How State Administrative Structures Influence Implementation Outcomes for Wraparound Care Coordination

Psychiatric Services, Journal Year: 2025, Volume and Issue: unknown

Published: March 27, 2025

The purpose of this study was to examine how inner-context (organizational) and outer-context (system) variables affect implementation outcomes for wraparound care coordination, an evidence-based strategy youths with complex behavioral health needs. This focused on data from 1,178 providers in 10 states that used one two state-level administrative structures implement coordination; four management entities (CMEs), six community mental centers (CMHCs). Implementation completeness duration were assessed the Stages Completion tool, practice fidelity Coaching Observation Measure Effective Teams. Multilevel models compare CMEs CMHCs at state level terms completeness, duration, fidelity. Compared CMHC states, CME had higher mean scores among practitioners (0.37 vs. 0.24; t=8.02, df=1,136, p<0.001), completed more activities, most activities faster. found preimplementation phase positively associated (b<0.001, t=3.62, df=10.85, p=0.004) negatively (b<-0.001, t=-6.64, df=7.04, p<0.001). results reinforce systems-level strategies such as coordination require considerable time plan meaningfully influence service quality. Taking design hospitable inner outer contexts is crucial efficiency,

Language: Английский

Multi-level alignment processes in the sustainment of a youth substance use treatment model following a federal implementation initiative: A mixed method study

Journal of Substance Use and Addiction Treatment, Journal Year: 2024, Volume and Issue: 166, P. 209445 - 209445

Published: July 1, 2024

Language: Английский