Organizational structure,leadership and readiness for change and the implementation of organizational cultural competence in addiction health services

Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed.     

State authority and national welfare programs in the world system context

Recent research on national welfare programs focuses upon the organizational capacity of nation-states, but it does not directly address the issue of why state bureaucracies institute such programs. We develop an institutionalist theory that views the rationalization of authority and concomitant national welfare programs as products of a world culture. By examining the interplay between national characteristics and world-system context, we are able to interpret worldwide adoption of welfare programs as well as the difference between formal programs and their implementation. We provide preliminary tests of hypotheses predicting worldwide patterns of welfare expenditures. We find that a state's incorporation in intergovernmental organizations and its level of investment dependence positively affect social security expenditures in 1965 and 1970. We conclude by briefly discussing implications of our research for further work on the relationship between state structures and national programs.     

Escape from the Iron Cage? Organizational Change and Isomorphic Pressures in the Public Sector

Institutional theory suggests that organizations pursue legitimacyby conforming to isomorphic pressures in their environment.We extend previous research on institutional theory by distinguishingbetween two definitions of conformity (compliance and convergence)and by taking a comprehensive view of the organizational characteristicsthat might be subject to isomorphic pressures. This frameworkis applied to change between 2001 and 2004 in the internal characteristicsof 101 public organizations in England. We find substantialevidence of compliance but more limited support for convergence.Furthermore, the impact of isomorphic pressures was strongeron organizational strategies and culture than on structuresand processes. Thus, the relevance of institutional theory tochange in the public sector depends on the definition of conformitythat is used and the organizational characteristics that areexamined.     

‘Family Friendly’ Employment Policies: A Route to Changing Organizational Culture or Playing About at the Margins?

Formal ‘family friendly’ policies, including flexible or reduced hours of work and periods of leave, designed to help employees to balance work and family demands have the potential to challenge traditional models of work and organizational values. However, while these policies can reduce stress for individual employees, it is argued that there is less evidence of widespread organizational culture change. This paper draws on case studies of organizations at various stages of developing ‘family friendly’ policies to identify two barriers to fundamental shifts in organizational culture; low sense of entitlement to consideration of family needs, and organizational discourses of time as representing productivity, commitment and value. Some conditions under which broader culture change may be achieved are explored.     

INTERNAL AND EXTERNAL SOURCES OF ORGANIZATIONAL CHANGE: Corporate Form and the Banking Industry

How do internal and external constraints impact the likelihood that organizations enact organizational change? Resource dependence theory argues that organizational change is a response to internal and external constraints. However, the interaction of these constraints remains theoretically and empirically underconsidered. Using longitudinal data from the U.S. banking industry, I examine this question from a resource dependence perspective and I also incorporate explanations from transaction cost economics, organizational ecology, and institutional theoretical perspectives. I find that external constraints limit the impact of internal constraints on organizational change. I explore how this finding fits within resource dependence theory.     

DO MANUFACTURERS POLLUTE LESS UNDER THE REGULATION‐THROUGH‐INFORMATION REGIME?

Because past studies on the effects of right-to-know laws have relied on highly aggregated data, it is still unknown whether being located in a state with a funded right-to-know program has a significant effect on the environmental performance of individual manufacturing plants. Nor has it been shown that such effects exist net of other plant characteristics that are known to increase pollution. To remedy this situation, we have used plant-level data from the EPA's Toxics Release Inventory to test the effects of states' right-to-know programs on the toxic emissions of chemical plants in 1990 and 2000. Consistent with several organizational theories (neoinstitutionalism, organizational ecology, and the resource dependence framework) that stress how regulatory policies are just one of several institutional forces that bear on organizations, our findings reveal that states' right-to-know programs have had no significant net effect on plants' toxic emissions. In addition to raising questions about the efficacy of information disclosure laws, our results underscore the importance of approaching pollution as an organizational phenomenon and studying organizations where they most directly impact the environment-at the site of production.     

Illuminating gendered organization assumptions

One key to why organizations have been less successful at integrating a work–family agenda into their organizational cultures is that workplaces have failed to consider how gender assumptions influence workplace practices, policies and cultures. This paper presents a theoretical framework for considering how gender role assumptions have prevented organizational attempts to become family friendly. Further, this paper uses an organizational case study to illustrate this point. Specifically, a theory of gendered organizations is used to frame an analysis of 30 employee interviews. Data suggest that gendered organizational assumptions inherent to several workplace policies and practices contribute to employee strain associated with negotiating the demands of life on and off the job. Further, the findings show that these gendered organizational assumptions prevent organizations from developing workplace cultures responsive to employees' work, family and personal needs. A brief review of the interdisciplinary work–family field is presented, followed by a discussion of gendered organizations. Then, using interview data collected from management and ‘front‐line’ female and male workers employed at a municipal government, this paper examines how workplace practices, presumably gender neutral, affect employees and the organizational culture in which they work.     

Fraud survival in nonprofit organizations: Empirical evidence

This study examines the survival of nonprofit organizations after the discovery of a fraud. Literature on nonprofit fraud claims that fraud has a destructive impact on nonprofit organizations. This study is the first to provide empirical evidence of the impact of fraud on a nonprofit organization's survival, and to analyze the significance of underlying organizational and fraud factors. An analysis of 115 nonprofit organizations experiencing a fraud shows that over one fourth of these organizations did not survive at least 3 years beyond the publication of the fraud, a rate considerably higher than the typical nonprofit failure rate. This article investigates the characteristics of surviving organizations and finds that older and larger organizations are more likely to survive, indicating the liabilities of newness and smallness hold in fraud survival situations. In cases where an executive‐level perpetrator committed the fraud, or where the organization victimized the public, the organization was less likely to survive. These findings suggest nonprofit organizations, particularly those that are new or small, could benefit by implementing governance policies and procedures that are consistent with those employed by more established organizations.     

Examining the Nursing Home Physical Environment Through Policy-Driven Culture Change

A critical need exists to challenge approaches to nursing home care due to rigid organizational factors and hospital-like culture. It has been argued that resident care needs to move toward a person-centered approach by addressing the organizational, social, and physical environments in nursing home facilities, a process often known as culture change. In response to this need, the Centers for Medicare & Medicaid Services (CMS) has created funding for pay for performance (P4P) nursing home incentive programs to allow nursing home providers to receive CMS reimbursements for culture change in the facilities. Through care staff interviews, site observations, and a document review, this qualitative study assesses the impact of a Midwestern state P4P incentive program in three participating nursing homes. Using an environment and behavior (E-B) policy orientation framework, this study examines culture change through a focus on policy, the physical environment, place attachment, and social and psychological processes in the study settings.     

Data culture as a change agent for organizations serving families and children experiencing homelessness

Over the past decade there have been considerable developments in the use of data in the field of child and family homelessness. The development of high-quality data collection processes—including Housing Management Information Systems (HMIS), community point-in-time counts, and school district data and evaluation infrastructure—has given nonprofit and social sector leaders unprecedented access to client-level data. However, it remains a challenge for nonprofits and community-based organizations to engage in work with families experiencing homelessness and demonstrate meaningful impact across a variety of outcomes. In this policy brief, the authors discuss (1) challenges facing the field of child and family homelessness with respect to data use, (2) recent advancements in the use of data, and (3) strategies to create an organizational culture of data that makes use of recent advancements in data use and addresses current challenges facing the field. The brief makes the argument that fostering a data culture at the organizational level has the capacity to operate as an organizational change agent that improves programs.     

Coalition for a Healthier Community: Lessons learned and implications for future work

The Coalition for a Healthier Community (CHC) initiative was implemented to improve the health and well-being of women and girls. Underpinning CHC is a gender-based focus that uses a network of community partners working collaboratively to generate relevant behavior change and improved health outcomes. Ten programs are trying to determine whether gender-focused system approaches are cost-effective ways to address health disparities in women and girls. Programs implemented through coalitions made up of academic institutions, public health departments, community-based organizations, and local, regional, and national organizations, are addressing health issues such as domestic violence, cardiovascular disease prevention, physical activity, and healthy eating. Although these programs are ongoing, they have made significant progress. Key factors contributing to their early success include a comprehensive needs assessment, robust coalitions, the diversity of populations targeted, programs based on findings of the needs assessments, evaluations taking into consideration the effect of gender, and strong academic–community partnerships. A noteworthy impact of these programs has been their ability to shape and impact public, social, and health policies at the state and local levels. However, there have been challenges associated with the implementation of such a complex program. Lessons learned are discussed in this paper.     

Serving public interests and enacting organizational values: An examination of public interest relations through AARP’s Tele-Town Halls

Public interest relations (PIR) is an approach to public relations scholarship and practice that contributes to the social good by integrating the concept of public interest into organizational goals and values. The need for PIR was emphasized during the COVID-19 pandemic as publics looked to organizations for information about a variety of topics (e.g., symptoms, vaccines). AARP created a series of tele-town halls to communicate with its publics, who are considered to be members of a “vulnerable population” during the pandemic. In order to understand how AARP’s Coronavirus Tele-Town Halls reflected the practices of PIR, I completed a critical thematic analysis of 28 virtual sessions that were hosted in 2020–2021. The analysis, which was guided by the tenets of PIR, found that AARP’s communication (1) highlighted common life course milestones of its publics, (2) emphasized the quality of the information, and (3) provided avenues to engage with the organization and its experts. Based on these findings, I developed theoretical implications that reflect a critical perspective on PIR and suggest future research avenues that seek to build this ethical and socially meaningful approach to public relations.     

Evaluating Organizations Through an Employee Assistance Program Using an Organization Development Model

This article describes one of the first accounts of an Employee Assistance Program (EAP) staffed by a social worker in industry in the United States. The author was the social worker employed in this EAP (called the Industrial Social Work Project) which was originally motivated by a vice president's concern over employee turnover. The article describes in detail how the EAP was operationalized and used to evaluate the organizational culture by using an organizational development model which involved five overlapping phases. These were: (1) orientation/information gathering; (2) individual treatment; (3) research on cultural change; (4) team building and O.D. projects; and (5) O.D. management training. The main contention of this article is that organizations do in fact contribute to the "professional suicide" of employees, and those who plan to evaluate ENS are remiss not considering the organization context of such programs and their possible impact on employees.     

Causes of Early and Later Organizational Adoption: The Case of Corporate Downsizing

While the causes of organizational adoption of new practices often vary across social contexts, organizational theories seldom recognize this fact. One of the few contextual theories on adoption views the causes of adoption as varying according to the timing of adoption: Economic causes should govern early adoption and institutional causes should govern later adoption. Tests of this theory generally have focused on gradual adoption among noneconomic organizations. Recognizing the need to expand our understanding of the timing of organizational adoption, I examine rapid adoption among economic organizations. More specifically, I focus on the adoption of downsizing programs among Fortune 100 firms and report that economic and institutional factors have affected downsizing throughout the downsizing era. Interpretation of these findings sheds light on the genesis and continuation of the downsizing era and on the impact that the rise of investor capitalism has had on shifts in the specific causes of early and later downsizings. I conclude by stressing the theoretical and practical utility of investigating how new practices spread across organizations in different contexts.     

Social Status and Attitudes toward Organizational Control of Genetic Data

Abstract

Advances in genetics testing technologies have lead to concerns over the use of genetic testing in non-medical, organizational settings. Genetic testing, which is becoming an increasingly common practice in organizations to screen employees and applicants for employment and insurance for genetic anomalies, has been demonstrated to be consistent with organizational goals such as profitablity and efficiency. This paper examines the characteristics of those who support organizational genetic screening. Data from a randomly selected sample of adults reveal that three indicators of socio-economic status — income, education and supervising others — were negatively associated with support for the non-medical use of genetic data. These findings suggest that working class individuals are more likely to conform to organizational policies requiring genetic testing of employees and clients. The study argues that managerial decisions based on genetic data may have the most impact on individuals with the fewest socio-economic resources.     

Organizational portfolio theory and international not-for-profit organizations

The organizational portfolio theory is used to explain performance-driven organizational changes in international not-for-profit organizations. The forces that push international not-for-profit organizations to adapt are those that exacerbate the effect of the downward swing in organizational performance that results from misfit. On the other hand, the forces that retard adaptive change in these organizations are those that counteract the effect of the downward swing in organizational performance that results from misfit. Each of seven factors analyzed may push the international not-for-profit organizations to adapt or to not adapt, depending on their effect on organizational performance.     

Institutional Pressures and Organizational Capacity: The Case of Outcome Measurement1

A central claim of new institutional theory is that organizations in a field come to exhibit shared characteristics over time. Recent literature emphasizes variation across field members, but has yet to concur on why differences occur. This study tests institutional explanations for the uneven implementation of one organizational practice—outcome measurement, an evaluative technique used to assess the impact of an organization’s programs. We analyze data from a new survey investigating the practices of nonprofit organizations (N = 379) and argue for the inclusion of the concept of organizational capacity to account for the uneven implementation of outcome measurement. As predicted by new institutional theory, organizations are more likely to adopt outcome measurement if key actors promulgate its use. However, the implementation of outcome measurement is best explained by the addition of the concept of organizational capacity alongside variables drawn from new institutionalism. Nonprofits with adequate organizational capacity, operationalized—following Weber’s concept of bureaucracy—as the presence of written rules and members with specialized knowledge, are better able to respond to isomorphic pressures to implement a new organizational practice. Our findings expand scholarship that examines the intersection of institutional dynamics and organizational traits in accounting for patterns of implementation of practices across an organizational field.     

Structure and accountability a study of national nonprofit associations

In the 1990s, the integrity and performance of nonprofit organizations in the United States have come increasingly under attack, and there are new calls to hold nonprofit organizations more accountable for their behavior and performance. This article reports on a study of the organizational structures of national nonprofit associations and asks how these umbrella organizations can help to self-regulate the sector through appropriate checks and balances between the national organization and local affiliates. The authors identify a number of differences in how associations with alternative structures hold local affiliates and national organizations responsible for their performances, and they conclude that structure is an avenue of self-regulation for nonprofit organizations deserving further attention.     

Challenges for environmental education evaluation

The articles in this special issue cover a range of practices in environmental education evaluation, from program evaluations to training and organizational impact. This article reflects on this collection and offers six recommendations on three broad themes that the issue's authors identify as shortcomings or opportunities for change: capacity building, program theory, and learning organizations.