There are many challenges when an innovation (i.e., a program, process, or policy that is new to an organization) is actively introduced into an organization. One critical component for successful implementation is the organization’s readiness for the innovation. In this article, we propose a practical implementation science heuristic, abbreviated as R= MC2. We propose that organizational readiness involves: 1) the motivation to implement an innovation, 2) the general capacities of an organization, and 3) the innovation-specific capacities needed for a particular innovation. Each of these components can be assessed independently and be used formatively. The heuristic can be used by organizations to assess readiness to implement and by training and technical assistance providers to help build organizational readiness. We present an illustration of the heuristic by showing how behavioral health organizations differ in readiness to implement a peer specialist initiative. Implications for research and practice of organizational readiness are discussed.
Afterschool programs (ASPs) have become increasingly recognized as a key context to support youth daily physical activity (PA) accrual. The purpose of the present study was to assess the physical and social-motivational climate characteristics of ASPs associated with youth PA, and variations in contextual correlates of PA by youth sex. Systematic observations of 7 ASPs serving underserved youth (minority, low income) was conducted using the System for Observing Play and Leisure Activity in Youth and a social-motivational climate observation tool founded on self-determination theory. For five program days at each site, teams of two coders conducted continuous observations of youth PA (sedentary, moderate, vigorous), five physical features (e.g., equipment availability), eight staff interactions (e.g., encourage PA), and seven motivational climate components (e.g., inclusive). Aligned with previous research, regressions controlling for variations by site indicated that organized PA, provision of portable equipment, and staff PA participation and supervision are key correlates of youth PA. Moreover, as the first study to systematically observe motivational-context characteristics of ASPs, we identified several key modifiable motivational features that are necessary to address in order to increase youth engagement in PA during the out-of-school hours. Among motivational features assessed, "relatedness" components (positive peer relations, inclusive/cooperative activities) were primary correlates of girls' PA. In contrast, all three motivational features specified by self-determination theory (support for autonomy, mastery/competence, and inclusion/relatedness) were correlated with boys' PA. Findings are discussed in terms of policy and practice for understanding strengths and needs of ASPs to effectively engage youth in PA.
Many evaluations of programs tend to show few outcomes. One solution to this has been an increasing prominence of the movement that requires programs to implement evidence-based interventions (EBIs). But in a complex world with complex organizations and complex interventions, many challenges have arisen to the implementation of EBIs with fidelity to achieve outcomes at scale. This includes challenges to achieving outcomes in each setting. In this article, we propose the use of empowerment evaluation and one of its major approaches (Getting To Outcomes [GTO]) as a promising method to address the challenges, and GTO can help organizations achieve outcomes by leading them through a set of “accountability questions” for implementing EBIs in their particular setting. These questions can be asked at multiple levels (e.g., national, state, and local organizations) responsible for achieving outcomes. Although we illustrate the possibilities with examples from health care and public health, the potential strategies can be applied to many areas of health and human services and education.
Afterschool programs (ASPs) have become increasingly recognized as a key context to support youth daily physical activity (PA) accrual. Using Self-Determination Theory (SDT) as a framework, this study examined staff perspectives on the strengths and barriers within under-resourced ASPs for establishing a social-motivational climate for encouraging and supporting youth PA. Analysis of semi-structured staff interviews (28 staff; 7 ASPs) indicated that staff had knowledge and value for establishing a PA-supportive motivational climate. However, the feasibility of implementing PA curricula was identified as challenging across programs. Findings suggest increased need for staff training and supports to provide a PA climate that meets the developmental needs/interests of all youth, with particular attention toward increasing the PA of girls and older program youth. Furthermore, striking an appropriate balance between PA and other competing program demands (e.g., academics) will be required to optimize on the effectiveness of PA program components.
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