Abstract
Implementation evaluations have increasingly taken into account how features of local context help determine implementation outcomes. The purpose of this study was to determine which contextual features of organizational capacity led directly to the RE-AIM Framework implementation outcomes of intervention reach and number of days taken to implement, in an implementation trial of a series of cancer education workshops conducted across 13 African-American churches in Maryland. We used a configurational approach with Coincidence Analysis to identify specific features of organizational capacity that uniquely distinguished churches with implementation success from those that were less successful. Aspects of organizational capacity (e.g., congregation size, staffing/volunteers, health ministry experience) were drawn from an existing measure of church organizational capacity for health promotion. Solution pathways leading to higher intervention reach included: having a health ministry in place for 1–4 years; or having fewer than 100 members; or mid-size churches that had conducted health promotion activities in 1–4 different topics in the past 2 years. Solution pathways to implementing the intervention in fewer number of days included: having conducted 1–2 health promotion activities in the past 2 years; having 1–5 part-time staff and a pastor without additional outside employment; or churches with a doctorally prepared pastor and a weekly attendance of 101–249 members. Study findings can inform future theory, research, and practice in implementation of evidence-based health promotion interventions delivered in faith-based and other limited-resource community settings. Findings support the important role of organizational capacity in implementation outcomes in these settings.Clinical trial registration The study was pre-registered at clinicaltrials.gov. Identifier: NCT02076958. Registered 3/4/2014. https://clinicaltrials.gov/ct2/show/NCT02076958.
Highlights
ObjectivesThe purpose of this study was to determine which contextual features of organizational capacity led directly to the RE-AIM Framework implementation outcomes of intervention reach and number of days taken to implement, in an implementation trial of a series of cancer education workshops conducted across 13 African-American churches in Maryland
Over half of the churches in the sample were in the medium size range of 101–499 members on their rosters, most of the pastors did not have outside employment in addition to their role in the church, and both full- and part-time staff were modest in number while the number of volunteers was considerably greater
The current study identified features of organizational capacity that can help explain key implementation outcomes in a trial that evaluated implementation of an evidence-based cancer control intervention delivered by volunteers in African-American churches
Summary
The purpose of this study was to determine which contextual features of organizational capacity led directly to the RE-AIM Framework implementation outcomes of intervention reach and number of days taken to implement, in an implementation trial of a series of cancer education workshops conducted across 13 African-American churches in Maryland. The purpose of the present study was to determine which individual and combinations of organizational capacity indicators were co-present with key implementation outcomes, identified based on the RE-AIM Framework
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