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APHA Scientific Session and Event Listing

Provider's perceptions of the organizational climate in public mental health services for children and adolescents

Carmen E. Albizu-García, MD1, Rafael R. Ramírez, PhD2, Mario H. Rodríguez, PhD3, and Pedro García-Pedraza, MA2. (1) Puerto Rico Health Services Research Institute, Graduate School of Public Health University of Puerto Rico, P.O. Box 365067, San Juan, PR 00936-5067, 787.758.3189, calbizu@rcm.upr.edu, (2) Behavioral Sciences Research Institute, Medical Sciences Campus University of Puerto Rico, P.O. Box 365067, San Juan, PR 00936-5067, (3) School of Public Health, University of Puerto Rico, Medical Sciences Campus, PO BOX 365067, San Juan, PR 00936-5067

Background: Organizational climate (OC) refers to the intrapersonal perception of the patterns of behaviors, attitudes, and feelings as experienced by the individual within an organization. Empirical evidence has linked specific organizational characteristics, such as culture and climate, to the quality and outcomes of social services for children. As the understanding of the effect of OC on the outcomes of human services accumulates, the importance of the construct has been brought to the attention of health services researchers, particularly in the mental health services field. The assumption is that there is a strong relationship between the way providers feel about their organizational context and their performance. To further the field in the assessment of OC and determine whether it has a significant impact on services outcomes in the health services setting there is a need for valid and reliable measures of OC and for empirical evidence exploring what accounts for its variability.

Methods: Secondary analysis was undertaken with a data set from a study on mental health services utilization by Puerto Rican children and adolescents. The unit of analysis for the present study was the providers of care for the participating children. Data were collected in 1999 from 124 providers of children and adolescents' public mental health services in Puerto Rico. Providers responded to a self-administered questionnaire assessing their perception of OC that was translated into Spanish and adapted from an existing instrument developed by Glisson and Hemmelgarn (1998). Another questionnaire requested information on demographics, practice setting, discipline, and professional history. Providers included psychiatrists, psychologists, social workers, nurses, and other master level professionals. Exploratory factor analysis was conducted for the OC scale. We report the factor structure, correlation between factors, and reliability of the OC scale and the regression model assessing the effects of provider, patient, and organization characteristics on OC.

Findings: The factorial analysis identified 7 factors that replicate the original scale. Internal consistency as measured by Cronbach's alpha was greater than .70 for all subscales. Regression analysis indicates that only provider discipline and type of organization (managed vs non-managed care) are significantly associated with variations in the OC subscales. Implications of findings will be discussed and future research directions that incorporate OC as an explanatory variable will be identified.

Learning Objectives:

  • At the end of the session participants will be able to

    Presenting author's disclosure statement:

    Not Answered

    Medical Care Poster Session: Health Services Research

    The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA