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Relationship between clinician-level attributes and implementation outcomes from the Pathways to Comorbidity Care
Eva Louie1,2, Vicki Giannopoulos2, Andrew Baillie3
1Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
BMC Medical Education
|August 5, 2022
Summary
Organizational readiness for change, specifically leadership support, positively influences the integration of evidence-based practices in comorbidity care. Clinician factors like self-efficacy and attitudes did not significantly impact this integration.
Area of Science:
- Addiction Medicine
- Mental Health Services
- Implementation Science
Background:
- Understanding clinician-level factors is crucial for improving evidence-based practice (EBP) uptake.
- The Pathways to Comorbidity Care (PCC) program aimed to enhance integrated management of co-occurring substance use and mental health disorders among clinicians.
- This study investigated the association between clinician-level characteristics and the uptake of integrated comorbidity management following the PCC program.
Purpose of the Study:
- To examine the relationship between clinician demographics, attitudes (EBP, therapist manuals, self-efficacy), and organizational readiness to change with the implementation of integrated comorbidity care.
- To identify factors that predict successful adoption of evidence-based practices in managing dual diagnoses.
Main Methods:
- Twenty clinicians participated in a 9-month PCC training program.
- Baseline assessments included demographics, attitudes towards EBPs and manuals, self-efficacy, and organizational readiness.
- Follow-up assessed integrated comorbidity management using the Comorbidity Practice (CoP) score, categorizing implementation into high, medium, or low.
Main Results:
- No significant differences were found across implementation groups regarding sociodemographic variables, attitudes towards EBPs, therapist manuals, or self-efficacy.
- The high implementation group showed significantly higher scores in the leadership practices aspect of organizational readiness to change compared to low and medium groups (p=0.05).
Conclusions:
- Confidence in leadership's role in implementation is key to enhancing the effectiveness of comorbidity training programs for substance use disorder clinicians.
- Contrary to hypotheses, clinician self-efficacy, attitudes towards EBPs and manuals, gender, education, and experience were not significant predictors of integrated care uptake.
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