Using Evidence-Based Constructs to Assess Extent of Implementation of Evidence-Based Interventions. Implications for Supporting Practice


Several implications for supporting practice are related to identifying and monitoring implementation milestones: (a) the importance of engaging in planning activities early in implementation, (b) the importance of providing support for implementing an intervention, and (c) the importance of measuring infrastructure for implementation support.

Importance of Engaging in Planning Activities Early in Implementation

Sometimes, activities such as including stakeholders in planning and assessing the fit of an intervention, identifying the knowledge and skills needed, anticipating likely concerns, exploring the availability of resources to support the intervention, and building the infrastructure to support the intervention might seem like a waste of time and causes of delay. However, if such activities are absent, it is less likely that key milestones will be met later. Initial implementation is typically an awkward learning period for practitioners. Novice implementers need TTA support to resolve challenges that arise during implementation; they must also have the necessary time, energy, and support to incorporate intervention practices into their daily behaviors. Matching the right implementation supports to these stages and milestones can be encouraging and motivating.

Importance of Providing Support for Implementing an Intervention

Implementation drivers can support implementation and provide information about the training, coaching, administrative facilitation, systems intervention, and performance assessment needed to remove barriers to progress. These drivers build staff competence through selection, training, and coaching; they assess performance; and they provide organizational support through data-driven decision making, facilitative administration, and systems interventions. For example, if offsite training is needed, it may be necessary for alternate staff members to substitute for those who are attending training. An administrator would need to facilitate this type of systems intervention. Leaders can support implementation by demonstrating how an intervention connects to the mission and vision of an organization and convincing staff of the organization’s long-term support of and commitment to the intervention.

Importance of Measuring Infrastructure To Support Implementation

Measuring improvements in the infrastructure to support implementation can produce feedback that helps decision making and encourages those building the infrastructure to keep moving toward the next milestone (Blase & Fixsen, 2013). Each part of the system that supports the practitioner implementing an intervention should have the appropriate infrastructure to support the larger initiative. Information should be collected at multiple levels (e.g., organization, local, and state) of the support system. This enables one level of the system to prevent barriers that are impeding successful implementation from occurring at another level.

View full report


"ib_Milestones.pdf" (pdf, 421.66Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®