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Collaboration, Negotiation, and Coalescence for Interagency-Collaborative Teams to Scale-up Evidence-Based Practice
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Details:
  • Pubmed ID:
    24611580
  • Pubmed Central ID:
    PMC4294431
  • Description:
    Objective

    Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team (ICT) approach.

    Methods

    Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare®. Semi-structured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework.

    Results

    Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration, competing priorities across levels of leadership, power struggles, and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process.

    Conclusions

    System wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes.

  • Document Type:
  • Collection(s):
  • Funding:
    18CE001334/CE/NCIPC CDC HHS/United States
    P30 MH074678/MH/NIMH NIH HHS/United States
    P30MH074678/MH/NIMH NIH HHS/United States
    R01 MH072961/MH/NIMH NIH HHS/United States
    R01 MH092950/MH/NIMH NIH HHS/United States
    R01MH072961/MH/NIMH NIH HHS/United States
    R01MH092950/MH/NIMH NIH HHS/United States
    R21 MH082731/MH/NIMH NIH HHS/United States
    R21MH082731/MH/NIMH NIH HHS/United States
    R25 MH080916/MH/NIMH NIH HHS/United States
    R25MH080916/MH/NIMH NIH HHS/United States
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