Cultural exchange and the implementation of evidence-based practice: Two case studies

Objective: The dynamics of interactions between evidence-based intervention (EBI) developers and trainers and organi-zations and providers that deliver the EBI was examined in two case studies, a statewide randomized effectiveness trial of an EBI to reduce child neglect and a randomized trial of EBIs for depression, anxiety, and conduct problems in children and adolescents.Methods: Data were collected using ethnographic methods of participant observation and semistructured interviews and analyzed using grounded theory analytic methods. Results: Formal and informal interactions between EBI propagators and end users provide access to resources and exchange of global and local knowledge of service delivery. Productive interactions require accessibility, mutual respect, a shared language, and a willingness to engage in negotiation and compromise to resolve differences in demands imposed by organizational culture, the need for EBI fidelity, and client characteristics. Conclusion: A cultural exchange characterized by information sharing and behavioral change through a process of negotiation and compromise is central to evidence-based practice in youth serving systems of care. Keywords: translational science; evidence-based practice; implementation; social work; mental health; evidence-based interventions As with health services in general (Institute ofMedicine, 2000), there remains a large gap between interventions shown to be effective in the pre-vention and treatment of mental health and behavioral problems among children and adolescents and their use in everyday clinical care. Although there are numerous evidence-based interventions (EBIs) for this purpos