Adoption of clinical and business trainings by child mental health clinics in New York State

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 hourlong Webinars (96%) followed by learning collaboratives, which take six to 18 months to complete (34%). Most (73%294%) adopters of business learning collaboratives and all adopters of clinical learning collaboratives had previously sampled a Webinar, althoughmaintaining 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.