Implementation Science 101 Vestena 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

Intervention a Implementation EffectiveNot Effective EffectiveActual BenefitsInconsistent; Not Sustainable; Poor OUtcomes Not EffectivePoor OutcomesPoor 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 Literature Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005)

Stages of Implementation Exploration: Getting Started Installation: launching Initial Implementation: Expect the Unexpected Full Implementation: Practice is in Place Program 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 CompetencyOrganization 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) TRAINING COMPONENTS KnowledgeSkill Demonstration Use in Classroom Theory and Discussion10%5%0% + Demonstration in Training 30%20%0% + Practice & Feedback in Training 60% 5% + Coaching in Classroom 95% Joyce and Showers, 2002

Homework Assignment: Review the Monograph Download the monograph at: Monograph

Homework Assignment: Join A Webinar The 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 25 th at 12:00pm EST/9:00am PST TSN_Implementing_and_Sustaining_Ev idence-Based_Practice_Speaker_Series.pdf TSN_Implementing_and_Sustaining_Ev idence-Based_Practice_Speaker_Series.pdf

Homework Assignment: Attend the GIC

Homework Assignment: Contact DBHDID Vestena (Tena) Robbins Kari Collins Outcome Transformation and Education Branch KDBHDID 502/