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Table 1 Organizational theory descriptions and applications to SafeCare

From: Organizational theory for dissemination and implementation research


Main propositions

Applications to SafeCare

Transaction cost economics

• Transaction costs influence whether an organization decides to contract with another organization to implement an EBI.

• Decreases in transaction frequency will increase the likelihood that organizations will contract with other organizations to implement an EBI.

• Past relationships between organizations reduce the uncertainty and costs associated with contracting.


• Child welfare systems’ decision to contract with CBOs to administer EBIs rather than acting as direct EBI providers internally was likely influenced by costs.

• The cost of EBI administration is driven by the frequency of collaboration between CBOs and child welfare systems and the familiarity of child welfare systems with CBOs.

Institutional theory

• Organizations implement EBIs that are viewed as legitimate by institutions within their environment.

• Organizations adopt certain EBIs in response to coercion or strong pressures to comply with rules, mandates, and regulations.

• Organizations mimic the behaviors and structures of other successful organizations such as adoption of certain EBIs.

• Organizations will adopt EBIs that align with professional norms.


• Child welfare systems’ decision to adopt SafeCare was likely influenced by pressure from policymakers to provide EBIs, perceptions that SafeCare was viewed as a norm, and advocacy from child welfare professional communities for use of SafeCare.


• Efforts to maintain SafeCare contracts may have coerced CBOs to sustain SafeCare by establishing rules, regulations, and mandates set forth in contracts.

• The contracts garnered support for SafeCare, creating normative pressure on CBOs to sustain SafeCare.

Contingency theories

• Organizations’ design decisions are contingent upon the organization’s internal and external contexts.

• Successful EBI implementation is influenced by whether the EBI fits with an organization’s internal context.

• Organizations’ ability to adapt to their external context influences successful EBI implementation.


• The use of ICTs allowed child welfare systems to respond to external contexts such as local client needs.

• Internal context influenced implementation as larger, governmental organizations had less flexibility in how SafeCare could be implemented.

Resource dependency theory

• Organizations’ design decisions are informed by their dependence on other organizations, ability to maintain autonomy, and relationships with other organizations.

• Organizations form relationships with other organizations to acquire and maintain resources and autonomy.


• CBOs depended on the organizations that funded them and SafeCare developers (for expertise), which lessened their autonomy and power.

• CBOs often negotiated the balance of autonomy and dependence on other organizations by establishing relationships via ICTs, which minimized the resources individual CBOs needed to implement SafeCare.


• Policymakers could have earmarked funds for contracts that would have supported SafeCare to obtain sufficient resources for SafeCare sustainment.

• Train-the-trainer models decreased CBOs’ dependence on SafeCare developers so that their staff could autonomously sustain the practice without.

  1. CBO community-based organization, EBI evidence-based intervention, ICT interagency collaborative team