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Articles   |    
Adoption of Clinical and Business Trainings by Child Mental Health Clinics in New York State
Ka Ho Brian Chor, Ph.D.; Su-Chin Serene Olin, Ph.D.; Jamie Weaver, M.S.; Andrew F. Cleek, Psy.D.; Mary M. McKay, Ph.D.; Kimberly E. Hoagwood, Ph.D.; Sarah M. Horwitz, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300535
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Dr. Chor is with the American Institutes for Research, Chicago (e-mail: kchor@air.org). Dr. Olin, Mr. Weaver, Dr. Hoagwood, and Dr. Horwitz are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York City. Dr. Cleek and Dr. McKay are with the Silver School of Social Work, New York University, New York City. Findings from this study were presented at the annual convention of the Association for Behavioral and Cognitive Therapies, Nashville, Tennessee, November 21–24, 2013, and at the National Institute of Mental Health Conference on Mental Health Services Research, Bethesda, Maryland, April 23–25, 2014.

Copyright © 2014 by the American Psychiatric Association

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Objective  This study prospectively examined the naturalistic adoption of clinical and business evidence-informed training by all 346 outpatient mental health clinics licensed to treat children, adolescents, and their families in New York State.

Methods  The study used attendance data (September 2011–August 2013) from the Clinic Technical Assistance Center, a training, consultation, and educational center funded by the state Office of Mental Health, to classify the clinics’ adoption of 33 trainings. Adoption behavior was classified by number, type, and intensity of trainings. The clinics were classified into four adopter groups reflecting the highest training intensity in which they participated (low, medium, and high adopters and “super-adopters”).

Results  A total of 268 clinics adopted trainings (median=5); business and clinical trainings were about equally accessed (82% versus 78%). Participation was highest for hour-long Webinars (96%) followed by learning collaboratives, which take six to 18 months to complete (34%). Most (73%−94%) adopters of business learning collaboratives and all adopters of clinical learning collaboratives had previously sampled a Webinar, although maintaining participation in learning collaboratives was a challenge. The adopter groups captured meaningful adopter profiles: 41% of clinics were low adopters that selected fewer trainings and participated only in Webinars, and 34% were high or super-adopters that accessed more trainings and participated in at least one learning collaborative.

Conclusions  More nuanced definitions of adoption behavior can improve the understanding of clinic adoption of training and hence promote the development of efficient rollout strategies by state systems.

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