Ecological factors impacting provider attitudes towards human service delivery reform

Although reform efforts are substantially altering the structural operation s and guiding ideological framework of the human service delivery system, l ittle empirical work has been done to systematically examine these transfor mations, This study examines providers' attitudes regarding two reform elem ents that are being widely implemented: an increased emphasis on interagenc y collaboration and a shift from a medical model service delivery philosoph y, that focuses on client deficits, to one that emphasizes consumer strengt hs. Through survey data collected from 186 providers from 32 human service agencies in one county, the relationship between providers' perceptions of contextual support for human service delivery reform and providers' attitud es towards these initiatives is explored. The findings from this study supp ort the importance of attending to the ecology in which we initiate system reform efforts. For both reform elements, working within contexts that are perceived as providing ideological and functional support for change was as sociated with positive provider attitudes towards those changes. Staffs' pe rceptions of the external environment played the most critical role in shap ing staff attitudes. Interestingly, unique aspects of providers' work envir onments were related to positive attitudes towards the two different reform s. The implications of these findings for the success of human service deli very reform are discussed.