Multilevel predictors of clinic adoption of state-supported trainings in children's services

Psychiatr Serv. 2015 May 1;66(5):484-90. doi: 10.1176/appi.ps.201400206. Epub 2015 Feb 17.

Abstract

Objective: Characteristics associated with participation in training in evidence-informed business and clinical practices by 346 outpatient mental health clinics licensed to treat youths in New York State were examined.

Methods: Clinic characteristics extracted from state administrative data were used as proxies for variables that have been linked with adoption of innovation (extraorganizational factors, agency factors, clinic provider-level profiles, and clinic client-level profiles). Multiple logistic regression models were used to assess the independent effects of theoretical variables on the clinics' participation in state-supported business and clinical trainings between September 2011 and August 2013 and on the intensity of participation (low or high). Interaction effects between clinic characteristics and outcomes were explored.

Results: Clinic characteristics were predictive of any participation in trainings but were less useful in predicting intensity of participation. Clinics affiliated with larger (adjusted odds ratio [AOR]=.65, p<.01), more efficient agencies (AOR=.62, p<.05) and clinics that outsourced more clinical services (AOR=.60, p<.001) had lower odds of participating in any business-practice trainings. Participation in business trainings was associated with interaction effects between agency affiliation (hospital or community) and clinical staff capacity. Clinics with more full-time-equivalent clinical staff (AOR=1.52, p<.01) and a higher proportion of clients under age 18 (AOR=1.90, p<.001) had higher odds of participating in any clinical trainings. Participating clinics with larger proportions of youth clients had greater odds of being high adopters of clinical trainings (odds ratio=1.54, p<.01).

Conclusions: Clinic characteristics associated with uptake of business and clinical training could be used to target state technical assistance efforts.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Ambulatory Care Facilities / statistics & numerical data*
  • Child
  • Child Health Services / statistics & numerical data*
  • Health Personnel / education*
  • Health Services Accessibility
  • Humans
  • Inservice Training / methods
  • Inservice Training / statistics & numerical data*
  • Mental Health Services / statistics & numerical data*
  • New York
  • Outpatients