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Table 2 Differences in Knowledge of EBCDP, Mis-implementation, and Reasons Programs End and Continue by Country

From: A cross-country study of mis-implementation in public health practice

 

Australia

Brazil

China

United States

  
 

N = 121

N = 76

N = 102

N = 101

Chi-Sq

p-value

Characteristic

%

n

%

n

%

n

%

n

  

 Knowledgeable of EBCDP

        

146.7

< 0.0001

  Not at all

0.8%

1

2.6%

2

15.7%

16

1.0%

1

  

  Slightly

4.2%

5

2.6%

2

31.4%

32

2.0%

2

  

  Somewhat

20.2%

24

32.9%

25

32.4%

33

14.9%

15

  

  Moderately

60.0%

73

44.7%

34

18.6%

19

54.5%

55

  

  Extremely

15.0%

18

17.1%

13

2.0%

2

27.7%

28

  

Mis-implementation

 Frequency of Mis-Termination (Inappropriate Ending)

        

148.4

< 0.0001

  Never

1.7%

2

2.6%

2

12.2%

12

1.0%

1

  

  Sometimes

31.6%

38

39.5%

30

36.7%

37

51.5%

52

  

  Often

56.4%

68

36.8%

28

5.1%

5

40.4%

41

  

  Don’t Know

9.4%

11

10.5%

8

45.9%

47

7.1%

7

  

  Missing

1.7%

2

10.5%

8

1.0%

1

0%

0

  

 Frequency of Mis-Continuation (Inappropriate Continuation)

        

241.1

< 0.0001

  Never

1.7%

2

10.5%

8

11.0%

11

5.9%

6

  

  Sometimes

0.0%

0

60.5%

46

33.0%

34

19.8%

20

  

  Often

58.0%

70

7.9%

6

4.0%

4

36.8%

37

  

  Don’t Know

37.8%

46

14.5%

11

52.0%

53

34.5%

35

  

  Missing

2.5%

3

6.6%

5

0%

0

3.0%

3

  

Reasons Programs End and Continue

 Reasons Programs End (% of times in top 3)a

          

  Grant funding ended

63.6%

77

43.4%

33

24.5%

25

84.2%

85

80.8

< 0.0001

  Funding diverted to a higher priority program

31.4%

38

31.6%

24

20.6%

21

36.6%

37

6.6

0.085

  Change in political leadership

50.4%

61

47.4%

36

8.8%

9

11.9%

12

73.2

< 0.0001

  Program was evaluated but did not demonstrate impact

22.3%

27

21.1%

16

42.2%

43

9.9%

10

30.0

< 0.0001

  Opposition/lack of support from policy makers

26.4%

32

28.9%

22

18.6%

19

18.8%

19

4.4

0.219

  Program was challenging to maintain

9.9%

12

10.5%

8

48.0%

49

20.8%

21

55.6

< 0.0001

  Program was never evaluated

19.0%

23

23.7%

18

10.8%

11

15.8%

16

5.6

0.130

  Opposition/lack of support from the general public

2.5%

3

21.1%

16

38.2%

39

8.9%

9

56.9

< 0.0001

  Opposition/lack of support from leaders in my agency

10.7%

13

35.5%

27

13.7%

14

10.9%

11

26.1

< 0.0001

  A program champion departed

22.3%

27

25.0%

19

5.9%

6

9.9%

10

19.1

< 0.0001

  Program was expensive

5.8%

7

11.8%

9

15.7%

16

8.9%

9

6.3

0.098

  Program was not evidence-based

3.3%

4

23.7%

18

12.7%

13

3.0%

3

29.4

< 0.0001

  Program was adopted or continued by other organizations

4.1%

5

2.6%

2

2.0%

2

13.9%

14

16.9

0.001

  Insurance funding/coverage ended

1.7%

2

9.2%

7

0.0%

0

7.9%

8

14.5

0.002

 Reasons Programs Continue (% of times in top 3)a

          

  Sustained support from policymakers

27.3%

33

43.4%

33

31.4%

32

22.1%

22

11.6

0.009

  Sustained funding

28.1%

34

39.5%

30

36.3%

37

35.6%

36

3.2

0.358

  Sustained support from leaders in your agency

27.3%

33

18.4%

14

35.3%

36

24.8%

25

6.7

0.084

  Absence of alternative options

28.1%

34

26.3%

20

22.5%

23

17.8%

18

3.6

0.310

  Program was never evaluated

33.1%

40

35.5%

27

8.8%

9

16.8%

17

27.1

< 0.0001

  Sustained support from the general public

15.7%

19

21.1%

16

37.3%

38

15.8%

16

18.7

< 0.0001

  Program was easy to maintain

24.0%

29

18.4%

14

21.6%

22

23.8%

24

1.0

0.799

  Presence of a program champion

23.1%

28

28.9%

22

13.7%

14

21.8%

22

6.3

0.096

  Program was low-cost

19.0%

23

18.4%

14

8.8%

9

18.8%

19

5.6

0.135

  Prohibitive costs of starting something new

13.2%

16

9.2%

7

9.8%

10

6.9%

7

2.5

0.473

  Program was considered evidence-based

10.7%

13

3.9%

3

16.7%

17

6.9%

7

9.3

0.026

  1. Boldface indicates significant at alpha < 0.05
  2. aThe original series of questions asked participants to select the three most frequent reasons from the lists above