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Factors Explaining Program Sustainability: A Study of the Implementation of a Social Services Program in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.ORCID iD: 0000-0002-3361-1911
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.ORCID iD: 0000-0002-5066-1232
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.ORCID iD: 0000-0002-3921-5522
2023 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 2023, article id 1458305Article in journal (Refereed) Published
Abstract [en]

Even for successfully implemented programs, there is a great risk that new work practices are not sustained over time. Previous research has yielded a number of factors which influence program sustainability, but little is known about which factors are most important in different contexts or how these factors interact. This study tests a model of sustainability factors in a case where a program for structured needs assessment and documentation was implemented in the Swedish social services. In November 2020, a questionnaire was sent out to local implementing actors in the municipalities. The data include 135 municipal organizations with 1–3 respondents per organization. Descriptive statistics and multiple regression were used in the analysis. The outcome variable was routinization as one of the most central components of sustainability. The findings show that while the program was implemented at 21.5% of sites, it was both implemented and routinized at only 13.3% of sites. A key factor for successful routinization was an open project strategy, which entails coordination between the implementation process and other change initiatives, the identification of a long-term planning horizon, and development based on continuous feedback. Additional factors found to contribute to routinization were management commitment, user participation, first-line manager commitment, and available resources. Certain factors were identified as pertinent to the implementing actors themselves, such as effective project leadership and rationally planned projects. These latter factors, however, demonstrated less importance towards routinization. These findings are discussed in relation to the fragmented context of the implementation, whereby the recipient organizations were not single, unified organizations, but rather organizational clusters involving both purchaser and provider organizations. The findings have implications for the planning, management, and evaluation of social program implementation and the ability to sustain novel work practices.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2023. Vol. 2023, article id 1458305
Keywords [en]
Sustainability, Routinization, Implementation, Organizational change, Social care, Survey research
National Category
Social Work
Identifiers
URN: urn:nbn:se:uu:diva-498743DOI: 10.1155/2023/1458305ISI: 000939316300001OAI: oai:DiVA.org:uu-498743DiVA, id: diva2:1744540
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01494Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2023-04-03Bibliographically approved

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Åhlfeldt, EmanuelIsaksson, DavidWinblad, Ulrika

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