Table 5.
Patient-level factor change coefficients and 95% confidence intervals for effects of implementation strategy and culture and climate measures, by the outcome, for 6-month intervals and 12 months cumulative post-randomization (N = 9225)
| Entrepreneurial culture | Task climate | Relational climate | |
|---|---|---|---|
| Updated documentation | |||
| Immediate vs. Delayed Enhanced REP at 6 months (vs. baseline) | 8.24 (5.74, 11.83)* | 9.69 (6.58, 14.27)* | 10.10 (6.83, 14.95)* |
| Immediate vs. Delayed Enhanced REP at 12 months (vs. baseline) | 5.91 (3.99, 8.76)* | 7.05 (4.63, 10.73)* | 7.72 (5.04, 11.84)* |
| Immediate Enhanced REP x culture/climate score at 6 months (vs. baseline) | 2.81 (1.98, 3.98)* | 3.05 (2.05, 4.55)* | 2.56 (1.72, 3.81)* |
| Immediate Enhanced REP x culture/climate score at 12 months (vs. baseline) | 2.05 (1.41, 2.97)* | 2.00 (1.30, 3.08)* | 1.94 (1.27, 2.98)* |
| BIC statistic | 7241.7 | 7271.8 | 7727.7 |
| Attempted contact | |||
| Immediate vs. Delayed Enhanced REP at 6 months (vs. baseline) | 3.38 (2.42, 4.74)* | 3.73 (2.64, 5.27)* | 3.72 (2.64, 5.25)* |
| Immediate vs. Delayed Enhanced REP at 12 months (vs. baseline) | 2.35 (1.67, 3.31)* | 2.52 (1.76, 3.59)* | 2.58 (1.81, 3.68)* |
| Immediate Enhanced REP x culture/climate score at 6 months (vs. baseline) | 1.59 (1.12, 2.25)* | 1.65 (1.14, 2.38)* | 1.27 (0.88, 1.84) |
| Immediate Enhanced REP x culture/climate score at 12 months (vs. baseline) | 0.99 (0.69, 1.41) | 0.98 (0.67, 1.43) | 0.79 (0.55, 1.16) |
| BIC statistic | 7511.1 | 7531.0 | 7536.5 |
| Completed contact | |||
| Immediate vs. Delayed Enhanced REP at 6 months (vs. baseline) | 1.59 (0.96, 2.63) | 1.64 (0.97, 2.79) | 1.66 (0.98, 2.78) |
| Immediate vs. Delayed Enhanced REP at 12 months (vs. baseline) | 1.22 (0.76, 1.98) | 1.15 (0.69, 1.90) | 1.18 (0.72, 1.94) |
| Immediate Enhanced REP x culture/climate score at 6 months (vs. baseline) | 1.07 (0.65, 1.77) | 1.29 (0.74, 2.23) | 1.01 (0.59, 1.75) |
| Immediate Enhanced REP x culture/climate score at 12 months (vs. baseline) | 0.92 (0.58, 1.48) | 1.11 (0.66, 1.88) | 0.96 (0.57, 1.63) |
| BIC statistic | 4873.4 | 4877.9 | 4880.8 |
*P value of <0.05. Factor change coefficients represent the change in the odds of observing the dependent variable for a given change in x. Immediate Enhanced REP refers to the adaptive intervention that starts with Enhanced REP for 6 months then steps all sites down to Standard REP for the second 6 months, while Delayed Enhanced REP refers to the adaptive intervention that starts with Standard REP for 6 months and then provides Enhanced REP for the second 6 months for sites that were still non-responsive. Interaction terms (e.g., Immediate Enhanced REP x culture/climate score at 6 months) indicate the difference in the treatment effect by culture/climate score. Full model adjusts for patient age, gender, number of medical comorbidities, marital status, VA service connection, homelessness, diagnosis of schizophrenia or related disorder, and site-level measures of facility size (number of unique patients in FY 2012), whether the site was an outpatient clinic or VA medical center, and total number of Veterans with SMI at the site identified as having been lost to follow-up care, and includes random intercepts for site and VISN. REP Replicating Effective Programs, BIC Bayesian information criterion