Despite the proliferation of evidence-based practices, we know little about how to achieve ‘successful’ implementation when interventions are rolled out into community settings. What agency-based factors need to be in place before successful implementation can occur?
The lack of understanding of ‘what it takes’ to install these evidence-based practices can have costly public health consequences, including a lack of availability of the most beneficial services, wasted efforts and resources on failed implementation attempts, and, after failed attempts, the potential for engendering reluctance to try implementing new ones. The Stages of Implementation Completion® (SIC), originally developed with funding from the National Institute of Mental Health, is an eight stage tool of implementation process and milestones, with stages spanning three implementation phases (pre-implementation, implementation, and sustainability). The eight stages span implementation activities from Engagement to Achieving Competency. This tool has been adapted for a number of evidence-based practices specifically, and a “universal” tool has been developed for use of monitoring of general implementation strategies.
The SIC and its associated cost mapping tool, the Cost of Implementing New Strategies (COINS), are being utilized in other implementation efforts funded by the NIMH. As part of sub-awards, the SIC research team is involved in (1) a pragmatic randomized controlled trial to evaluate an implementation strategy for collaborative care for perinatal depression in federally qualified health centers (R01 MH108548; PI: Bennett) and (2) a global health study in Myanmar focused on developing a protocol, including relevant measurement tools, to assess organizational readiness to implement evidence-based mental health services and to monitor organizational progress to achieving service sustainability in low resourced global settings (U19MH110002; PI: Bass).
In addition to these NIH-funded efforts, the SIC team currently collaborates with implementers of multiple evidence-based practices, with purveyors, and with implementing systems and organizations. If you would like consultation on assessing roll-outs of evidence-based practices or other general implementation efforts, please contact Lisa Saldana, Ph.D. or visit www.oslc.org/sic.
Lisa Saldana, Ph.D.
Funder: National Institute of Mental Health
Lisa Saldana, Ph.D.
Oregon Social Learning Center
Active Research Projects
- UGH FAIR (Families Actively Improving Relationships)
- SIC Coaching Strategy
- FAIR (Families Actively Improving Relationships)
- R3 Supervisor Strategy
Primary Research and Clinical Interests
Lisa joined OSLC in 2007. She received her doctorate in clinical psychology from the University of Missouri-Columbia in 2003 with a research and clinical emphasis in child maltreatment and evidence-based practice (EBP). She has been active in the development, evaluation, and implementation of EBPs, with a particular emphasis in services for child welfare populations.
Lisa currently is the PI of a number of federally funded projects related to implementation in child serving systems. Building on her previous work with the Stages of Implementation Completion (SIC) ®, she and the SIC team are extending the SIC into the Sustainment Phase of the implementation process. Moreover, they are conducting a randomized trial of the SIC-Coaching strategy as a method for integrating implementation fidelity with intervention fidelity to increase rates of successful implementation among adolescent substance use treatment EBPs. Lisa and the SIC team have collaborated with a number of EBP developers in different service sectors, serving different populations to operationalize and monitor real-world implementation efforts. Similarly, the SIC team has developed the Cost of Implementing New Strategies (COINS) tool for assessing implementation costs across the three phases of implementation.
Lisa also is the primary developer and evaluator the R3 Supervisor Strategy. Developed in collaboration with child welfare leaders, R3 aims to bring evidence-based strategies into child welfare worker-family interactions. The model has been implemented and evaluated across both state and county driven child welfare systems. R3 has received strong endorsement from supervisors trained in the model and consistently has produced positive organizational change.
Lisa is the developer of the Families Actively Improving Relationships (FAIR) model, an integrative intervention for families referred to the child welfare system for parental substance abuse. FAIR integrates evidence-based techniques targeting four key treatment components including parental substance use, maladaptive parenting, and mental health symptoms as well as their correlated contextual problems such as housing and employment. Families referred to FAIR receive services in their natural environments (e.g., home, school, court) and receive incentives related to healthy households for meeting individualized treatment goals. Currently, Lisa and her team are implementing FAIR, and its adaptation PRE-FAIR, in five Oregon counties, as part of a NIDA-funded HEAL prevention study. FAIR is recognized by the California Evidence-Based Clearinghouse. Lisa oversees FAIR services provided to Lane and Douglas County residents through the ODI Clinic; for more information, visit odiclinic.org/fair.