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- Billsten, Johan, 1971-, et al.
(författare)
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Organizational Readiness for Change (ORC) test used in the implementation of assessment instruments and treatment methods in a Swedish National study
- 2018
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Ingår i: Journal of Substance Abuse Treatment. - Amsterdam : Elsevier. - 0740-5472 .- 1873-6483. ; 84, s. 9-16
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Tidskriftsartikel (refereegranskat)abstract
- Organizational climate and related factors are associated with outcome and are as such of vital interest for healthcare organizations. Organizational Readiness for Change (ORC) is the questionnaire used in the present study to assess the influence of organizational factors on implementation success. The respondents were employed in one of 203 Swedish municipalities within social work and psychiatric substance/abuse treatment services. They took part in a nationwide implementation project organized by the Swedish Association of Local Authorities and Regions (SALAR), commissioned by the Swedish National Board of Health and Welfare. Aim The aims were: (a) to identify classes (clusters) of employees with different ORC profiles on the basis of data collected in 2011 and (b) to investigate ORC profiles which predicted the use of assessment instruments, therapy methods and collaborative activities in 2011 and 2013. Design and recruitment The evaluation study applied a naturalistic design with registration of outcome at consecutive assessments. The participants were contacted via official e-mail addresses in their respective healthcare units and were encouraged by their officials to participate on a voluntary basis. Statistics Descriptive statistics were obtained using SPSS version 23. A latent profile analysis (LPA) using Mplus 7.3 was performed with a robust maximum likelihood estimator (MLR) to identify subgroups (clusters) based on the 18 ORC indexes. Results A total of 2402 employees responded to the survey, of whom 1794 (74.7%) completed the ORC scores. Descriptive analysis indicated that the respondents were a homogenous group of employees, where women (72.0%) formed the majority. Cronbach's alpha for the 18 ORC indexes ranged from α = 0.67 to α = 0.78. A principal component analysis yielded a four-factor solution explaining 62% of the variance in total ORC scores. The factors were: motivational readiness (α = 0.64), institutional resources (α = 0.52), staff attributes (α = 0.76), and organizational climate (α = 0.74). An LPA analysis of the four factors with their three distinct profiles provided the best data fit: Profile 3 (n = 614), Profile 2 (n = 934), and Profile 1 (n = 246). Respondents with the most favorable ORC scores (Profile 3) used significantly more instruments and more treatment methods and had a better collaborating network in 2011 as well as in 2013 compared to members in Profile 1, the least successful profile. Conclusion In a large sample of social work and healthcare professionals, ORC scores reflecting higher institutional resources, staff attributes and organizational climate and lower motivational readiness for change were associated with a successful implementation of good practice guidelines for the care and treatment of substance users in Sweden. Low motivational readiness as a construct may indicate satisfaction with the present situation. As ORC proved to be an indicator of successful dissemination of evidence-based guidelines into routine and specialist healthcare, it can be used to tailor interventions to individual employees or services and to improve the dissemination of and compliance with guidelines for the treatment of substance users. © 2017
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| 3. |
- Pernebo, Karin, et al.
(författare)
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Outcomes of a psychotherapeutic and a psychoeducative group intervention for children exposed to intimate partner violence
- 2017
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Konferensbidrag (refereegranskat)abstract
- Introduction: Experience of violence towards a caregiver during childhood is associated with a risk of negative impacton children’s health and development, and there is a need for effective interventions in clinical as well as in communitysettings. Research has shown that existing interventions in Sweden for children with experience of violence towards acaregiver are associated with positive but insufficient outcomes. In addition to implementation of new evidence basedinterventions expanded knowledge is needed on outcomes of established interventions aiming at identifying possibleneeds for improvement.Method: The current study is an effectiveness study aiming at investigating the outcomes of two established groupinterventions for children exposed to intimate partner violence and their non-offending parent, one community basedpsychoeducative intervention and one psychotherapeutic treatment intervention. The study included 50 children, 24girls and 26 boys, aged 4-13 years. Background information, child and parental mental health problems and traumasymptoms was assessed pre- and post-treatment as well as 6 and 12 months post treatment.Results: The results indicate that children benefit from both interventions, yet mothers of a majority of the children stillreported child trauma symptoms at clinical levels post treatment. Preliminary results from the follow up assessments willbe presented, such as outcomes in symptoms reduction and possible associations with confounding variables.Discussion: Theoretical, methodological and clinical implications will be discussed.
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| 4. |
- Pernebo, Karin, et al.
(författare)
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Outcomes of group interventions for children exposed to intimate partner violence, 6- and 12-months follow-up of an effectiveness study
- 2018
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Konferensbidrag (refereegranskat)abstract
- AbstractIntroduction: Intimate partner violence is a global public health problem. Many children worldwide are living with a mother who is a victim of intimate partner violence, a situation associated with a serious risk of short- as well as long-term consequences to children’s health and development.There is a need for effective interventions for children exposed to intimate partner violence. Existing interventions in Sweden have shown positive but insufficient outcomes. Extended knowledge on lasting outcomes, aiming at improving established interventions is needed.Method: The current study is an effectiveness study investigating the outcomes of two established group interventions for children exposed to intimate partner violence and their non-offending parent. The study included 50 children, 24 girls and 26 boys, aged 4-13 years. Background information, child and parental mental health problems and trauma symptoms were assessed pre- and post-treatment, as well as 6 and 12 months post treatment.Results: The results indicate that children benefit from the group interventions, although post intervention a majority of mothers still reported symptoms in their children at clinical levels. Late improvements were registered at the follow-up assessments. The findings indicate that mothers benefit from these primarily child-oriented interventions, showing considerable and lasting reduction of symptoms.Discussion: Currently data from the 6- and 12-months follow-up assessments are being analyzed. Preliminary results include paths of continuous symptoms reduction for children and mothers. Possible associations between child and maternal levels of symptoms, as well as methodological and clinical implications will be discussed.
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| 5. |
- Pernebo, Karin, et al.
(författare)
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Reduced psychiatric symptoms at 6 and 12 months’ follow-up of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence
- 2019
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Ingår i: International Journal of Child Abuse & Neglect. - : Elsevier. - 0145-2134 .- 1873-7757. ; 93, s. 228-238
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Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term follow-up studies of interventions for children exposed to intimate partner violence are few, and the sustainability of their outcomes often remains unexplored and uncertain. Current research including follow-up assessment suggests that treatment gains may be maintained or continue post termination. In addition some children may show increased levels of symptoms. Objective: The present effectiveness study investigated the long-term outcomes of two established group interventions for children exposed to intimate partner violence and their non-offending parent. Participants and Setting: The study included 50 children, 24 girls and 26 boys, aged 4 to 13 years attending a psychotherapeutic child and adolescent mental health service intervention and a psychoeducative community-based intervention. Methods: Background information, child and parental mental health problems, trauma symptoms, and exposure to violence were assessed pre- and post treatment and at 6 and 12 months’ follow-up. Results: Sustained treatment gains and late improvements in children's internalizing and externalizing symptoms and in symptoms of traumatic stress were recorded from post treatment to the follow-up assessments (p =.004–.044; d = 0.29–0.67). No significant increase in symptoms was reported. Additionally, very little continued or renewed child exposure to violence was reported. Conclusions: The results of the study indicate that the children did benefit from the two interventions studied and that the outcomes of reduced child symptoms and protection from exposure to violence were sustainable. Children with severe trauma symptoms benefited the most, though maternal psychological problems may for some have hindered recovery. Clinical implications are discussed.
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