What strategies are used to build practitioners' capacity to implement community-based interventions and are they effective?: A systematic review

• Authors: Jennifer Leeman, The University of North Carolina at Chapel Hill; Larissa Calancie, The University of North Carolina at Chapel Hill; Marieke A. Hartman, University of Texas School of Public Health; Ngoc-Cam Escoffery, Emory University; Alison K. Herrmann, UCLA School of Public Health; Lindsay E. Tague, The University of North Carolina at Chapel Hill; Alexis A. Moore, The University of North Carolina at Chapel Hill; Katherine M. Wilson, Centers for Disease Control and Prevention; Michelle Schreiner, The University of North Carolina at Chapel Hill; Carmen Samuel-Hodge, The University of North Carolina at Chapel Hill
• Journal Title: Implementation Science
• Volume: Volume 10, Number 80
• Publisher: BioMed Central | 2015-05-29
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/s13012-015-0272-7
• Subjects: Sociology, Social Structure and Development; Psychology, Behavioral; Health Sciences, Public Health
• Keywords: capacity building; prevention support; interactive systems framework; technical assitance; evidence-based practice

Abstract

Background Numerous agencies are providing training, technical assistance, and other support to build community-based practitioners’ capacity to adopt and implement evidence-based prevention interventions. Yet, little is known about how best to design capacity-building interventions to optimize their effectiveness. Wandersman et al. (Am J Community Psychol.50:445–59, 2102) proposed the Evidence-Based System of Innovation Support (EBSIS) as a framework to guide research and thereby strengthen the evidence base for building practitioners’ capacity. The purpose of this review was to contribute to further development of the EBSIS by systematically reviewing empirical studies of capacity-building interventions to identify (1) the range of strategies used, (2) variations in the way they were structured, and (3) evidence for their effectiveness at increasing practitioners’ capacity to use evidence-based prevention interventions. Methods PubMed, EMBASE, and CINAHL were searched for English-language articles reporting findings of empirical studies of capacity-building interventions that were published between January 2000 and January 2014 and were intended to increase use of evidence-based prevention interventions in non-clinical settings. To maximize review data, studies were not excluded a priori based on design or methodological quality. Using the EBSIS as a guide, two researchers independently extracted data from included studies. Vote counting and meta-summary methods were used to summarize findings. Results The review included 42 publications reporting findings from 29 studies. In addition to confirming the strategies and structures described in the EBSIS, the review identified two new strategies and two variations in structure. Capacity-building interventions were found to be effective at increasing practitioners’ adoption (n = 10 of 12 studies) and implementation (n = 9 of 10 studies) of evidence-based interventions. Findings were mixed for interventions’ effects on practitioners’ capacity or intervention planning behaviors. Both the type and structure of capacity-building strategies may have influenced effectiveness. The review also identified contextual factors that may require variations in the ways capacity-building interventions are designed. Conclusions Based on review findings, refinements are suggested to the EBSIS. The refined framework moves the field towards a more comprehensive and standardized approach to conceptualizing the types and structures of capacity-building strategies. This standardization will assist with synthesizing findings across studies and guide capacity-building practice and research. Electronic supplementary material The online version of this article (doi:10.1186/s13012-015-0272-7) contains supplementary material, which is available to authorized users.