An Agency Capacity Model to Facilitate Implementation of Evidence-based Behavioral Interventions by Community-based Organizations

Abstract

The Centers for Disease Control and Prevention (CDC) implemented the Diffusion of Effective Behavioral Interventions Project to disseminate evidence-based behavioral interventions to community-based HIV prevention providers. Through development of intervention-specific technical assistance guides and provision of face-to-face, telephone, and e-mail technical assistance, a range of capacity-building issues were identified. These issues were linked to a proposed agency capacity model for implementing an evidence-based intervention. The model has six domains: organizational environment, governance, and programmatic infrastructure; workforce and professional development; resources and support; motivational forces and readiness; learning from experience; and adjusting to the external environment. We think this model could be used to implement evidence-based interventions by facilitating the selection of best-prepared agencies and by identifying critical areas of capacity building. The model will help us establish a framework for informing future program announcements and predecisional site visit assessments, and in developing an instrument for assessing agency capacity to implement evidence-based interventions.

Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness

“…As the compendia of EBTs for mental health have grown, so has the literature on the failure to implement EBT with fidelity. For example, only half of service providers trained to use an EBT for HIV prevention ever attempt to implement that treatment, and only half of those providers implement the treatment with fidelity (Collins et al, 2007). The consistency of such findings outside of laboratory clinics, regardless of the specific treatment being evaluated, suggest the additional need for routine feedback on how the clinician is implementing the treatment, even if only at the level of adherence to basic treatment elements.…”

Promoting Science‐based Approaches to Teen Pregnancy Prevention: Proactively Engaging the Three Systems of the Interactive Systems Framework

“…Capacity building is a common approach to bridging research and practice and an emerging field of inquiry (Labonte and Laverack 2001a, b;Chinman et al 2005;Collins et al 2006Collins et al , 2007Livet and Wandersman 2005). Despite differences in the type of public health problem being addressed (e.g., HIV prevention, substance abuse prevention, teen pregnancy prevention) or in the venue of prevention practice (e.g., community based organizations, faith-based organizations, schools), common threads are seen across the literature regarding barriers that arise and capacities needed to overcome them.…”

Provider Perspectives on Evidence-Based HIV Prevention Interventions: Barriers and Facilitators to Implementation

“…8 In recognition that training in the intervention alone is insufficient to ensure adoption and implementation, 9 the CDC has spearheaded efforts to build the organizational capacity of communitybased organizations (CBOs) to implement these interventions. 10 These capacity-building efforts have concentrated on fiscal, administrative, and program management; community mobilization; and leadership development. 10,11 Despite these efforts, CBOs participating in the CDC's DEBI and technical assistance programs continue to experience high rates of staff turnover, lack of access to and use of technical assistance resource, and inconsistent program evaluation and implementation.…”

“…10 These capacity-building efforts have concentrated on fiscal, administrative, and program management; community mobilization; and leadership development. 10,11 Despite these efforts, CBOs participating in the CDC's DEBI and technical assistance programs continue to experience high rates of staff turnover, lack of access to and use of technical assistance resource, and inconsistent program evaluation and implementation. 12 This lack of wholesale incorporation of DEBI interventions into local programming raises questions regarding the additional factors-beyond organizational capacitythat contribute to service providers' ability and desire to adopt and implement EBIs.…”