This document offers clear definitions of core intervention and implementation components and their influences on successful implementation.
Core components are the most essential and indispensable components of an intervention practice or program (“core intervention components”) or the most essential and indispensable components of an implementation practice or program (“core implementation components”).
Part of an implementer’s goal is to implement only those attributes of a program or practice that are replicable and add value. Core intervention components are, by definition, essential to achieving good outcomes for consumers. However, understanding and adhering to the principles of intervention underlying each core component may allow for flexibility in form (e.g. processes and strategies) without sacrificing the function associated with the component. Knowing the core intervention components may allow for more efficient and cost effective implementation and lead to decisions about what can be adapted to suit local conditions. Core intervention components may best be defined after a number of attempted applications of a program or practice, not just the original one.
The goal of implementation is to have practitioners base their interactions with clients and stakeholders on research findings (evidence-based practices and programs). Core implementation components help accomplish this task. The core implementation components are: staff selection, preservice and inservice training, ongoing consultation and coaching, staff and program evaluation, facilitative administrative support, and systems interventions.
These are interactive components that can compensate for one another so that a weakness in one component can be overcome by strengths in other components. Organizations are dynamic and there is an ebb and flow to the relative contribution of each component to the overall outcomes. The feedback loops are important in keeping the evidence-based program “on-track.” If the feedback loops (staff or process evaluations) indicate needed changes, then the system needs to be adjusted to improve effectiveness or efficiency.
Critical functions of implementation consist of practitioner training, coaching the practitioner on the job, regularly assessing fidelity, and using that information to improve the performance of practitioners who are selected for the position.
The core implementation components are important in changing the behavior of practitioners and other personnel who are key providers of evidence-based practices within an organization. The core components are contained within and supported by an organization that establishes facilitative administrative structures and processes to select, train, coach, and evaluate the performance of practitioners and other key staff members; carries out program evaluation functions to provide guidance for decision making; and intervenes in external systems to assure ongoing resources and support for the evidence-based practices within the organization. The core components must be present for the implementation to occur with fidelity and good outcomes. The organizational components must be present to enable and support those core components over the long term. And, all of this must be accomplished over the years in the context of variable but influential changes in governments, leadership, funding priorities, economic boom-bust cycles, shifting social priorities, and so on.
Implementation of evidence-based practices and programs almost always requires organizational change. The elements often described as important to organizational change are:
Fixsen, DL, Naoom, SF, Blase, KA, Friedman, RM, and Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: The National Implementation Research Network, Louis de la Parte Florida Mental Health Institute, University of Florida.
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.