Fidelity and sustainability in evidence-based treatments for children: An investigation of implementation determinants

ABSTRACT In order to improve access to and utilization of high-quality children’s mental health services, there have been considerable efforts to disseminate evidence-based treatments (EBTs) into community-based settings. However, these efforts have not always led to successful use of interventions overtime, and further understanding of how organizational and individual factors may serve as barriers to the implementation process is needed. To help measure implementation and sustainability success in a sample of 118 community-based mental health providers, a 70-item electronic survey was developed to query participant’s experiences with EBT implementation post-training. Results of hierarchical regression analysis suggest that more positive attitudes toward evidence-based practices, the provision of agency incentives, and more intensive training of the intervention increase the likelihood of EBT sustainability, while more positive attitudes toward evidence-based practice and more intensive training increase the likelihood that strategies to help promote protocol fidelity are used. Results contribute to the growing implementation literature in mental health. Post-training consultation may help increase a provider’s ability to manage organizational barriers inherent to providing EBTs within community-based settings. Provision of agency incentives, such as praise and financial compensation, as well as helping promote trainee’s positive attitudes toward EBTs, may also help increase likelihood of implementation success.