%0 Journal Article
%T Implementation of evidence-based practices for children in four countries: a project of the World Psychiatric Association
%A Hoagwood Kimberly E
%A Kelleher Kelly
%A Murray Laura K
%A Jensen Peter S
%J Revista Brasileira de Psiquiatria
%D 2006
%I Associa??o Brasileira de Psiquiatria (ABP)
%X OBJETIVE: The present study examined implementation issues in adopting cognitive-behavioral therapies in routine clinical settings in four countries reflecting diverse cultures, languages, settings, and traditions. METHOD: A Director's Systems Survey was administered prior to program implementation and one year later. Therapist ratings on attitudes about evidence-based practices and satisfaction were also gathered. RESULTS: All sites reported successful adoption of the program, although significant variations existed in fiscal support, family involvement, prior experience with cognitive-behavioral therapies, and plans for sustainability. Therapists' ratings indicated overall satisfaction with the implementation of the project. Findings from the Director's Systems Survey pointed to five factors facilitating implementation: 1) early adoption and guidance by innovative leaders (i.e., the Directors); 2) attention to the "fit" between the intervention model and local practices; 3) attention to front-end implementation processes (e.g., cultural adaptation, translation, training, fiscal issues); 4) attention to back-end processes early in the project (e.g., sustainability); and 5) establishing strong relationships with multiple stakeholders within the program setting. CONCLUSIONS: The implementation issues here mirror those identified in other studies of evidence-based practices uptake. Some of the obstacles to implementation of evidence-based practices may be generic, whereas issues such as the impact of political/economic instability, availability of translated materials, constitute unique stressors that differentially affect implementation efforts within specific countries.
%K Evidence-based medicine
%K Cognitive therapy
%K Behavior
%K Feasibility studies
%K Child
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000100012