The Interaction Between General and Strategic Leadership and Climate on Their Cross-Level Associations with Implementer Attitudes Toward Universal Prevention Programs for Youth Mental Health: A Multilevel Cross-Sectional Study

Emerging literature highlighted the importance to discern the general and strategic types of organizational context (OC) factors (e.g., leadership and climate) and explore their interaction effect on individual implementation behaviors (e.g., attitudes toward evidence-based practices; EBPs) in youth mental healthcare. This study aimed to examine the associations among implementer attitudes toward EBPs and leadership and climate (general and strategic) across the individual and organizational levels and their interaction effect in schools. A series of multilevel models (MLMs) were fitted on a diverse sample of schools actively implementing universal prevention programs for youth mental health (441 implementers from 52 schools). The organization-level aggregates and individual educator's perceptions of general and strategic leadership and climate, and their interaction terms, were entered as level-2 and level-1 predictors based on their level of measurement. The outcomes are four attitudinal dimensions (Requirement, Openness, Appeal, and Divergence). At the organizational level, higher levels of strategic leadership and climate, but not their general counterparts, were consistently associated with more favorable attitudes in all four dimensions. At the individual level, higher levels of perceived general and strategic leadership and climate were associated with more favorable attitudes of Requirement and Openness. At the organizational-level, general climate moderated the positive effect of strategic climate on implementers' perception of appeal and divergence of EBPs. Our findings indicate that leaders need to make data-based decisions to allocate resources on strategic and/or general leadership and climate to foster favorable staff attitudes toward EBPs based on the level of measurement, implementation-specificity, and attitudinal dimensions.