Abstract
Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP).Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents.Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission.Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.
Highlights
In the past two decades, there has been an increased effort to implement evidence-based practices (EBPs) into real world community public social service settings [1, 2]
There remains much to be learned regarding which aspects of these methods and interactions are most valuable for successful installation of new practices [8] and which are considered by agency leaders when conducting self-assessments throughout the full implementation process
Analysis of the self-assessments made by system leaders in the course of adopting, supporting and sustaining the three EBPs revealed distinct influences on the decisions about the feasibility and desirability of the EBP and its implementation as measured by each of the three Stages of Implementation Completion (SIC) phases—Pre-Implementation, Implementation, and Sustainment (Table 1)
Summary
In the past two decades, there has been an increased effort to implement evidence-based practices (EBPs) into real world community public social service settings [1, 2]. Agency leaders are necessarily involved in extensive planning and self-assessments of the organization’s capacity to engage in training and quality assurance in the EBP, which often involves a complex set of interactions among developers and system leaders, front line staff, and consumers [3]. There remains much to be learned regarding which aspects of these methods and interactions are most valuable for successful installation of new practices [8] and which are considered by agency leaders when conducting self-assessments throughout the full implementation process. There is consensus that implementation of psychosocial interventions within social service settings is a recursive process with well-defined stages or steps [5, 12]. This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP)
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