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Implement Sci. 2019 Feb 12;14(1):15. doi: 10.1186/s13012-019-0863-9.

Organizational culture and climate profiles: relationships with fidelity to three evidence-based practices for autism in elementary schools.

Author information

1
School of Social Work, Boise State University, 1910 University Drive, Boise, ID, 83625, USA. natewilliams@boisestate.edu.
2
Department of Psychology, Temple University, 1701 N 13th St., Philadelphia, PA, 19122, USA.
3
Department of Speech and Hearing Sciences, University of Washington, 1417 NE 42nd St, Seattle, WA, 98105, USA.
4
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA.
5
Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
6
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
7
Department of Psychiatry, University of California, San Diego, CA, USA.
8
Center for Behavioral Health Research, University of Tennessee, Knoxville, TN, USA.

Abstract

BACKGROUND:

Implementation researchers have typically studied organizational culture and climate by testing whether individual dimensions are linked to the implementation of evidence-based practices (EBPs) rather than examining how the overarching social context influences implementation. This approach may limit implementation theory and strategy development to the extent that individual dimensions of culture and climate interact, mutually reinforce or counteract one another, or exhibit non-linear relationships. This study tests whether empirically identifiable culture and climate profiles emerge in a sample of organizations and examines how these profiles relate to EBP fidelity and work attitudes that support EBP sustainment, focusing on three EBPs for youth with autism delivered in schools as an example.

METHODS:

The study included 65 elementary schools in the U.S. that implemented three EBPs-discrete trial training, pivotal response training, and visual schedules-for youth with autism. Organizational culture and climate and work attitudes were assessed using the Organizational Social Context measure at the beginning of the school year. Observations of EBP fidelity occurred mid school-year. We used bias-adjusted stepwise latent profile modeling to (1) identify subpopulations of schools that share similar culture and climate profiles, and (2) test for mean differences across profiles in observed EBP fidelity and teacher and staff work attitudes.

RESULTS:

Controlling for region, four profiles best characterized the organizational cultures and climates of schools. Teachers and staff in schools with a comprehensive profile (high proficiency culture, positive climate) exhibited higher fidelity to two of three EBPs (d's = .95 to 1.64) and reported superior work attitudes (d's = .71 to 1.93) than teachers and staff in all other schools. Teachers and staff in supportive schools (low rigidity culture, positive climate) had better work attitudes, but not better fidelity, than those in schools with indifferent (low culture/climate, elevated stress) and constrained (high rigidity and resistance, high stress) profiles.

CONCLUSIONS:

Organizational culture and climate profiles are a strong predictor of EBP fidelity and work attitudes that support EBP sustainment, highlighting the importance of an organization's overarching social context when developing implementation theory and strategies. Strategies that foster a comprehensive profile may improve EBP implementation.

KEYWORDS:

Autism; Fidelity; Implementation; Organizational climate; Organizational culture; Schools

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