Developing Theory to Guide Building Practitioners’ Capacity to Implement Evidence-Based Interventions

• Type of Material: Article
• Authors: Jennifer Leeman, The University of North Carolina at Chapel Hill; Larissa Calancie, The University of North Carolina at Chapel Hill; Michelle Kegler, Emory University; Ngoc-Cam Escoffery, Emory University; Alison K. Herrmann, University of California Los Angeles; Esther Thatcher, The University of North Carolina at Chapel Hill; Marieke A. Hartman, University of Texas; Maria Fernandez, University of Texas
• Language: English
• Date: 2017-01-01
• Publisher: SAGE Publications (UK and US)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 Society for Public Health Education.
• Final Published Version (URL): http://dx.doi.org/10.1177/1090198115610572
• Title of Journal or Parent Work: Health Education and Behavior
• ISSN: 1090-1981
• Volume: 44
• Issue: 1
• Start Page: 59
• End Page: 69
• Grant/Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This publication was supported by Cooperative Agreement Numbers U48DP00194409, U48DP001949, U48DP0010909, and U48DP001934 from the Centers for Disease Control and Prevention and the National Cancer Institute to Cancer Prevention and Control Research Network sites.; Marieke A. Hartman was supported by the postdoctoral fellowship, University of Texas School of Public Health Cancer Education and Career Development Program, National Cancer Institute (NIH Grant R25CA57712) and NIH Grant R01CA163526.; Esther Thatcher was supported by the National Institute of Nursing Research (Grant 5T32NR00856).
• Keywords: knowledge translation; evidence-based interventions; capacity building; dissemination; prevention support
• Research Categories: Health Sciences, Education; Health Sciences, Public Health

Abstract

Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners’ capacity to adopt and implement a variety of EBIs across diverse practice contexts.