October 2018Vol. 19, No. 8Choosing the Right Solution: Finding, Adapting, or Designing an Intervention to Improve Outcomes for Children and Families

Written by the Children's Bureau's Capacity Building Center for States.

In a variety of situations—whether developing a statewide strategic plan to strengthen families, implementing a new provision of the Family First Prevention Services Act, or launching a local improvement initiative—child welfare agencies face decisions about how best to address their needs and improve outcomes. Selecting an effective solution is key to success.

The Center's forthcoming brief, Change and Implementation in Practice: Intervention Selection and Design/Adaptation, describes how agencies can thoughtfully select and adapt or design an intervention (any well-defined practice, policy, or program that is clearly described, operationalized, and distinguishable) to achieve desired outcomes and meet specific needs. Key ideas from that brief are highlighted below.

Exploring Possible Interventions

Selecting an appropriate intervention can be challenging. Most agencies will seek interventions that have already been proven effective for a similar situation and population. However, an "off-the-shelf" evidence-supported intervention is not always available. Further, a promising intervention used elsewhere may not fit the agency's context, population served, or capacity.

To select the best possible intervention, agencies should first consider the root cause(s) of their identified problem, target population(s) affected by the problem, theory of change for addressing the problem, and desired outcomes.

Familiar sources for finding potential interventions include online directories on evidence-based practices (EBPs) in child welfare and related fields and related literature. Agencies can also contact technical assistance providers, program developers, and other child welfare agencies and tap into the knowledge of their staff, systems, and community members.

When researching possible interventions, the agency should consider asking the following questions to help zero in on the most appropriate solution:

• Does the intervention clearly address our identified problem and align with our theory of change?
• Is there evidence that the intervention will work for our specific target population?
• Is the intervention well-defined and usable or transferable? In other words, is there enough information and guidance for us to understand it, implement it, and observe it? A well-defined intervention should have clearly designated core components—the essential building blocks and related activities that are believed to lead to positive outcomes.
• Is the intervention a good fit? Is it compatible with our agency? (Does it align with our values, priorities, and service delivery structure?) Is it compatible with the community we serve? (Is it relevant for our target population's culture and preferences, age, setting, risk factors, etc.?)
• Is the intervention feasible for us to implement? Does our agency have the capacity, or could it build the capacity, to implement and sustain the intervention?

Deciding to Use or Adapt an Existing Intervention or Design a New One

Drawing on available research and consulting with key stakeholders, the agency then typically decides on one of three options:

• An existing intervention is appropriate for our needs, and we can replicate it with minor or no changes. In best-case scenarios, agencies will find an EBP or well-defined intervention that they should attempt to reproduce with few or no adjustments.
• An existing intervention can be appropriate, if we further define or adapt it to better fit agency and community needs. When adapting an intervention, agencies should make every effort to preserve the intervention's core components. Major changes can increase the risk that the adapted intervention will not achieve desired outcomes. Where possible, adapting an established intervention should occur in partnership with program developers or researchers so the underlying theory is not weakened.
• No existing interventions are appropriate for our needs, so we need to design a new one. Developing a new intervention can produce a customized solution, though it can take significant time and resources. When designing a new intervention, agencies don't need to start from a blank slate, since existing, research-based intervention components or known practices often can be innovatively combined into a coherent intervention strategy.

While it may be tempting to rush to a solution, taking time to research and think critically about available options will help put agencies on the right path.

For more information on selecting, adapting, and designing an intervention and other change and implementation topics, visit the Change and Implementation in Practice webpage.