his “View From the Field” column is the first in a series discussing aspects of implementation science important for scaling up and sustaining evidence-based practices in schools and districts. Recent research suggests there are important approaches to instruction, behavior support, and mental health that have been empirically documented but are not being implemented widely across local schools and school districts (Ginns et al., 2020; Mazzotti & Plotner, 2016; Powell et al., 2020).

This article is a demonstration of how an implementation-science (IS) framework can be coupled with the measurement of implementation outcomes to effectively integrate evidence-based family interventions in primary care. The primary care environment presents a number of challenges for successfully integrating such interventions. However, IS methods can improve the prospect of successfully implementing a new intervention while simultaneously and rigorously evaluating the impact on salient outcomes. We used our experiences across 2 pilot trials in which the family check-up (Smith, Montaño, Mauricio, Berkel, & Dishion, 2016), an evidence-based family intervention, was integrated into primary care. In these pilot trials, the exploration, preparation, implementation, and sustainment (EPIS) framework and the Proctor et al. taxonomy of implementation outcomes were used to guide the implementation and evaluate its success. Grounding our presentation in our pilot work offers an illustration of applying the EPIS framework and outcomes measurement to real-world problems and contexts. When embarking on new efforts to integrate behavioral interventions into health-care settings, the application of IS frameworks and measurement strategies can create generalizable knowledge that substantively contributes to a sparse literature. Today, those “in the trenches” who are translating evidence-based interventions to their setting can contribute to the corpus of research in integrated care by using IS methods to plan a new program and evaluate its feasibility, adoption, and reach.

Introduction: Health service organizations and their partners are increasingly under pressure to collaborate to deliver integrated patient care. The Collective Impact framework aligns well with respectful engagement and decision making between an organization and its partners, ensuring long-term change at the systems level. Shared vision, mutually reinforcing activities, and continuous communication are key components of a collective impact effort. Communication, in particular, plays an important role in all aspects of an organization, both internally and externally. Thoughtful feedback from partners and collaborative efforts can achieve collective impact and improved patient and population outcomes. Choose Well (CW), a statewide contraceptive access initiative in South Carolina, was developed using Collective Impact principles. CW launched in 2017 and continued through 2022. CW aimed to implement best practices for contraceptive access and provision. This study examined the perceptions of CW staff towards shared vision for contraceptive access, mutually reinforced activities, and communication strategies between CW and its partners. Methods: Data were collected in 2022 via exit key-informant interviews with CW staff to reflect across-all-years of their involvement with the initiative. A semi-structured interview guide was used, and the interviews were recorded, transcribed, and coded. A codebook was developed based on the interview guide. Data from questions related to 1) shared vision, 2) communication, and 3) mutually reinforcing activities between CW staff and partners were analyzed for this study. Coding was conducted with NVivo software version 1.7. Results: A total of eight CW staff participated in the interviews. Findings indicate that participants were very satisfied with the shared vision for contraceptive access between CW and its partners. The most prevalent facilitators for shared vision were constant and ongoing communication, collaboration with partners, and CW changes in framing for the initiative. Regarding communication, most participants perceived that the level of communication and coordination among various CW partners was consistent and streamlined. Integration of communication into daily processes, open communication with partners, and use of an online communication tool were mentioned as strategies that facilitated communication. Lack of administrative and partner buy-in among some partners, staff turnover, and pandemic-related challenges were commonly mentioned by participants as barriers to communication. Most participants perceived mutually reinforcing activities to be adaptability to partner needs, funding for the full range of contraceptive methods, collaboration efforts, and feedback from the partners. Conclusion: While lack of buy-in among some partners and the pandemic posed challenges, most participants perceived that constant and consistent communication facilitated a shared vision among the CW partners. Through adaptability, collaboration, and open communication with partners, CW adjusted its work to align with their partners’ goals. The findings of this study indicate that CW has coordinated their efforts around a common goal that aligns with their partners. CW maintained effective and consistent communication and integrated partner feedback as a Collective Impact approach towards improving contraceptive access and provision in SC. Shared vision and understanding of the health issue between the organization and partners can lead to a collective impact towards solving community health problems such as contraceptive access.

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Trauma is a substantial threat to public health. As such, significant effort has been exerted into developing interventions which mitigate the consequences of trauma. Trauma-informed practice (TIP) aims to alleviate the effects of trauma by building policies and practices focused on safety, trust, transparency, support, collaboration, and empowerment. This study investigated how individual-level factors, including readiness for organizational change, perceived benefit of TIP training, and personal trauma history affect one’s ability to apply a TIP lens in a sample (n =100) of members of a graduate-level college. Further, it explored if one’s perceptions of and response to trauma-informed practice training predict changes in well-being, stress, and burnout. Results indicated that perceived benefit and readiness for organizational change are important predictors of post-training outcomes. Participants with a history of trauma performed more poorly on post-training trauma-informed knowledge questions. Results provided initial utility for use of objective measurement of trauma-informed application abilities.

In many academic disciplines, there are promising discoveries and valuable information, which have the potential to improve lives but have not been transferred to or taken up in ‘real world’ practice. There are multiple, complex reasons for this divide between theory and practice—sometimes referred to as the ‘know-do’ gap—and there are a number of disciplines and research fields that have grown out of the perceived need to close these gaps. In the field of health, Knowledge Translation (KT) and its related research field, Implementation Science (IS) aim to shorten the time between discovery and implementation to save and improve lives. In the field of humanitarian development, the discipline of Communication for Development (ComDev) arose from a belief that communication methods could help close the perceived gap in development between high- and low-income societies. While Implementation Science and Communication for Development share some historical roots and key characteristics and IS is being increasingly applied in development contexts, there has been limited knowledge exchange between these fields. The aim of this paper is to provide an overview of the characteristics of IS and ComDev, analyze some key similarities and differences between them and discuss how knowledge from each could help inform the other to more effectively achieve their common goals.

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Problem: A major gap in adolescent mental health services exists in the United States. Nearly 80% of children and adolescents who are defined as needing mental health services are not receiving mental health care. School-based services have demonstrated promise as a strategy to address this gap. The purpose of this dissertation is to determine how a large urban school system implemented and sustained an innovative service of care model in response to financial, human resource, and community constraints and opportunities. Methods: A case study of the San Diego Unified School District’s (SDUSD) Mental Health Resource Center (MHRC) was completed using Pettigrew and Whipp's Content, Context, and Process Model of Strategic Change (PWM) as the theoretical framework that guided the research. Three primary sources of evidence were collected covering a fifteen-year period of implementation (1999–2014): 1) documents; 2) archival records; and, 3) interviews. The interviews were conducted with local and state stakeholders (n=20) and with students who received MHRC services and their parents (n= 15). A chronological reconstruction was completed and all data underwent a content analysis to organize and identify emergent themes based on the PWM framework. Results: Eight factors were identified as critical to the implementation and sustainability of the MHRC: establishing the legitimacy of school as environment for the delivery of mental health services; aligning education and mental health policies; implementing cross systems collaboration; utilizing data to improve performance and prioritize services; strengthening parent and student involvement; commitment to lead; institutionalization of mental health training; and, investment in staff. Further analysis assessed potential system improvements and opportunities for new collaborations and produced sustainability recommendations for SDUSD and MHRC administration, staff, and stakeholders. Conclusion: The MHRC provides a unique systems model that can inform best practices and policy decisions regarding the implementation and sustainability of school-based mental health services. Lessons learned from the sustainability of the MHRC support schools as a legitimate environment for the delivery of mental health services and the integration of mental health services in schools as a feasible strategy to improve student academic and mental health outcomes.

Abstract This was a modified integrated mixed methods study of teachers’ perceptions of factors that influence transfer of research-based teaching strategies into classroom practice. Participants were made up of 66 respondents to a researcher made survey, “Survey of Teacher Attitudes toward Change and Classroom Implementation of Research–Based Strategies”. Respondents were divided into two groups based on participation in Louisiana Systemic Initiatives Programs (LaSIP): LaSIP, N= 39 and Non-LaSIP, N= 27. Answers to five research questions were based on analysis of quantitative data from a survey, recorded on a five-point Likert scale and qualitative data from analyses of transcripts of three personal interviews, two focus group discussions and five short-answer questions on the survey. SPSS software version 9 and Atlas.ti version 7 were used in quantitative and qualitative analyses, respectively. Concurrent quantitative and qualitative strands of data were integrated throughout the study. Findings from quantitative data included the following: (1) Teacher perceptions of features of the LaSIP were predictive of reported frequency of use of research-based teaching strategies (RBTS); (2) Reported frequency of use of RBTS was not significantly different in LaSIP versus non-LaSIP teachers, except in reported use of alternative assessments. (3) Both LaSIP and non-LaSIP teachers indicated that implementation of RBTS increased student achievement (4) LaSIP teachers identified factors such as opportunity to collaborate with colleagues, time to acquire content knowledge, practice with material and supplies as features of the LaSIP that influenced implementation of RBTS. (5) Perceived barriers to implementation of RBTS included lack of equipment and lack of teacher input into planning of professional development. and modeling of RBTS as factors that positively influence classroom implementation. Analyses of qualitative data supported many of the findings due to quantitative analyses. Additionally, qualitative data provided more in-depth information concerning teacher perceptions of barriers to implementation such as lack of teacher input into planning and implementation of professional development, and lack of time for in-depth learning during professional development activities. Key Words: Teacher Professional Development, Research-based Teaching Strategies, Classroom Implementation, Science Pedagogy, Mixed Methods, Student Achievement

Améliorer la qualité des soins à l'hôpital reste un enjeu. Mettre en place des interventions efficaces pour changer les pratiques cliniques et les évaluer avec une méthodologie adaptée est crucial. L'objectif de ce travail est de proposer une démarche d'évaluation des interventions complexes. Dans une première partie, nous présentons et discutons quatre études conduites en milieu hospitalier. Celles-ci ont permis de dégager les spécificités méthodologiques des évaluations des interventions complexes que nous développons dans une seconde partie. De ce travail, nous retenons les éléments suivants : la conception d'interventions efficaces repose sur la connaissance des freins au changement de pratique et des facteurs favorisants ; l'évaluation de l'impact dispose de différentes alternatives méthodologiques ; les approches sont pragmatiques, intégrées au contexte local. En contrepartie, la validité interne de l'étude est souvent affectée par l'absence de comparabilité initiale des groupes et l'absence d'insu des professionnels. Le processus d'implémentation et les facteurs contextuels doivent être compris pour interpréter les résultats des études et pour pouvoir transposer l'intervention. Nous proposons une démarche en 5 étapes pour l'élaboration et l'évaluation des interventions complexes : I. Conception de l'intervention, II. Déploiement, III. Evaluation de l'impact, IV. Transférabilité et V. Pérennité. Une grille est proposée pour guider la réalisation de chacune de ces étapes. Les perspectives de recherche sont de prendre en compte la préférence des professionnels dans les essais d'intervention, d'intégrer les connaissances en sciences humaines sur les changements de comportement pour concevoir les interventions et en comprendre les effets, et de développer des approches mixtes combinant des résultats qualitatifs et quantitatifs pour conclure sur l'impact des interventions / Improving the quality of hospital care remains a challenge. Setting up effective interventions to change clinical practices and evaluating them with an appropriate methodology is crucial. The objective of this work is to propose a process to evaluate complex interventions. In a first part, we discuss four studies conducted in hospitals. They allowed us to identify the methodological specificities of the evaluations of complex interventions that we develop in a second part. From this work, we take away the following items. Effective interventions are based on the knowledge of barriers and facilitators to change clinical practices. Various methodological approaches exist to evaluate the impact of complex interventions. These approaches are pragmatic, integrated into the local context. On the flip side, the internal validity of the study is often impacted by the lack of comparability of the original groups and the lack of blinding of the professionals; the implementation process and contextual factors need to be understood to interpret the results and to be able to transfer the intervention. We propose a 5-step approach for the development and the evaluation of complex interventions: I. Design II. Implementation, III. Impact assessment, IV. Transferability and V. Sustainability. A grid is provided in order to guide the completion of each of these steps. The research perspectives are: take into account the preference of professionals in intervention trials, integrate knowledge about behavior change to design interventions and understand the effects, and develop joint approaches combining qualitative and quantitative results to conclude on the impact of interventions