with tools and support for leading the implementation in their clinic. Two participants experienced LOCI as less beneficial than the others. Our results support the strategy's potential to engage and empower first-level leaders to get involved in implementation processes and point to important challenges for future research on implementation strategies.

Keywords: Evidence-based practices; Implementation leadership; Implementation strategy; LOCI; Mental health services.

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Conflict of interest statement

Authors have no competing interests.

Figures

Fig. 1
Fig. 1
Purposeful sampling approach. 1Not able to recruit
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