Abstract Background Leaders of healthcare organizations are often called on to guide the implementation of new innovations, including evidence-based practices and digital health technologies. However, many leaders lack preparation for this role and most available leadership trainings have not been rigorously tested, particularly over periods incorporating multiple implementation phases. Purpose This study tested the effects of the Leadership and Organizational Change for Implementation (LOCI) strategy on the uptake of digital measurement-based care (MBC) in mental health settings across 35 months, incorporating implementation and sustainment phases. Methods In 21 outpatient mental health clinics serving youth, a two-arm, cluster randomized, hybrid type III effectiveness-implementation trial tested whether adding LOCI (k = 11) to standard digital MBC training and technical assistance (k = 10) improved uptake of digital MBC, assessed using system generated data and operationalized as clinic-level monthly counts of the number of youths with a measure administered and with feedback viewed by their clinician. Results On both outcomes, clinics randomized to LOCI exhibited superior initial uptake (3 months post-baseline: mean difference in youths with measure administered per clinic (MYMADiff=5. 09, 95% CI=1. 63–8. 55) ; mean difference in youths with feedback viewed per clinic (MYFVDiff=3. 81 1. 26–6. 37), superior uptake when the implementation phase concluded (13 months post-baseline: MYMADiff=9. 03, 1. 64–16. 41; MYFVDiff=8. 31 3. 07–13. 56), and superior uptake when the sustainment phase concluded (35 months post-baseline: MYMADiff=3. 82 1. 28–6. 36; MYFVDiff=1. 41 0. 22–2. 60). Conclusions LOCI is an effective approach for training organizational leaders to support implementation of evidence-based digital health technologies in healthcare settings. Studies examining how policy-level variables interact with leadership training are needed.
Williams et al. (Thu,) studied this question.