Factors that Contribute to Capacity Building and Sustainability

According to SAMHSA’s Strategic Prevention Framework (SPF), “Capacity refers to the various types and levels of resources available to establish and maintain a community prevention system that can identify and respond to community needs.” While this definition focuses on resources, the SPF goes on to state that capacity also depends on the readiness of both the organization and the broader community to actually commit their resources to addressing the identified problem(s). Although the planning process itself can strengthen capacity, intentional capacity building at all levels helps ensure that successful programs are sustained within a larger community context, and therefore less vulnerable to local budgetary and political fluctuations. Effective capacity building also increases an organization’s or community’s ability to respond to changing issues with innovative solutions.

Capacity building is best viewed as a process of “ensuring an adaptive, effective, and [cost-effective] substance abuse prevention system that achieves long-term results that benefit [diverse stakeholders]” (Southeast Center for the Application of Prevention Technologies, 2003, p. 1). Organizational/infrastructure development is necessary to build capacity as well as to sustain effective prevention policies, systems, and programs, and therefore includes a sustainability component. Johnson et al. (2004) offers a planning logic model which addresses both organizational/infrastructure development and sustainability. The purpose of organizational/infrastructure development in the model is to build, support, and strengthen organizational infrastructures. This is accomplished by examining five factors which, if addressed intentionally through strategic planning, can facilitate building the infrastructure capacity. These include the following:

Administrative structures and formal linkages. These must be built and strengthened so that the organizations and systems responsible for the implementation, integration, and oversight of programs have the capacity to carry out their functions effectively and responsively and to sustain them over time. Linkages that facilitate cooperation among diverse organizations also contribute to sustainability.
Champion and leadership roles. Leadership buy-in and active promotion by multiple champions across organizations and systems help ensure success. Champions and leaders with the ability to communicate their commitment, engage others, address barriers, and build system capacity are especially valuable.
Resource development. Adequate and sustainable funding, staffing, technical assistance, and materials can help sustain innovations.
Administrative policies and procedures that support programs, organizations, and systems also support adoption and sustainability of innovations. These help to assure that innovations remain part of the routine practice of organizations and send a clear message about the desirability and expectation for sustaining efforts. The absence of the policies can create political barriers to sustaining the innovation.
Community and practitioner expertise. Building and maintaining expertise in such areas as needs assessment, logic model construction, selection and implementation of evidence-based programs, fidelity and adaptation, evaluation, and cultural competence supports capacity building and sustainability.

The goal of sustainability in the model is to implement and maintain effective programs and systems that are continually responsive to stakeholder needs. This is accomplished by examining another five factors which, if addressed intentionally through strategic planning, can facilitate building sustainability. These five factors include:

Alignment of program with stakeholder needs. Despite the capacity of the organization to implement an innovation, it must meet the needs of intended users and other stakeholders if it is to be sustained. Less complexity, more compatibility, and a high degree of perceived benefit are associated with sustainability.
Relationship among stakeholders. Establishing and maintaining positive relationships among stakeholders supports sustainability. Collaboration between program developers and implementers and supportive networks among implementers is helpful.
Quality of program implementation. Commitment to quality of program implementation via process, fidelity, and outcome evaluation based on logic models helps sustain an innovation and ensure commitment by adopters.
Effectiveness. Commitment to effectiveness is also critical to sustainability.
Ownership among stakeholders. Strengthening ownership of an innovation among stakeholders and adopters increases its sustainability. Ownership has a stronger influence on sustainability than do regulative measures.

Each of these 10 factors can be addressed with action steps. These action steps include:

assessing existing conditions
developing a plan to strengthen that factor
implementing the plan
evaluating the plan’s effectiveness
reassessing/modifying the plan

Taking these actions in support of the capacity building and sustainability objectives represents an ongoing process, rather than a one-time, event.

References

Southeast Center for the Application of Prevention Technologies. (2003). Sustainability. Jackson, MS: DREAM, Inc.

Hawe, P., King, L., Noort, M., Jordens,C., & Lloyd, B. (2002). Indicators to Help with Capacity Building in Health Promotion. North Sydney, New South Wales: NSW Health.

Johnson, K., Hays, C., Hayden, C., & Daley, C. (2004). Building capacity and sustainability prevention innovations: A sustainability planning model. Evaluation and Program Planning, 27, 135-149.

Developed under the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for the Application of Prevention Technologies contract. Reference #HHSS277200800004C. For training and/or technical assistance purposes only.