Defining and measuring implementation processes and milestones: The stages of implementation completion

Lisa Saldana, Ph.D.
Oregon Social Learning Center

ABSTRACT:
There is a dearth of knowledge regarding what it takes to implement and sustain evidence-based practices (EBP) into children’s social service settings. Some postulate that it takes greater time, coordination, and resources than other settings. In recognition of the complexity of the process, which involves planning, training, quality assurance, and interactions among developers, system leaders, practitioners, and consumers, the Stages of Implementation Completion (SIC) was developed. The SIC is an 8-stage tool that maps onto three phases of implementation (pre-implementation, implementation, and sustainability), and was developed to assess sites’ implementation process and obtainment of implementation milestones for Multidimensional Treatment Foster Care (MTFC). Using the SIC, the influence of MTFC sites’ early implementation behaviors on their abilities to obtain successful program start-up and competency have been demonstrated. Following the validation of the SIC for MTFC, efforts have begun to adapt and examine the SIC for other EBPs in children’s social service systems including juvenile justice, school, mental health, substance abuse, and child welfare.  Currently, the adaptation process is underway for multiple EBPs (e.g., MST, KEEP, Coping Cat) within these service settings. This presentation will describe the adaptation process and the complexities that arise when defining implementation processes and outcomes across different service systems. Psychometric properties of the MTFC SIC will be presented and the outcomes linked to decisions for future adaptations. The need to balance developer rigor with real-world site resources in defining successful implementation will be described. Initial evidence for common implementation factors identified between the different EBPs and social service systems will be presented. Common factors thought to be most critical for successful achievement and sustainment of competent EBP delivery for these vulnerable child populations will be highlighted.