The Importance of Leadership and Organizational Readiness for Change in the Effective Implementation of Evidence Based Practices Among Addiction Health Services Programs

Background:

While addiction health service (AHS) providers play an integral role in reducing the drug and alcohol addiction epidemic, their impact is limited by their organizational capacity. Therefore, when seeking to transform the provision of addiction treatment services through the implementation of evidence based practices (EBPs) it is essential to understand how AHS providers can best facilitate the process of organizational readiness for change. Using aspects of the TCU Organizational Readiness for Change framework, this study aims to examine how attitudes towards leadership, training and staffing needs, communication, and stress influence AHS provider staff members’ perceptions of their needs for more training on effective implementation of EBP practices.

Methods:

Secondary data used was used to analyze the relationship between AHS provider staffs’ perceptions of attitudes towards leadership, training and staffing needs, communication, and stress and how it influences AHS provider staff’s perceptions of their needs for more training on effective implementation of EBP practices. The data was collected from a mixed-method study funded by the National Institute of Drug Abuse, which focused on exploring factors associated with high coordination of mental health and public health services in addiction health services programs that serve low-income racial and ethnic minority communities. The study included 122 participants, representing adult outpatient substance use treatment centers operating within the County of Los Angeles.

Results:

The majority of the participants were female (n = 74, 61%). The reported age of the participants ranged from 25 to 68 with a mean age of 46.8 (sd=10.62). Most of the participants were Program Directors (60%), followed by Clinical Supervisors (29%), and Counselors and Support Staff, 13% and 6% respectively. Participants’ work experience ranged from a few months to 37 years, with an average mean of 12.8 (sd=9.35). While most programs (95%) were reported as being licensed by the state, 83% were reported as not being accredited by the Joint Commission on Accreditation of Hospitals and other Organizations (JCAHO).

Results from an ordinal logistic regression analysis showed a significant and positive relationship of staff’s needs for more training on “effective implementation of evidence based practices” with leadership (OR=1.11, 95% CI: 1.01-1.21), stress (OR=1.10, 95% CI: 1.01-1.20), and training needs (OR=1.24, 95% CI: 1.15-1.34).

Discussion:

Given their limited organizational capacity, it is important to understand how AHS providers can facilitate the appropriate organizational readiness for change conditions necessary to make meaningful and sustainable changes to the provision of addiction treatment services. Findings from the study suggest, that when AHS provider staff’s attitudes increase favorably towards their leadership, the odds that they will express a greater need for training on effective implementation of EBP practices also increases which indicates that they may become more open to towards feedback and additional support. Further, when seeking to implement EBP practices, AHS providers need to prepare their leadership to address the rising levels of stress among their staff as well as in assessing the training needs which are important in preparing an organization for change and in increasing their probabilities for success.