# Randomized trial of a leadership and organizational change strategy to improve the implementation and sustainment of digital measurement-based care in youth mental health services

> **NIH NIH R01** · BOISE STATE UNIVERSITY · 2021 · $76,850

## Abstract

Project Summary/Abstract
 This proposed Diversity Research Supplement aims to extend the scientific impact of the parent trial to test
the effects of the Leadership and Organizational Change for Implementation (LOCI) strategy on the
implementation (aim 1) and sustainment (aim 2) of digital measurement-based care (MBC) and the
mechanisms that link LOCI to improve MBC fidelity (aim 3) and support a promising early career investigator
who will contribute to the diversity of the NIH workforce. Within the scope of Aim 3 (mechanisms), the
proposed diversity research supplement extends the study’s scientific impact by generating new data and
testing new hypotheses regarding the role of cost-neutral workplace-based clinical supervision in optimizing
MBC fidelity and youth clinical outcomes. This work fills a critical gap in scalable, supervision-focused
implementation strategies that could be integrated into, or deployed independently of, the LOCI strategy.
 Workplace-based clinical supervision is an essential, ubiquitous, and often State-mandated infrastructure
for delivering community mental health care. As such, it is a potentially powerful, cost-neutral entry point for
improving clinical outcomes by supporting high fidelity delivery of evidence-based practices (EBP), such as
MBC. However, the evidence-informed clinical supervision strategies (CSS) that are most effective are least
used in routine settings and the key determinants of this variation are yet to be discovered. Evidence suggests
that the organizational climate for implementation of EBP, which is a key target of LOCI, improves intensity of
EBP-related supervision content. However, experiments are needed to test the linkage. Furthermore, beyond
organizational climate, quantitative studies have failed to identify tractable determinants, highlighting the
importance of qualitative inquiry to generate deeper understanding and new hypotheses regarding the potential
multilevel supervision determinants and their potentially complex interactions. The proposed supplement takes
the essential first steps toward generating a scalable, effective, and theoretically grounded implementation
strategy that leverages routine workplace-based clinical supervision to promote MBC fidelity and clinical
outcomes. Within the context of the parent trial, using an explanatory mixed method design, the proposed
supplement will: 1) Test the effect of LOCI on supervisors’ use of evidence-informed CSS, 2) Test supervisors’
use of CSS as a link between LOCI and MBC fidelity and clinical outcomes within the parent cluster
randomized controlled trial, and 3) Identify the most salient and tractable determinants of supervisors’ use of
evidence-informed CSS that are not targeted by LOCI at the policy, agency, supervisor, supervisee, and
technique levels through in-depth qualitative interviews with end users and potential adopters. This supplement
launches a program of research focused on closing the research-practice gap by appl...

## Key facts

- **NIH application ID:** 10265809
- **Project number:** 3R01MH119127-02S1
- **Recipient organization:** BOISE STATE UNIVERSITY
- **Principal Investigator:** Nathaniel J. Williams
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $76,850
- **Award type:** 3
- **Project period:** 2019-06-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10265809

## Citation

> US National Institutes of Health, RePORTER application 10265809, Randomized trial of a leadership and organizational change strategy to improve the implementation and sustainment of digital measurement-based care in youth mental health services (3R01MH119127-02S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10265809. Licensed CC0.

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