Abstract: Identifying and Ranking Implicit Leadership Strategies to Promote Evidence-Based Practice Implementation in Addiction Health Services (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Schedule:

Saturday, January 14, 2017: 10:45 AM

Balconies K (New Orleans Marriott)

* noted as presenting author

Howard Padwa, PhD, Professor, University of California, Los Angeles, Los Angeles, CA

Erick Guerrero, PhD, Assistant Professor, University of Southern California, Los Angeles, CA

Lesley Harris, MSW, PhD, Assistant Professor, University of Louisville, Louisville, KY

Gregory Aarons, PhD, Professor, University of California, San Diego, San Diego, CA 92123, CA

Karissa Fenwick, MSW, Doctoral Candidate, University of Southern California, Los Angeles, CA

Background: Despite a solid research base supporting the implementation of evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely delivered in community-based addiction treatment programs in the United States. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices.

Methods: We relied on an iterative mixed-methods approach to achieve the following four goals: (1) collect data from focus groups and semistructured interviews to identify implicit managerial strategies for implementation; (2) use surveys to quantitatively rank strategy effectiveness; (3) determine how strategies fit with existing theories of organizational management and change; and (4) utilize a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytical approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs.

Results: Findings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in-vivo and hands-on training. Most strategies represented emergent leadership approaches for implementation that relied on the principles of transformational leadership, but expanded on key orientations. Leaders’ behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff during the uptake of new practices, knowledgeable to properly guide the implementation process, and perseverant to address ongoing barriers that are likely to stall implementation efforts.

Conclusions: These findings will be used to emphasize leadership approaches as implementation strategies to deliver EBPs in community-based addiction treatment settings. Findings have implications for the content and structure of leadership interventions needed in community-based addiction treatment programs, and the development of leadership interventions in these and other real-world service systems.