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      Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda


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          An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of “implementation outcomes” distinct from service system and clinical treatment outcomes. This paper proposes a heuristic, working “taxonomy” of eight conceptually distinct implementation outcomes—acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability—along with their nominal definitions. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.

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              Mental health provider attitudes toward adoption of evidence-based practice: the Evidence-Based Practice Attitude Scale (EBPAS).

              Mental health provider attitudes toward organizational change have not been well studied. Dissemination and implementation of evidence-based practices (EBPs) into real-world settings represent organizational change that may be limited or facilitated by provider attitudes toward adoption of new treatments, interventions, and practices. A brief measure of mental health provider attitudes toward adoption of EBPs was developed and attitudes were examined in relation to a set of provider individual difference and organizational characteristics. Participants were 322 public sector clinical service workers from 51 programs providing mental health services to children and adolescents and their families. Four dimensions of attitudes toward adoption of EBPs were identified: (1) intuitive Appeal of EBP, (2) likelihood of adopting EBP given Requirements to do so, (3) Openness to new practices, and (4) perceived Divergence of usual practice with research-based/academically developed interventions. Provider attitudes varied by education level, level of experience, and organizational context. Attitudes toward adoption of EBPs can be reliably measured and vary in relation to individual differences and service context. EBP implementation plans should include consideration of mental health service provider attitudes as a potential aid to improve the process and effectiveness of dissemination efforts.

                Author and article information

                +314-935-6660 , ekp@wustl.edu
                Adm Policy Ment Health
                Administration and Policy in Mental Health
                Springer US (Boston )
                19 October 2010
                19 October 2010
                March 2011
                : 38
                : 2
                : 65-76
                [1 ]George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130 USA
                [2 ]Division of Social Work, Roberts Wesleyan College, Rochester, USA
                [3 ]Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
                [4 ]Department of Psychiatry, University of California, San Diego, La Jolla, CA USA
                [5 ]Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO USA
                © The Author(s) 2010
                Original Paper
                Custom metadata
                © Springer Science+Business Media, LLC 2011

                Social policy & Welfare
                implementation,outcomes,evaluation,research methods
                Social policy & Welfare
                implementation, outcomes, evaluation, research methods


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