December/January 2019Vol. 19, No. 10Defining the 'It': Helping Teams Understand, Implement, and Observe Improvements
Written by the Children's Bureau's Capacity Building Center for States.
Imagine that, after exploring several options, a state child welfare agency selects and adapts a program to improve timely permanency for youth in care. When the program is implemented throughout the state, each county interprets key program components in different ways, leading to inconsistent service delivery. When state evaluators begin to assess program implementation and outcomes, they are unable to tell if the program is being implemented as intended. As a result, the agency may be wasting valuable resources. How can agencies avoid facing similar situations?
To effectively replicate or adapt an existing program or practice, or design a new one, teams must be able to define the "it." This means explaining the intervention and its parts in simple terms so that everyone is clear on what the intervention is and what needs to be done to carry it out (Permanency Innovations Initiative Training and Technical Assistance Project, 2016). When a program or other intervention is well defined, trainers can teach it, staff can deliver it, agencies can consistently expand it, and evaluators can see if it works.
The Center's brief, Change and Implementation in Practice: Intervention Selection and Design/Adaptation, describes how agencies can select, adapt, or design well-defined interventions to achieve desired outcomes and meet specific needs. Some ideas from that brief are highlighted below.
A Well-Defined Intervention
A well-defined intervention is usable and transferable, which means that it has enough information and guidance for individuals to understand, implement, and observe it.
The National Implementation Research Network (NIRN) recommends four criteria for ensuring an intervention is usable and transferable (Van Dyke & Metz, 2014):
- A clear description of the intervention, including its underlying philosophy, values, and principles, and the intended target population
- Core components (essential functions) that define the essence of the program and represent the key building blocks leading to positive outcomes
- Operational definitions of the core components that include specific actions and behaviors required to carry out the intervention
- Practical performance assessment to enable monitoring of the intervention
Together, these criteria contribute to "operationalizing" an intervention. A NIRN (2014) intervention development tool, What's the Way Forward? Usable Intervention Criteria, can help agencies analyze an intervention under consideration for use.
The Core Components of a Well-Defined Intervention
Core components are the essential building blocks, principles, and related activities or "active ingredients" that produce the desired outcomes and make the intervention work (Blase & Fixsen, 2013). Ideally, core components are clearly articulated by program developers and supported by research (Blase & Fixsen, 2013). Core components should do the following:
- Align with the team's theory of change
- Adhere to the intervention's underlying values, guiding principles, and philosophy
- Be grounded in research and best practice
- Reflect stakeholder input
- Be appropriate for the target population and agency setting
When adapting an intervention, teams should attempt to maintain the integrity of the core components to the extent possible. Changing core components can result in interventions that do not produce expected outcomes.
If an agency chooses to design an intervention, development work requires getting specific about how the core components will work in practice. This design process should blend research, practice knowledge, and theory (Fraser & Galinsky, 2010). Whether adapting or designing an intervention, teams should invite program developers, child welfare staff, and representatives from the target population to provide input about the core components. You can find additional information in the Administration for Children and Families' video, "A Framework to Design, Test, Spread, and Sustain Effective Child Welfare Practice: Develop & Test and Compare & Learn (Part 3)."
With a well-defined intervention, teams set the foundation for implementation. For more information on selecting, adapting, and designing a well-defined intervention and other change and implementation topics, visit the Change and Implementation in Practice web page on the Center for States website.
Administration for Children and Families. "A framework to design, test, spread, and sustain effective child welfare practice: Develop & test and compare & learn (Part 3)" [Video]. Retrieved from https://www.acf.hhs.gov/cb/capacity/program-evaluation/virtual-summit/framework/video3.
Blase, K., & Fixsen, D. (2013). Core intervention components: Identifying and operationalizing what makes programs work. doi: 10.1177/1049731509358424. Retrieved from https://aspe.hhs.gov/report/core-intervention-components-identifying-and-operationalizing-what-makes-programs-work.
Fraser, M. W., & Galinsky, M. J. (2010). Steps in intervention research: Designing and developing social programs. Research on Social Work Practice, 20(5), 459-466. Retrieved from http://journals.sagepub.com/doi/10.1177/1049731509358424.
National Implementation Research Network. (2014). What's the way forward? Usable intervention criteria. Retrieved from http://static1.squarespace.com/static/545cdfcce4b0a64725b9f65a/t/553a9e8ce4b03939abed1645/1429905036097/NIRN_WayForward_Intervention+Criteria.pdf.
Permanency Innovations Initiative Training and Technical Assistance Project. (2016). Guide to developing, implementing, and assessing an innovation. Volume 2: Exploration. Retrieved from https://www.acf.hhs.gov/sites/default/files/cb/guide_vol2_exploration.pdf.
Van Dyke, M., & Metz, A. (2014). Usable intervention criteria. Chapel Hill, NC: National Implementation Research Network.