| This three-paper dissertation examines a sample (n = 52) of data from an ongoing NIMH-funded multi-phase randomized controlled trial, Family Groups for Urban Youth with Disruptive Disorders (R01 MH106771; PI: McKay) which examines the effectiveness of a protocol-guided Multiple Family Group (MFG) approach with a sample of children challenged by Disruptive Behavior Disorders (such as Oppositional Defiant Disorder and Conduct Disorder) and their primary adult caregivers seeking services at public outpatient mental health clinics. In all analyses, Structural Equation Modeling (SEM) is used to examine models involving both mediation and moderation dynamics to examine multiple predictor variables on outcomes of interest. The first two papers, informed by the Theoretical Framework for the Predictors of Adoption (Chor et al. 2015), examine organizational factors ( Paper 1) and provider factors (Paper 2) that facilitate the adoption and implementation of evidence-based practices in outpatient mental health setting serving youths. Both the hypothesized relationship in Paper 1 and Paper 2 were supported by the study. Paper 1 found a significant positive relationship between organizational climate and adoption of evidenced- based practices among outpatient mental health providers. Paper 2 found a significant relationship between provider beliefs and the adoption of evidence-based practices among outpatient mental health providers. Paper 3 explores the implication of organizational and provider level factors on adoption of evidence-based practices to improve mental health services for youth. Discussion and limitations of this research and implications for social work and health care practice, policy, and research are discussed throughout these papers, as well as in the overall dissertation introduction and conclusion. |
