Implementation Science

101Vestena Robbins, PhD

Kentucky Dept for Behavioral Health, Developmental and

Intellectual Disabilities

LESSON #1

Individuals cannot benefit from good

interventions… if they don’t experience them!Nor do they benefit… even with the best of

intentions.

Funding for Innovation

US Federal Government spends $95+ billion a year to fund research on new interventions

and over $1.6 trillion to support services to

citizens but these do not result in intended

benefits or outcomes to consumers and communities.

SCIENCE TO SERVICE GAP

SCIENCE

SERVICE

?

IMPLEMENTATION GAP

SCIENCE

SERVICE

IMPLEMENTATION

“The bridge from science to service must be built, repaired, maintained, and improved.” -—NIRN Brief, January 2009

Implementation Defined

Putting a program or specific set of activities to work in a real setting, such as a school, hospital, or community, to bring benefits to the population you want to serve.

LESSON #2

Evidence Usability

“Evidence” on effectiveness helps you select what to implement for whom and under what circumstances

“Evidence” on effectiveness does not help you implement

LESSON #3

Interventiona

Implementation

Effective Not Effective

Effective Actual Benefits

Inconsistent; Not Sustainable; Poor OUtcomes

Not Effective

Poor Outcomes

Poor Outcomes; Sometimes harmful

Institute of Medicine, 2000; 2001; 2009; New Freedom Commission on Mental Health, 2003; National Commission on Excellence in Education, 1993; Department for Health and Human Services, 1999)

“The use of effective interventions without

implementation strategies is like serum without a

syringe; the cure is available but the delivery system is

not.”

~Fixsen, Blase, Duda, Naoom, & Van Dyke, 2010

LESSON #4

Successfully implementing a program that fits your organization’s needs is a process—not a single event—that occurs in multiple stages of planning, purposeful action, and evaluating.

Implementation Research: A Synthesis of the LiteratureFixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005)

Stages of ImplementationExploration: Getting

StartedInstallation: launchingInitial Implementation:

Expect the UnexpectedFull Implementation:

Practice is in PlaceProgram

Sustainability: Maintaining Success

LESSON #5

Successful implementation is based on a framework of integrated and compensatory core components or “drivers”

Adapted from © Fixsen & Blase, 2008

Consumer Benefits

Technical

Integrated & Compensatory

Participant Assessment

Coaching

Preparation & Training

Participant Recruitment & Selection

System Intervention (External Supports)

Facilitative Administration (Internal Supports)

Data to Support Decision Making

Competency Organization

Leadership

Adaptive

Implementation Drivers Framework

Integrated and Compensatory(% of Participants who Demonstrate Knowledge, Demonstrate New Skills in a Training Setting, and Use New Skills in the Classroom)

TRAININGCOMPONENTS

Knowledge Skill Demonstration

Use in Classroom

Theory and Discussion 10% 5% 0%

+ Demonstration in Training

30% 20% 0%

+ Practice & Feedback in Training

60% 60% 5%

+ Coaching in Classroom 95% 95% 95%

Joyce and Showers, 2002

Homework Assignment: Review the Monograph

Download the monograph at:http://www.fpg.unc.edu/~nirn/resources/publications/Monograph

Homework Assignment: Join A WebinarThe National Center for Child

Traumatic Stress will host a live webinar with Dean Fixsen, Ph.D. on Establishing a Framework for the Implementation of Evidence-Based Programs

Wednesday, May 25th at 12:00pm EST/9:00am PST

http://learn.nctsn.org/file.php/1/pdf/NCTSN_Implementing_and_Sustaining_Evidence-Based_Practice_Speaker_Series.pdf

Homework Assignment: Attend the GIC

Homework Assignment:Contact DBHDIDVestena (Tena) RobbinsKari CollinsOutcome Transformation

and Education BranchKDBHDID502/564-4456vestena.robbins@ky.gov

kari.collins@ky.gov