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<!DOCTYPE html> <html lang="en" class="no-js"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=yes"> <title>Operational and organizational variation in determinants of policy implementation success: the case of policies that earmark taxes for behavioral health services.</title> <meta id="meta-title" property="citation_title" content="Operational and organizational variation in determinants of policy implementation success: the case of policies that earmark taxes for behavioral health services."/> <meta id="og-title" property="og:title" content="Operational and organizational variation in determinants of policy implementation success: the case of policies that earmark taxes for behavioral health services."/> <meta name="twitter:widgets:autoload" content="off"/> <meta name="twitter:dnt" content="on"/> <meta name="twitter:widgets:csp" content="on"/> <meta name="google-site-verification" content="lQbRRf0vgPqMbnbCsgELjAjIIyJjiIWo917M7hBshvI"/> <meta id="meta-abstract" name="citation_abstract" content="BACKGROUND: Research on determinants of health policy implementation is limited, and conceptualizations of evidence and implementation success are evolving in the field. This study aimed to identify determinants of perceived policy implementation success and assess whether these determinants vary according to: (1) how policy implementation success is operationally defined [i.e., broadly vs. narrowly related to evidence-based practice (EBP) reach] and (2) the role of a persons organization in policy implementation. The study focuses on policies that earmark taxes for behavioral health services. METHODS: Web-based surveys of professionals involved with earmarked tax policy implementation were conducted between 2022 and 2023 (N = 272). The primary dependent variable was a 9-item score that broadly assessed perceptions of the tax policy positively impacting multiple dimensions of outcomes. The secondary dependent variable was a single item that narrowly assessed perceptions of the tax policy increasing EBP reach. Independent variables were scores mapped to determinants in the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Multiple linear regression estimated associations between measures of determinants and policy implementation success. RESULTS: Perceptions of tax attributes (innovation determinant), tax EBP implementation climate (inner-context determinant), and inter-agency collaboration in tax policy implementation (outer-context and bridging factor determinant) were significantly associated with perceptions of policy implementation success. However, the magnitude of associations varied according to how success was operationalized and by respondent organization type. For example, the magnitude of the association between tax attributes and implementation success was 42% smaller among respondents at direct service organizations than non-direct service organizations when implementation success was operationalized broadly in terms of generating positive impacts (β = 0.37 vs. β = 0.64), and 61% smaller when success was operationalized narrowly in terms of EBP reach (β = 0.23 vs. β = 0.59). Conversely, when success was operationalized narrowly as EBP reach, the magnitude of the association between EBP implementation climate and implementation success was large and significant among respondents at direct service organizations while it was not significant among respondents from non-direct service organizations (β = 0.48 vs. β=-0.06). CONCLUSION: Determinants of perceived policy implementation success may vary according to how policy implementation success is defined and the role of a persons organization in policy implementation. This has implications for implementation science and selecting policy implementation strategies."/> <meta id="meta-description" name="description" content="Author(s): Purtle, Jonathan; Stadnick, Nicole; Mauri, Amanda; Walker, Sarah; Bruns, Eric; Aarons, Gregory | Abstract: BACKGROUND: Research on determinants of health policy implementation is limited, and conceptualizations of evidence and implementation success are evolving in the field. This study aimed to identify determinants of perceived policy implementation success and assess whether these determinants vary according to: (1) how policy implementation success is operationally defined [i.e., broadly vs. narrowly related to evidence-based practice (EBP) reach] and (2) the role of a persons organization in policy implementation. The study focuses on policies that earmark taxes for behavioral health services. METHODS: Web-based surveys of professionals involved with earmarked tax policy implementation were conducted between 2022 and 2023 (N = 272). The primary dependent variable was a 9-item score that broadly assessed perceptions of the tax policy positively impacting multiple dimensions of outcomes. The secondary dependent variable was a single item that narrowly assessed perceptions of the tax policy increasing EBP reach. Independent variables were scores mapped to determinants in the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Multiple linear regression estimated associations between measures of determinants and policy implementation success. RESULTS: Perceptions of tax attributes (innovation determinant), tax EBP implementation climate (inner-context determinant), and inter-agency collaboration in tax policy implementation (outer-context and bridging factor determinant) were significantly associated with perceptions of policy implementation success. However, the magnitude of associations varied according to how success was operationalized and by respondent organization type. For example, the magnitude of the association between tax attributes and implementation success was 42% smaller among respondents at direct service organizations than non-direct service organizations when implementation success was operationalized broadly in terms of generating positive impacts (β = 0.37 vs. β = 0.64), and 61% smaller when success was operationalized narrowly in terms of EBP reach (β = 0.23 vs. β = 0.59). Conversely, when success was operationalized narrowly as EBP reach, the magnitude of the association between EBP implementation climate and implementation success was large and significant among respondents at direct service organizations while it was not significant among respondents from non-direct service organizations (β = 0.48 vs. β=-0.06). CONCLUSION: Determinants of perceived policy implementation success may vary according to how policy implementation success is defined and the role of a persons organization in policy implementation. This has implications for implementation science and selecting policy implementation strategies."/> <meta id="og-description" name="og:description" content="Author(s): Purtle, Jonathan; Stadnick, Nicole; Mauri, Amanda; Walker, Sarah; Bruns, Eric; Aarons, Gregory | Abstract: BACKGROUND: Research on determinants of health policy implementation is limited, and conceptualizations of evidence and implementation success are evolving in the field. This study aimed to identify determinants of perceived policy implementation success and assess whether these determinants vary according to: (1) how policy implementation success is operationally defined [i.e., broadly vs. narrowly related to evidence-based practice (EBP) reach] and (2) the role of a persons organization in policy implementation. The study focuses on policies that earmark taxes for behavioral health services. METHODS: Web-based surveys of professionals involved with earmarked tax policy implementation were conducted between 2022 and 2023 (N = 272). The primary dependent variable was a 9-item score that broadly assessed perceptions of the tax policy positively impacting multiple dimensions of outcomes. The secondary dependent variable was a single item that narrowly assessed perceptions of the tax policy increasing EBP reach. Independent variables were scores mapped to determinants in the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Multiple linear regression estimated associations between measures of determinants and policy implementation success. RESULTS: Perceptions of tax attributes (innovation determinant), tax EBP implementation climate (inner-context determinant), and inter-agency collaboration in tax policy implementation (outer-context and bridging factor determinant) were significantly associated with perceptions of policy implementation success. However, the magnitude of associations varied according to how success was operationalized and by respondent organization type. For example, the magnitude of the association between tax attributes and implementation success was 42% smaller among respondents at direct service organizations than non-direct service organizations when implementation success was operationalized broadly in terms of generating positive impacts (β = 0.37 vs. β = 0.64), and 61% smaller when success was operationalized narrowly in terms of EBP reach (β = 0.23 vs. β = 0.59). Conversely, when success was operationalized narrowly as EBP reach, the magnitude of the association between EBP implementation climate and implementation success was large and significant among respondents at direct service organizations while it was not significant among respondents from non-direct service organizations (β = 0.48 vs. β=-0.06). CONCLUSION: Determinants of perceived policy implementation success may vary according to how policy implementation success is defined and the role of a persons organization in policy implementation. This has implications for implementation science and selecting policy implementation strategies."/> <meta id="og-image" property="og:image" content="https://escholarship.org/images/escholarship-facebook2.jpg"/> <meta id="og-image-width" property="og:image:width" content="1242"/> <meta id="og-image-height" property="og:image:height" content="1242"/> <meta id="meta-author0" name="citation_author" content="Purtle, Jonathan"/> <meta id="meta-author1" name="citation_author" content="Stadnick, Nicole"/> <meta id="meta-author2" name="citation_author" content="Mauri, Amanda"/> <meta id="meta-author3" name="citation_author" content="Walker, Sarah"/> <meta id="meta-author4" name="citation_author" content="Bruns, Eric"/> <meta id="meta-author5" name="citation_author" content="Aarons, Gregory"/> <meta id="meta-publication_date" name="citation_publication_date" content="2024-10-31"/> <meta id="meta-doi" name="citation_doi" content="10.1186/s13012-024-01401-8"/> <meta id="meta-journal_title" name="citation_journal_title" content="Implementation Science"/> <meta id="meta-volume" name="citation_volume" content="19"/> <meta id="meta-issue" name="citation_issue" content="1"/> <meta id="meta-online_date" name="citation_online_date" content="2024-11-26"/> <meta id="meta-pdf_url" name="citation_pdf_url" content="https://escholarship.org/content/qt5q74b3gw/qt5q74b3gw.pdf?t=snjrjn"/> <link rel="canonical" href="https://escholarship.org/uc/item/5q74b3gw"/> <link rel="stylesheet" href="/css/main-62e3023ddd136de2.css"> <link rel="resource" type="application/l10n" href="/node_modules/pdfjs-embed2/dist/locale/locale.properties"> <noscript><style> .jsonly { display: none } </style></noscript>   <script> var _paq = window._paq = window._paq || []; 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</li><li><a href="/search/?q=author%3AStadnick%2C%20Nicole">Stadnick, Nicole</a>; </li><li><a href="/search/?q=author%3AMauri%2C%20Amanda">Mauri, Amanda</a>; </li><li><a href="/search/?q=author%3AWalker%2C%20Sarah">Walker, Sarah</a>; </li><li><a href="/search/?q=author%3ABruns%2C%20Eric">Bruns, Eric</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3AAarons%2C%20Gregory">Aarons, Gregory</a> </li></ul></div><div class="c-pubinfo"><h2 class="c-pubinfo__location-heading">Published Web Location</h2><a href="https://doi.org/10.1186/s13012-024-01401-8" class="c-pubinfo__link">https://doi.org/10.1186/s13012-024-01401-8</a></div><div class="c-tabs"><div class="c-tabs__tabs"><button class="c-tabs__button-more" aria-label="Show all tabs">...</button><button class="c-tabs__button--active">Main Content</button><button class="c-tabs__button">Metrics</button><button class="c-tabs__button">Author & Article Info</button></div><div class="c-tabs__content"><div class="c-tabcontent"><a name="article_abstract"></a><details class="c-togglecontent" open=""><summary>Abstract</summary><div class="c-clientmarkup"><p>BACKGROUND: Research on determinants of health policy implementation is limited, and conceptualizations of evidence and implementation success are evolving in the field. This study aimed to identify determinants of perceived policy implementation success and assess whether these determinants vary according to: (1) how policy implementation success is operationally defined [i.e., broadly vs. narrowly related to evidence-based practice (EBP) reach] and (2) the role of a persons organization in policy implementation. The study focuses on policies that earmark taxes for behavioral health services. METHODS: Web-based surveys of professionals involved with earmarked tax policy implementation were conducted between 2022 and 2023 (N = 272). The primary dependent variable was a 9-item score that broadly assessed perceptions of the tax policy positively impacting multiple dimensions of outcomes. The secondary dependent variable was a single item that narrowly assessed perceptions of the tax policy increasing EBP reach. Independent variables were scores mapped to determinants in the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Multiple linear regression estimated associations between measures of determinants and policy implementation success. RESULTS: Perceptions of tax attributes (innovation determinant), tax EBP implementation climate (inner-context determinant), and inter-agency collaboration in tax policy implementation (outer-context and bridging factor determinant) were significantly associated with perceptions of policy implementation success. However, the magnitude of associations varied according to how success was operationalized and by respondent organization type. For example, the magnitude of the association between tax attributes and implementation success was 42% smaller among respondents at direct service organizations than non-direct service organizations when implementation success was operationalized broadly in terms of generating positive impacts (β = 0.37 vs. β = 0.64), and 61% smaller when success was operationalized narrowly in terms of EBP reach (β = 0.23 vs. β = 0.59). Conversely, when success was operationalized narrowly as EBP reach, the magnitude of the association between EBP implementation climate and implementation success was large and significant among respondents at direct service organizations while it was not significant among respondents from non-direct service organizations (β = 0.48 vs. β=-0.06). CONCLUSION: Determinants of perceived policy implementation success may vary according to how policy implementation success is defined and the role of a persons organization in policy implementation. This has implications for implementation science and selecting policy implementation strategies.</p></div><p class="o-well-colored">Many UC-authored scholarly publications are freely available on this site because of the UC's <a href="https://osc.universityofcalifornia.edu/open-access-at-uc/open-access-policy/">open access policies</a>. <a href="https://help.escholarship.org/support/tickets/new">Let us know how this access is important for you.</a></p></details><details class="c-togglecontent" open=""><a name="article_main"></a><summary>Main Content</summary><div class="c-pdfview"><button class="c-pdfview__button-download">Download PDF to View</button><button class="c-pdfview__button-view">View Larger</button></div><div class="c-pdfview__accessibility">For improved accessibility of PDF content, <a href="/content/qt5q74b3gw/qt5q74b3gw.pdf?t=snjrjn">download the file</a> to your device.</div><div class="c-pdfview__viewer"><div id="pdfjs-cdl-wrapper"> <div id="pdfjs-viewer" 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that Earmark Tax Revenue for Behavioral Health Services</a></li><li><a href="/uc/item/5q74b3gw">Methods</a></li><li><a href="/uc/item/5q74b3gw">Conceptual Framework</a></li><li><a href="/uc/item/5q74b3gw">Data</a></li><li><a href="/uc/item/5q74b3gw">Dependent variables</a></li><li><a href="/uc/item/5q74b3gw">Inner context determinants of tax policy implementation</a></li><li><a href="/uc/item/5q74b3gw">Outer context and bridging determinants of tax policy implementation</a></li><li><a href="/uc/item/5q74b3gw">Results</a></li><li><a href="/uc/item/5q74b3gw">Discussion</a></li><li><a href="/uc/item/5q74b3gw">Conclusion</a></li><li><a href="/uc/item/5q74b3gw">Acknowledgements</a></li><li><a href="/uc/item/5q74b3gw">References</a></li></ul><ul class="c-jump__siblings"><li><a href="/uc/item/5q74b3gw">Metrics</a></li><li><a href="/uc/item/5q74b3gw">Author & Article Info</a></li></ul></div></section><div><section class="o-columnbox1"><header><h2>Related Items</h2></header><ul 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Published Works"},{"id":"ucsdsom_psych_oapdeposits","name":"Department of Psychiatry - Open Access Policy Deposits"}],"attrs":{"doi":"10.1186/s13012-024-01401-8","toc":{"divs":[{"title":"Operational and\u00A0organizational variation in\u00A0determinants of\u00A0policy implementation success: the\u00A0case of\u00A0policies that\u00A0earmark taxes for\u00A0behavioral health services","anchor":"page=1"},{"title":"Abstract","anchor":"page=1"},{"title":"Contributions to\u00A0the\u00A0literature","anchor":"page=2"},{"title":"Background","anchor":"page=2"},{"title":"Policies that\u00A0Earmark Tax Revenue for\u00A0Behavioral Health Services","anchor":"page=2"},{"title":"Methods","anchor":"page=3"},{"title":"Conceptual Framework","anchor":"page=3"},{"title":"Data","anchor":"page=3"},{"title":"Dependent variables","anchor":"page=4"},{"title":"Inner context determinants of\u00A0tax policy implementation","anchor":"page=5"},{"title":"Outer context and\u00A0bridging determinants of\u00A0tax policy implementation","anchor":"page=5"},{"title":"Results","anchor":"page=6"},{"title":"Discussion","anchor":"page=8"},{"title":"Conclusion","anchor":"page=11"},{"title":"Acknowledgements","anchor":"page=11"},{"title":"References","anchor":"page=11"}],"source":"mutool"},"abstract":"BACKGROUND: Research on determinants of health policy implementation is limited, and conceptualizations of evidence and implementation success are evolving in the field. This study aimed to identify determinants of perceived policy implementation success and assess whether these determinants vary according to: (1) how policy implementation success is operationally defined [i.e., broadly vs. narrowly related to evidence-based practice (EBP) reach] and (2) the role of a persons organization in policy implementation. The study focuses on policies that earmark taxes for behavioral health services. METHODS: Web-based surveys of professionals involved with earmarked tax policy implementation were conducted between 2022 and 2023 (N\u2009=\u2009272). The primary dependent variable was a 9-item score that broadly assessed perceptions of the tax policy positively impacting multiple dimensions of outcomes. The secondary dependent variable was a single item that narrowly assessed perceptions of the tax policy increasing EBP reach. Independent variables were scores mapped to determinants in the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Multiple linear regression estimated associations between measures of determinants and policy implementation success. RESULTS: Perceptions of tax attributes (innovation determinant), tax EBP implementation climate (inner-context determinant), and inter-agency collaboration in tax policy implementation (outer-context and bridging factor determinant) were significantly associated with perceptions of policy implementation success. However, the magnitude of associations varied according to how success was operationalized and by respondent organization type. For example, the magnitude of the association between tax attributes and implementation success was 42% smaller among respondents at direct service organizations than non-direct service organizations when implementation success was operationalized broadly in terms of generating positive impacts (\u03B2\u2009=\u20090.37 vs. \u03B2\u2009=\u20090.64), and 61% smaller when success was operationalized narrowly in terms of EBP reach (\u03B2\u2009=\u20090.23 vs. \u03B2\u2009=\u20090.59). Conversely, when success was operationalized narrowly as EBP reach, the magnitude of the association between EBP implementation climate and implementation success was large and significant among respondents at direct service organizations while it was not significant among respondents from non-direct service organizations (\u03B2\u2009=\u20090.48 vs. \u03B2=-0.06). CONCLUSION: Determinants of perceived policy implementation success may vary according to how policy implementation success is defined and the role of a persons organization in policy implementation. This has implications for implementation science and selecting policy implementation strategies.","keywords":["Humans","Taxes","Health Policy","Mental Health Services","Female","Male","Evidence-Based Practice","Implementation Science","Middle Aged","Adult","Surveys and Questionnaires"],"local_ids":[{"id":"4752415","type":"oa_harvester"}],"submitter":"auto@EuroPMC.uc","thumbnail":{"width":121,"height":173,"asset_id":"a87ff0b4a66f03fd555e7b19a204c031a2783f38c7689ccd545bdcb3bb21c98b","timestamp":1732635059,"image_type":"png"},"ext_journal":{"name":"Implementation Science","issue":"1","volume":"19"},"native_file":{"name":"PMC11526668.pdf","size":1233821},"content_length":1233821,"uc_pms_pub_type":"journal-article","is_peer_reviewed":true},"authors":[{"name":"Purtle, Jonathan","fname":"Jonathan","lname":"Purtle"},{"name":"Stadnick, Nicole","fname":"Nicole","lname":"Stadnick"},{"name":"Mauri, Amanda","fname":"Amanda","lname":"Mauri"},{"name":"Walker, Sarah","fname":"Sarah","lname":"Walker"},{"name":"Bruns, Eric","fname":"Eric","lname":"Bruns"},{"name":"Aarons, Gregory","fname":"Gregory","lname":"Aarons"}],"citation":{"id":"qt5q74b3gw","type":"article","title":"Operational and organizational variation in determinants of policy implementation success: the case of policies that earmark taxes for behavioral health services.","URL":"http://escholarship.org/uc/item/5q74b3gw","issued":{"raw":["2024-10-31"]},"doi":"10.1186/s13012-024-01401-8","issn":null,"author":[{"literal":"Purtle, Jonathan","given":"Jonathan","family":"Purtle"},{"literal":"Stadnick, Nicole","given":"Nicole","family":"Stadnick"},{"literal":"Mauri, Amanda","given":"Amanda","family":"Mauri"},{"literal":"Walker, Sarah","given":"Sarah","family":"Walker"},{"literal":"Bruns, Eric","given":"Eric","family":"Bruns"},{"literal":"Aarons, 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