Associations between teamwork and implementation outcomes in multidisciplinary cross-sector teams implementing a mental health screening and referral protocol
Open accessAbstract
Purpose: Teams play a central role in the implementation of new practices in settings providing team-based care. However, the implementation science literature has paid little attention to potentially important team-level constructs. Aspects of teamwork, including team interdependence, team functioning, and team performance, may affect implementation processes and outcomes. This cross-sectional study tests associations between teamwork and implementation antecedents and outcomes in a statewide initiative to implement a standardized mental health screening/referral protocol in Child Advocacy Centers (CACs). Methods: Multidisciplinary team members (N= 433) from 21 CACs completed measures of team interdependence; affective, behavioral, and cognitive team functioning; and team performance. Team members also rated the acceptability, appropriateness, and feasibility of the screening/referral protocol and implementation climate. The implementation outcomes of days to adoption and reach were independently assessed with administrative data. Associations between team constructs and implementation antecedents and outcomes were tested with linear mixed models and regression analyses. Results: Team task interdependence was positively associated with implementation climate and reach, and outcome interdependence was negatively correlated with days to adoption. Task and outcome interdependence were not associated with acceptability, appropriateness, or feasibility of the screening/referral protocol. Affective team functioning (i.e., greater liking, trust, and respect) was associated with greater acceptability, appropriateness, and feasibility. Behavioral and cognitive team functioning were not associated with any implementation outcomes in multivariable models. Team performance was positively associated with acceptability, appropriateness, feasibility, and implementation climate; performance was not associated with days to adoption or reach. Conclusions: We found associations of team interdependence, functioning, and performance with both individual- and center-level implementation outcomes. Implementation strategies targeting teamwork, especially task interdependence, affective functioning, and performance, may contribute to improving implementation outcomes in team-based service settings.
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Outcome interdependence was significantly negatively correlated with time to adoption but not reach.
“Outcome interdependence (i.e., extent to which outcomes are evaluated at the team vs. individual level) was significantly negatively correlated with time to adoption but not reach.”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
Task interdependence was positively associated with reach but not time to adoption in multidisciplinary child abuse teams implementing a mental health screening/referral protocol.
“In multidisciplinary child abuse teams implementing a mental health screening/referral protocol, task interdependence (i.e., reliance on team members to share resources and coordinate workflows) was positively associated with reach but not time to adoption.”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
Neither task nor outcome interdependence were associated with team members' perceptions of acceptability, appropriateness, or feasibility of the innovation.
“Neither task nor outcome interdependence were associated with team members’ perceptions of acceptability, appropriateness, or feasibility of the innovation [65].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
In multidisciplinary teams responding to child abuse, affective integration was not associated with time to adoption or reach.
“In a study of multidisciplinary teams responding to child abuse, affective integration (i.e., liking, trust, respect) was positively associated with acceptability, appropriateness, and feasibility but not time to adoption or reach [65].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
No significant associations were found between shared goals and implementation outcomes.
“The first study found no significant associations between shared goals and implementation outcomes [65].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
Team learning behavior in child abuse teams was not associated with appropriateness, time to adoption, or reach.
“Team learning behavior in child abuse teams was positively correlated with acceptability and feasibility; it was not associated with appropriateness, time to adoption, or reach [65].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
In multidisciplinary teams responding to child abuse, affective integration (liking, trust, respect) was positively associated with acceptability, appropriateness, and feasibility.
“In a study of multidisciplinary teams responding to child abuse, affective integration (i.e., liking, trust, respect) was positively associated with acceptability, appropriateness, and feasibility but not time to adoption or reach [65].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
Team learning behavior in child abuse teams was positively correlated with acceptability and feasibility.
“Team learning behavior in child abuse teams was positively correlated with acceptability and feasibility; it was not associated with appropriateness, time to adoption, or reach [65].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
Team members' ratings of team performance were associated with innovation acceptability, appropriateness, and feasibility.
“One quantitative study found that team members’ ratings of team performance were associated with innovation acceptability, appropriateness, and feasibility; performance was not associated with time to adoption or reach [65].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
Team performance was not associated with time to adoption or reach.
“One quantitative study found that team members’ ratings of team performance were associated with innovation acceptability, appropriateness, and feasibility; performance was not associated with time to adoption or reach [65].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [65]
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References 72 · Cited by 23
Research works printed but not linked: 2
- [28]Mathieu JE Maynard MT Rapp T Gilson L Team effectiveness 1997–2007: a review of recent advancements and a glimpse into the future J Manag. 2008 34 3 410 76
- [30]Mathieu JE Tannenbaum SI Donsbach JS Alliger GM A review and integration of team composition models: moving toward a dynamic and temporal framework J Manag. 2014 40 1 130 60
- Authors
- McGuier, E. A., Aarons, G. A., Byrne, K. A., Campbell, K. A., Keeshin, B., Rothenberger, S. D., Weingart, L. R., Salas, E., & Kolko, D. J.
- Affiliations
- University of Pittsburgh (US)
- University of California San Diego (US)
- University of Utah (US)
- Carnegie Mellon University (US)
- Corresponding author
- McGuier, Elizabeth A.
- ORCID
- Venue
- Implementation Science Communications
- Published
- 2023-02-10
- Volume
- 4
- Issue
- 1
- Pages
- 13-13
- ISSN
- 2662-2211 (ISSN-L)
- PMC
- PMC9921625
- OpenAlex
- W4319957229
- Cited by
- 23
- References
- 72
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 8 · 2023: 6
- FWCI
- 8.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Implementation Science Communications (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Rice Research Repository (Rice University) (submittedVersion, cc-by)
- Funders
- Center for Clinical and Translational Science, University of Utah (8UL1TR000105)
- National Center for Advancing Translational Sciences (UL1TR001442, TL1TR001858)
- National Institute of Mental Health (MH080916, MH123729, MH018951)
- Substance Abuse and Mental Health Services Administration (1U79SM080000)
- National Institute on Drug Abuse (DA049891)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Keywords
- teamwork, team interdependence, team functioning, team performance, mental health screening, mental health referral, child advocacy centers, multidisciplinary team, implementation outcomes, implementation climate, acceptability, appropriateness, feasibility, REACH regulation, team-based care
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