The authors of this article present their research on organizational process improvement intervention, and suggest that their research findings are relevant to researchers, clinicians, administrators and policy makers; they also suggest that goal completion during implementation of evidence-based practices requires monitoring of leadership competence, fidelity to implementation strategies and attendance to goal importance.
This study examined fidelity of implementation strategies used in an organizational process improvement intervention (OPII), designed to improve evidence-based practices related to assessments for drug-involved clients exiting incarceration. Leadership was studied as a moderating factor between fidelity and outcomes. The authors used a mixed-method cluster randomized design to randomize 21 sites to early- or delayed-start within 9 research centers. They reviewed parent study protocol to develop fidelity constructs, i.e., responsiveness, dose, quality, adherence. Outcomes were site-level success in achieving goals and objectives completed during the OPII (e.g., percentage goals achieved). The authors performed correlations, analyses of covariance, regressions, and moderation analyses, as well as qualitative interviews to assess facilitators/barriers to implementation. Results showed that fidelity constructs related to outcomes. No differences were found in fidelity by early or delayed condition. At low levels of leadership, high staff responsiveness related to poorer outcomes. The authors conclude that is important to consider contextual factors, such as leadership, that may influence implementation strategy fidelity when deploying evidence-based practices. Findings are relevant to researchers, clinicians, administrators and policy makers, and suggest that goal completion during implementation of evidence-based practices requires monitoring of leadership competence, fidelity to implementation strategies (i.e., staff responsiveness to strategies) and attendance to goal importance. Publisher Abstract Provided