Provider Factors Associated with Motivation for Training in an Effectiveness-Implementation Trial of Autism Evidence-Based Practices

Many studies have shown the efficacy, cost-effectiveness, and improved outcomes associated with the use of evidence-based practices (EBPs) in mental health settings (Drake et al., 2001, Brookman-Frazee et al., 2012). Provider characteristics associated with implementation outcomes are a necessary focus of research to improve the methods to scale up these EBPs for multiple service systems, as providers play an essential role in the successful implementation of EBPs (Brookman-Frazee et al., 2018, Brownson, Colditz, & Proctor, 2012). The present study examines therapist-level factors (i.e., demographics, EBP attitudes, organizational climate) associated with the provider's initial motivation for training in one of two mental health interventions for autism (“An Individualized Mental Health Intervention for Autism Spectrum Disorder” (AIM HI; Brookman-Frazee et al., 2021) and “Classroom Pivotal Response Teaching” (CPRT; Suhrheinrich et al., 2019). Data were collected from 490 providers from 74 programs/districts. Providers were 89.2% female and 28.2% Hispanic and 229 were trained in AIM HI, while 261 providers were trained in TEAMS CPRT. Results showed a positive correlation between EBP attitudes and provider motivation ( r = .41, p <.001) and implementation climate and provider motivation ( r = .27, p <.001). Providers’ years of experience and motivation ( r = -.12, p = .01) were negatively correlated. No significant differences in motivation by provider race/ethnicity ( F = .39, p = .68) nor by study were found ( t = 1.34, p = .18). These results point to the importance of examining and addressing therapist-level factors, such as EBP attitude, organizational climate, and years of experience, prior to implementation of EBPs, which might play a role in provider training completion and intervention fidelity across multiple service systems. The current study involves secondary data analysis of data collected within two paired Hybrid Type 3 implementation-effectiveness trials: TEAMS ( T ranslating E vidence-Based Interventions for A SD: A M ulti-level Implementation Strategy) AIM HI and TEAMS CPRT. The research protocol was reviewed and approved by the UC San Diego Institutional Review Board. Data collection was coordinated between these two studies and pooled for analyses. While the overall project assessed provider ratings of motivation, EBP attitudes, and implementation climate at baseline, 6 months post-training, and 6 months follow up, the current analyses are focused on ratings of provider motivation at baseline or pre-training. Programs and districts were recruited over 3 years. Potentially eligible providers were recruited through presentations at staff meetings or team meetings. All providers who chose to participate were given information about the study from the research team and provided with consent obtained prior to data collection. When the baseline data was collected, a $25 gift card per assessment was given to all providers. EBPs, EBPs, etc.) to see if are any other organization level factors that might affect initial to engage EBPs. EBPs for other mental health disorders also studied if Once of collected, towards EBPs. EBPs