Coaching As a Key Implementation Strategy for Evidence-Based Interventions: Core Functions and Critical Features

Background/Purpose: 

This study examines coaching as a strategy for supporting implementation of evidence-based interventions (EBIs) in child welfare settings. Despite increasing use of EBIs, more knowledge is needed on how to effectively implement these interventions which are new to the child welfare context. Implementation science guides practitioners and administrators by drawing attention to a variety of factors that may influence the adoption, uptake, and sustainability of evidence-based interventions (e.g., Aarons, Hurlburt & Horwitz; Fixsen et al, 2005; Powell et al, 2011). Coaching is identified as a specific strategy that may contribute to successful implementation (Nadeem et al, 2013). The purpose of the present study was to investigate the role of coaching in adopting and implementing an EBI in a child welfare setting. We sought to gain greater understanding of the core functions and critical features of effective coaching that support implementation as perceived by professionals that were implementing an EBI in child welfare.

Methods:  The project setting was a statewide demonstration project funded under the federal Permanency Innovations Initiative which sought to reduce long-term foster care and improve child and family outcomes. This project site tested the Parent Management Training, Oregon Model (PMTO). Focus groups and individual interviews were conducted with 12 coaches, 13 coachees, and 4 administrators (n=29) implementing PMTO. Study participants had 15-42 months of experience with this implementation. Transcripts were coded and analyzed using theoretical thematic analysis (Braun & Clarke, 2006). Member checking was used to confirm identified themes.

Results:  Findings revealed several major themes. Four themes emerged regarding core functions of coaching: 1) using a vigorous strengths orientation to support new frontline implementers in gaining competence and confidence with an EBI, 2) emphasizing active learning and modeling of the EBI’s principal practices, 3) problem-solving for appropriate adaptation of the EBI in real-world cases, and 4) providing an accountability mechanism for high-quality implementation and intervention fidelity. The critical features of effective coaching were captured in three additional themes: 1) dedication to lifelong learning and reflective practice, 2) multiple and unique coaching approaches to fit individual practitioners, and 3) hospitable organizations with key administrative supports.

Conclusion:  This study describes important insights into the experiences of child welfare professionals using coaching as an implementation strategy.  Given the challenges with successfully implementing EBIs into routine child welfare practice, implementation strategies are necessary. While coaching has become a more common strategy with the growing use of EBIs, its clear definition and operationalization is still lacking. This study addresses this gap and works toward building knowledge on the core functions and features of coaching that can help integrate EBIs into usual practice in child welfare settings. Findings on coaching functions suggest that this implementation strategy is more than a simple extension of training. Coaching was viewed as necessary for fitting an EBI to the complex needs of child welfare families and intricately connected to fidelity. Additionally, findings on core features suggest that EBI implementers must consider multiple levels of implementation factors, including individual coach competencies as well as infrastructure and organizational supports.