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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