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Collaborative Dissemination and Implementation of Evidence Based Practice in Social Work Agencies. Sarah E. Bledsoe Jennifer Bellamy Lin Fang Catherine Coppolino Jennifer Crumpley Julia Jean-Francios Edward J. Mullen Columbia University, School of Social Work, Musher Center

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collaborative dissemination and implementation of evidence based practice in social work agencies

Collaborative Dissemination and Implementation of Evidence Based Practice in Social Work Agencies.

Sarah E. Bledsoe

Jennifer Bellamy

Lin Fang

Catherine Coppolino

Jennifer Crumpley

Julia Jean-Francios

Edward J. Mullen

Columbia University, School of Social Work, Musher Center

Supported in part by National Institute of Health Doctoral Training Program in Mental Health

Services Research #5 T32 MH14623-24/25 & the Willma & Albert Musher Center at Columbia University

background
Background
  • Comprehensive and unified approach to EBP:
    • Share resources between agencies and practitioners
    • Increase buy-in and ownership at all levels
    • Increase quality continuing education
    • Make research more user-friendly
    • Provide tools
    • Attach meaningful signposts
    • Protect time

(Bellamy, Traube & Bledsoe,2004)

literature review
Literature Review

Barriers:

  • Lack of Knowledge & Skills for EBP
  • Lack of Fit to Agency Practice
  • Suspicion of Researchers & EBP
  • Limited Resources for EBP

(Bellamy, Traube & Bledsoe,2004)

current strategies for ebp implementation
Current Strategies for EBP Implementation
  • Bottom-up:

Teaching professionals to be evidence-based, lifetime learners

(Sackett, 2000; Gibbs & Gambrill, 2002; Gibbs, 2003; Gray, 2001)

  • Top-down:

Tool kits/application kits/manuals/guidelines

(Mueser, Torrey, Lynde, Singer and Drake, 2003)

  • Top-down/bottom-up:

Combining evidence & consensus

(Cook, 2004)

  • Combine focus on practitioner training & organizational development:

A. Interactive staff training

(McCracken & Corrigan, 2004)

B. Outcomes & objectives orientation

(Rosen, Proctor, Morrow-Howell, Auslander, & Staudt, 1993)

  • Targeting the Social Work Profession
    • Objectives-Focused Multilevel Strategy

(Proctor, 2004)

pilot study
Pilot Study
  • Pilot study aim:
    • Design-pilot-refine strategy for implementing EBP in social work agencies
  • Multi-site to permit comparison
main research question
How can social work organizations & practitioners be engaged & helped to adopt & implement evidence-based practice?Main Research Question:
social intervention research design
Social Intervention Research Design
  • Phase one

Review literature, interview experienced EBP researchers

  • Phase two

Select partner agencies, design study

  • Phase three

Implement and modify intervention, evaluate outcomes

findings from initial meetings
Findings from Initial Meetings
  • Agency-university RELATIONSHIP is key
  • Evidence based practice is an relatively unfamiliar term
  • Preference for a team approach
  • Resources may be limited (e.g. computers, time and scheduling)
more findings
More Findings
  • Agencies want trainings in EBP, but not to be told how to practice
  • Staff have varying levels of expertise and education
  • It’s a struggle to find the “perfect” question
process of initial meetings
Process of Initial Meetings
  • Understanding problem formulation

-large agencies with diverse programs

-continual narrowing of focus

-process vs. outcome interest

  • Team building

-creative, innovative, or change oriented staff

-midlevel administrator interest

overview of the model curriculum
Overview of the Model Curriculum
  • Based largely on Gibbs’ book: Evidence Based Practice for the Helping Professions
  • Multi-session, multi-module flexible design
  • Reflects Gibbs’ seven stages of evidence based practice
first step motivation
First Step: Motivation

Rapport building at Pre-implementation

  • Initial meetings

Knowledge gathering (Baseline data)

  • Module 1: Focus group and questionnaires
  • Module 2: Overview of EBP including history and motivation for use
second step question formulation
Second Step: Question Formulation

Module 3:

  • Components of a researchable question (COPES)
  • Question types
  • Brainstorming question
  • Selection of team question
third step tracking down evidence
Third Step: Tracking Down Evidence

Module 4:

  • Types of research evidence

Module 5:

  • Search tools (search terms and electronic resources)
  • Team searching plan
  • Hands-on computer lab searching
step four appraising the evidence
Step Four: Appraising the Evidence

Module 7:

  • Trouble-shooting the search (homework)

Module 8:

  • Review of research evidence
  • General discussion of quality and quick tips
  • Formal assessment instruments
step five applying the results
Step Five: Applying the Results

Module 9: Group discussion format

Module 10: Synthesis of findings (along with practitioner knowledge)

step 6 evaluation
Step 6: Evaluation

Evaluation of the experience by the team- debriefing

Formal Evaluation

  • Focus groups
  • Questionnaires
  • Feedback on Instruments
step 7 teaching
Step 7: Teaching

Module 11: Agency action plan

  • Training to others
  • Reporting findings/experience to wider agency
  • Adding resources
  • Duplication and continuation of model
preliminary findings barriers
Preliminary Findings (Barriers)

1. Validated barriers:

  • Lack of Knowledge & Skills for EBP
  • Lack of Fit to Agency Practice
  • Suspicion of Researchers & EBP
  • Limited Resource for Doing EBP

(Bellamy, Traube & Bledsoe,2004)

2. New Barriers: Agency culture, Larger community environment

preliminary findings knowledge
Preliminary Findings (Knowledge)

Knowledge

1. Some exposure to EBP

2. Varied and partial definitions of EBP

3. Little Pressure to Use EBP

preliminary findings promoters
Preliminary Findings (Promoters)

1. Administrative leadership (time, culture, etc.)

2. Partnership with researchers

3. Incentives to use EBP

4. Acknowledge the humanity and art of practice

5. Value agency philosophy

6. Research evidence that’s useful

preliminary findings curriculum
Preliminary Findings (Curriculum)
  • Practitioners are motivated to use EBP
  • Practical tools and hands-on training experiences are most helpful
  • There is not enough time to learn all that is necessary to use EBP
  • Two agencies plan to incorporate components of the training into existing agency processes
for more information
For More Information

Betsy Bledsoe

seb2108@columbia.edu

Jennifer Bellamy

jlb2109@columbia.edu