Allison Metz

Statewide Implementation of Evidence-Based Programs:

Evidence-based programs will be useful to the extent they produce benefits to individuals on a socially significant scale. It appears the combination of effective programs and effective implementation methods is required to assure consistent uses of programs and reliable benefits to children and families. To date, focus has been placed primarily on generating evidence and determining degrees of rigor required to qualify practices and programs as “evidence-based.” To be useful to society, the focus needs to shift to defining “programs” and to developing state-level infrastructures for statewide implementation of evidence-based programs and other innovations in human services. In this article, the authors explicate a framework for accomplishing these goals and discuss examples of the framework in use.

Active Implementation Frameworks for Successful Service Delivery Catawba County Child Wellbeing Project

Traditional approaches to disseminating research based programs and innovations for children and families, which rely on practitioners and policy makers to make sense of research on their own, have been found insufficient. There is growing interest in strategies that “make it happen” by actively building the capacity of service providers to implement innovations with high fidelity and good effect. This article provides an overview of the Active Implementation Frameworks (AIFs), a science-based implementation framework, and describes a case study in child welfare, where the AIF was used to facilitate the implementation of research-based and research-informed practices to improve the well-being of children exiting out of home placement to permanency. In this article, we provide descriptive data that suggest AIF is a promising framework for promoting high-fidelity implementation of both research-based models and innovations through the development of active implementation teams.

Advancing Implementation: Toward an Inclusive View of Research in Behavioral Medicine

Like other fields, research in behavioral medicine can be strengthened by taking a broader look at knowledge from implementation science. The success of an evidence-based innovation is not measured by its effectiveness alone, but needs to take into account the ability to bring the full, intended experience of the innovation into the lives of children, families, and communities. Implementation – often noted as a critical missing link for getting research into practice – is an active and outcome-oriented process that is focused on how to support full and effective use of an innovation as intended in typical service settings. What do we know about the conditions that affect implementation? This chapter outlines the need for and history of implementation science as framed in the context of the evidence-based movement across medicine, behavioral medicine, and other fields. Authors then present a set of factors that influence implementation as synthesized from reviews of implementation frameworks across multiple disciplines. Recurring themes include (a) the need for a defined set of an innovation’s core components that can guide parameters for necessary adaptations based on context; (b) building the competence and confidence of those delivering the innovation; and (c) developing and strengthening organizational infrastructure to create culture, climate, practices, and policies that support implementation activities. Authors make the case for a universal set of such implementation factors and illustrate their application across public health, behavioral medicine, child welfare, and other fields.