An agency capacity model to facilitate implementation of evidence-based behavioral interventions by community-based organizations
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.
Available from: Nasser Shahrasbi
- "Table 1. Conceptualizations of Organizational Readiness: Two Views Characteristics Structural view Psychological view Examples of definitions found in the literature -The efficient use of human, physical, and knowledge resources and the processes employed to transform these resources into services (Collins et al. 2007) "
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ABSTRACT: The organizational readiness construct has been investigated in information systems (IS) research for
more than two decades and has yielded tremendous in sights on topics such as IS organizational adoption
, IS organizational use and institutionalization, IS project success, and knowledge acquisition and sharing.
Notwithstanding the strong implications of this construct for our discipline, a critical and comprehensive
assessment of the conceptualization of organizational readiness in IS research has not yet been conducted.
Thus, this review article proposes to fill this gap and reflects on the conceptualization of organizational readiness in prior IS literature. Building upon the recommendations made by change management theorists, it proposes a new, yet multi-dimensional conceptualization of organizational readiness, including two overarching dimensions and nine sub-dimensions. We discuss how the proposed conceptualization is likely to offer a richer understanding of this construct in the IS discipline.
Available from: Steffanie A Strathdee
- "Prior to commencing the project, our research team developed an instrument to assess the capacity of the 12 selected CBOs to implement the Mujer Segura intervention. Indicators were derived from the CDC’s six-domain model
. Possible scores ranged from 0 (no capacity) to 150 (100% capacity). "
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Studies of implementation of efficacious human immunodeficiency virus (HIV) prevention interventions are rare, especially in resource-poor settings, but important, because they have the potential to increase the impact of interventions by improving uptake and sustainability. Few studies have focused on provider and organizational factors that may influence uptake and fidelity to core intervention components. Using a hybrid design, we will study the implementation of an efficacious intervention to reduce sexually transmitted infections (STIs) among female sex workers (FSWs) in 12 cities across Mexico. Our protocol will test a ‘train-the-trainer’ implementation model for transporting the Mujer Segura (Healthy Woman) intervention into community-based organizations (CBOs).
We have partnered with Mexican Foundation for Family Planning (Mexfam), a non-governmental organization that has CBOs throughout Mexico. At each CBO, trained ethnographers will survey CBO staff on characteristics of their organization and on their attitudes toward their CBO and toward the implementation of evidence-based interventions (EBIs). Then, after CBO staff recruit a sample of 80 eligible FSWs and deliver a standard-care, didactic intervention to 40 women randomly selected from that pool, a Mexfam staff person will be trained in the Mujer Segura intervention and will then train other counselors to deliver Mujer Segura to the 40 remaining participating FSWs. FSW participants will receive a baseline behavioral assessment and be tested for HIV and STIs (syphilis, gonorrhea, and chlamydia); they will be reassessed at six months post-intervention to measure for possible intervention effects. At the same time, both qualitative and quantitative data will be collected on the implementation process, including measures of counselors’ fidelity to the intervention model. After data collection at each CBO is complete, the relative efficacy of the Mujer Segura intervention will be analyzed, and across CBOs, correlations will be examined between individual and organizational provider characteristics and intervention efficacy.
This cooperative, bi-national research study will provide critical insights into barriers and facilitating factors associated with implementing interventions in CBOs using the ‘train the trainer’ model. Our work builds on similar scale-up strategies that have been effective in the United States. This study has the potential to increase our knowledge of the generalizability of such strategies across health issues, national contexts, and organizational contexts.
Available from: Mary Jane Rotheram-Borus
- "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. "
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ABSTRACT: Kazdin and Blase (2011) propose that traditional models of delivering therapy require more resources than are available to address the scope of mental illness. We argue that finding new platforms and avenues for our existing treatments is a good start but that it is not enough. We contend that the field also needs to develop formal strategies to reorganize its increasing abundance of knowledge to address the scarcity of resources for its application. If we can better utilize our existing knowledge, treatment delivery and service resource allocation can become more efficient and effective. If the field continues with its almost singular emphasis on knowledge proliferation (e.g., developing new treatments), as opposed to knowledge management (e.g., developing new ways to design, apply, and organize existing treatments), the problem outlined by Kazdin and Blase cannot be solved.
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