Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112968

Peter S. Hovmand, PhD, MSW, George Warren Brown School of Social Work, Washington University in St. Louis, Campus box 1196, One Brookings Drive, St. Louis, MO 63130, David E. Pollio, PhD, George Warren Brown School of Social Work, Washington University, One Brookings Dr., Box 1196, St. Louis, MO 63130-4899, (314) 935-7516, depollio@gwbmail.wustl.edu, Kraig J. Knudsen, PhD, Center for Mental Health Services Research, Washington University in Saint Louis, 1 Brookings Drive, Campus Box 1196, Saint Louis, MO 63130, and Brian McKean, Washington University, George Warren Brown School of Social Work, Box 1196, St. Louis, MO 63130-4899.

Introduction: There has been a recent impetus at the national level to broadly disseminate effective interventions into community practices. This dissemination “from bench to trench” (NIMH, 1999) has been more difficult to implement than expected, in part because of unanticipated barriers to implementing evidence-based practice (EBP) in community settings. While research on these barriers has proceeded and potential solutions proposed, an integrated set of has not been developed or tested in specific settings. Using systems dynamics to model barriers has the advantage of specifying both barriers and novel solutions to improving the dissemination of EBPs. This presentation presents just such an endeavor.

Methods: The study was conducted at a large Midwestern not-for-profit agency with fifteen separate programs ranging from early-childhood to transition-to-adulthood, serving approximately 4,500 families a year. Two focus groups with staff (n=25) and one focus group with agency management and board members (n=8) were conducted to identify perceived barriers to implementing EBPs and potential solutions. The results of the focus groups were used to build a system dynamics computer model of implementing EBP.

Results: Barriers and potential solutions were identified. Specifically, involving workers in decision-making was a critical factor to successful implementation, especially for more complicated innovations. Surprisingly, costs had little effect on the overall dynamics of organizational change.

Discussion: Implementation of evidence-based practices clearly rests on the ability to effectively address barriers within the dynamics of organizational change. The results provide directions to implementation and future research on the management of change and innovation in community settings.

Learning Objectives: At the conclusion of the session, the participant will be able to

• List three potential barriers to implementing evidence based practice in a community setting.
• Describe how these barriers can emerge within an community setting.
• Identify two potential solutions that are robust with respect to managing change and innovation in a community setting.

Keywords: Organizational Change, Evidence Based Practice

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation