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 | Â | Â |
 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 |