Implementation Support Strategies to Promote the Use of Evidence in Child Welfare Systems

Background and Purpose: A range of strategies are emerging to support organizational uptake of evidence, including knowledge brokering, technical assistance, and implementation support. Implementation support is an approach to strengthen implementation processes by regularly guiding and assisting service providers in their use of evidence-based and evidence-informed programs and practices, and in the troubleshooting of challenges that emerge during implementation and scaling efforts. Despite significant investments in implementation support, such strategies are not well documented, and inconsistencies remain in how implementation support is defined, delivered, and measured. The goal of this study was to understand and further define implementation support strategies used in child welfare systems to support the use of evidence.

Methods: A purposive sample of 17 highly experienced implementation support practitioners (ISPs) participated in in-depth interviews. A semi-structured interview guide was used to ascertain participants’ perceptions about various aspects of their work providing implementation support, particularly in child welfare systems. Interviews were conducted via Zoom and were approximately 60 minutes in length. Following the verbatim transcription of interviews, we analyzed our data using a qualitative content analysis approach as outlined by Schreier (2014). The analysis for the current study focused on subcategories related to the larger category of implementation support strategies employed by participants to promote the use of evidence in child welfare systems. A multi-researcher team engaged in data coding and analysis in an effort to triangulate observations and maintain consensus with respect to emerging findings.

Results: The implementation support strategies (intended to support evidence use) identified by respondents aligned with core competencies recently posited as being integral to the provision of implementation support (Metz et al., 2021), namely (a) co-creation (e.g., providing training and education, tailoring support, cultural responsiveness), (b) ongoing improvement (e.g., understanding context; establishing communication and feedback loops; conducting needs assessments; supporting data use and ongoing improvement; applying frameworks, theories, and tools; assessing readiness; supporting intervention selection; attending to racial equity; and providing fidelity support), and (c) sustaining change (e.g., developing teams, developing champions, and promoting peer-to-peer learning among implementation support recipients); all respondents identified building relationships with partners and recipients of implementation support as foundational. Respondents also called attention to general implementation strategies we categorized as being universally applied throughout the implementation support process, such as use of a stage-based approach to providing support and use of coaching or consultation.

Conclusions and Implications: Findings suggest that implementation support is a multi-faceted endeavor carried out by implementation support strategies with a broad range of knowledge and skills. The respondents enacted technical strategies (e.g., supporting data use, developing communication protocols), while simultaneously carrying out relational strategies (e.g., building trusting relationships, developing teams, cultural responsiveness). These findings are consistent with recent evidence suggesting that trusting relationships are a central mechanism connecting the work of ISPs with the uptake of evidence in organizations. Therefore, it appears crucial to attend to more than just the quality of the technical aspects of implementation work and focus on the quality of the relationships among the stakeholders involved.