A multilevel study of leadership, change-oriented staff, and propensity for innovation adoption

In response to increasing demands on treatment providers to enhance service delivery and improve client outcomes, agencies within the substance abuse treatment field are placing emphasis on the adoption and implementation of evidence-based interventions. Because trial use of new innovations by program staff is considered a vital stage in the process of moving practices into routine care, it is important to explore mechanisms involved in the initial adoption of innovations. One of the unique contributions of the current study is a glimpse into the process by which staff members decide to try new innovations in their clinical work as facilitated by the combined effect of creative and engaged leaders and change-oriented staff attributes (i.e., opportunities for professional growth, efficacy, adaptability, and influence on others). The current study used hierarchical linear modeling to test specific hypotheses characterizing the inter-relations among these organizational factors. First, a series of models tested whether staff attributes served as potential mediators of the relationship between leadership and innovation adoption. Second, a series of models tested whether organizational climate served as a potential moderator of the relationship between leadership and staff attributes. The data were collected in 2004 as part of the Treatment Costs and Organizational Monitoring project and consist of 421 counseling staff from 71 Outpatient treatment programs in 4 US regions. Results reveal that the propensity to adopt workshop-based interventions is facilitated by two important mechanisms (1) an innovative organization with creative leadership and (2) change-oriented staff attributes. The current study further defines the process of individual adoption by showing that leadership not only supports the development of change-oriented staff attributes, but also bolsters the impact that leadership has on innovation adoption by fostering these staff attributes. A climate receptive to change also supports the development of these attributes by motivating staff to develop job efficacy, be adaptive in job completion, and support program success by positively influencing coworkers. One implication of these findings is the cascading effect of leaders' support of innovative thinking and action resulting in employees strengthening their own adaptive skills and carrying this innovative thinking into individual adoption.