Leadership in the Implementation of Evidence-Based Interventions in Child and Adolescent Services: A Systematic Review

Abstract

Evidence-based interventions (EBIs) are commonly implemented in child and adolescent services. However, when translating research on EBIs into practice, comparable effective results are not consistently observed. Implementation frameworks aim to support successful EBI implementation, with leadership being a fundamental tenet. Existing reviews have predominantly focused on understanding leadership in implementation within the social care setting. Leadership exists in all children and adolescent services. Therefore, understanding the role of leadership across contexts is clinically valuable. This systematic review aimed to identify components of leadership that influence EBI implementation in child and adolescent settings. Studies were required to be empirical, peer-reviewed, written or translated into English, and have a qualitative design. Studies explicitly researched leadership or had leadership or a closely related term as a major or subtheme. Eligible studies had to name the implemented EBI overtly. A literature search yielded 24 eligible studies. Thematic synthesis revealed one overarching theme, two themes, and six subthemes. Findings demonstrated that ‘power imbalances’ were critical in hindering implementation. Moreover, ‘developing a core purpose’ involved ‘obtaining staff buy-in’, ‘creating a shared vision’, and leaders demonstrating their ‘commitment to the EBI’, which created a context conducive to implementing EBIs. Leaders’ focus on ‘maintaining implementation’ through taking ‘a collaborative approach’ while working on ‘effective communication’ and ‘providing holistic support’ was vital to facilitation. Findings suggest that leaders are required to be upskilled and stay informed with implementation research to garner optimal outcomes for young people when implementing EBIs.