Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth A National Agenda (2019) / Chapter Skim
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9 Effective Implementation: Partners and Capacities
9 Effective Implementation: Partners and Capacities
Pages 255-282
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From page 255... ...
We then explore the roles of key partners involved in this model -- the "co-creation" partners who each play a part in developing the capacities needed to make programs and interventions work and sustain them at scale. Next we focus on some key elements of effective overall system capacities for scale-up: collaboration, including leadership and implementation teams, community coalitions, and learning collaboratives; workforce development systems; systems to monitor and improve quality and outcomes; and communications and media systems for disseminating sciencebased information within communities beyond direct intervention services alone.
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From page 256... ...
The system is optimized to pursue key implementation outcomes as it is first put into practice and then adapted (center band) ; information is collected about initial results and developments on the ground related to feasibility, fidelity, cost, how the intervention is received by participants, and the like (Proctor et al., 2011)
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From page 257... ...
From case studies of the implementation of a practice model in county child welfare environments, Boothroyd and colleagues (2017) identified five key functions that community members may play in the development of system capacity for program implementation and scale-up: (1)
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From page 258... ...
Service Providers Service providers are leaders, managers, supervisors, and practitioners who have a stake in the adoption, implementation, and outcomes of a program, and they play at least two key roles. First, practitioners and their direct supervisors have a distinct perspective on program fit, delivery, and reception.
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From page 259... ...
. Purveyors also may collect evaluation data, as well as local and clinical knowledge, from the service providers with whom they work as part of effective adaptation of the program to the local context.
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From page 260... ...
One key benefit of such collaboration is in the translation of field evidence to ongoing program improvements that support more efficient implementation processes, better implementation outcomes, and stronger program outcomes (Chambers, Glasgow, and Stange, 2013)
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From page 261... ...
KEY ELEMENTS OF CAPACITY FOR SCALE-UP Several key elements support effective implementation of a program at scale, including collaboration, workforce development systems, quality and outcome monitoring systems, and communications and media systems. Collaboration Collaboration is needed at multiple levels, including both within and among leadership and implementation teams and broader community coalitions.
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From page 262... ...
. Researchers who have examined implementation frameworks suggest that to be effective, leadership and implementation teams need to include individuals who have decision-making authority within the organization or community, some form of oversight over front-line practitioners' delivery of a program, and the capacity to both engage others (secure buy-in)
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From page 263... ...
. Community Coalitions Successful leadership and implementation teams bring together individuals and groups within organizations and single-system environments and, depending on the scale of the program, across organizations and system environments.
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From page 264... ...
As with any effort of this complexity, strong leadership, sharing among participants, and infrastructure are key ingredients in success. Workforce Development Systems The effectiveness of any program to foster healthy mental, emotional, and behavioral (MEB)
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From page 265... ...
Thus, these workers are called on to engage in quality improvement and to work collaboratively in interdisciplinary settings and across sectors of the landscape of programs that serve children and families and promote MEB health. Program developers frequently specify criteria for recruitment and selection of workers based on the professional qualifications and experience determined to be necessary for staff who can deliver core components of the program design.
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From page 266... ...
Quality and Outcome Monitoring Systems The collection of information about quality and outcomes is vital to the continuous improvement that fuels effective implementation, and can be done in 3A medical coach supplements care given by the physician by providing patient education and supporting patients in adhering to prescribed care or treatments; see, e.g., https://www.ama-assn.org/practice-management/payment-delivery-models/why-yourmedical-practice-needs-health-coach.
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From page 267... ...
For example, if intervention fidelity is low, it may be useful to increase practitioner supports during program training or coaching or to refine practitioner recruitment and selection criteria. Likewise, if reach is low, community leaders and implementation teams may seek to increase program adoption through the community, train more practitioners, or involve the support of community members and partners to address access problems or stigmas that may be associated with seeking support.
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From page 268... ...
. Elevated risk factors at the other high school indicated a need for programs to reduce community disorganization, academic failure, and interaction with antisocial peers.
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From page 269... ...
. We note also that a considerable amount of data is routinely collected as children and youth go about their lives, and much of these data have potential utility for researching and monitoring MEB health and development.
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From page 270... ...
There is more to learn about how to support and sustain implementation systems, but it is clear that successful implementation of an MEB health promotion or prevention program at a population scale is a complex endeavor that depends on the involvement of multiple partners to create system capacity: Community members provide relationship building, support culturally relevant adaptation, provide communication and feedback, and partner with researchers and service providers. Service providers execute the program strategies and provide feedback on program fit, delivery, and reception.
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From page 271... ...
Purveyors and intermediary organizations oversee program delivery, provide expertise, collect evaluation data and feedback from practitioners and clients, and collaborate with local service agencies, community members, and researchers. Researchers generate and improve the program design to meet community needs, analyze data and collaborate with service providers and purveyors to fine tune the program and address problems, monitor program fidelity, conduct evaluations, and analyze results.
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From page 272... ...
. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations.
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From page 273... ...
. Workforce development to enhance the cognitive, affective, and behavioral health of children and youth: Opportunities and barriers in child health care training.
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From page 274... ...
. Predictive validity of established cut points for risk and protective factor scales from the Communities That Care youth survey.
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From page 275... ...
. Assessing community coalition capacity and its association with underage drinking prevention effectiveness in the context of the SPF SIG.
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From page 276... ...
. Sustainability of community coalitions: An evaluation of communities that care.
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From page 277... ...
. Long-term sustainability of evidence-based prevention interventions and community coalitions survival: A five and one-half year follow-up study.
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From page 278... ...
American Journal of Community Psychology, 50(3-4)
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From page 279... ...
Implementation Science, 6(1)
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From page 280... ...
. A practical implementation science heuristic for organizational readiness: R = mc(2)
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From page 281... ...
. American Indian perspectives on evidence-based practice implementation: Results from a statewide tribal mental health gathering.
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