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The Stages of Implementation Completion® (SIC) is an eight stage tool of implementation process and milestones, with stages spanning three implementation phases: pre-implementation, implementation, and sustainment. The eight stages span implementation activities from Engagement to Achieving Competency.
SIC scores have predicted variations in implementation behavior. Analyses from a wide range of implementing sites across service sectors suggest that completing implementation thoroughly (high proportion) and relatively rapidly (duration) had the highest probability of initiating services.
Developed with funding from the National Institutes of Health (R01MH076158, R01MH097748, R01DA044745), this tool now has been adapted for a number of evidence-based practices, and a “universal” version has been developed for use in monitoring general implementation strategies.
The SIC Framework
The Stages of Implementation Completion® framework focuses on the following eight stages of implementation activities: engagement, consideration of feasibility, readiness planning, staff hired and trained, fidelity monitoring processes in place, services and consultation begin, ongoing services and fidelity monitoring, and competency.
Uses of the SIC
The SIC team has produced adaptations for more than thirty child and family-focused practices across a range of service sectors. This has made it possible to evaluate SIC performance under varying implementation contexts. Examples of practices that have used the SIC include:
- Cognitive Behavioral Intervention for Trauma in Schools (CBITS)
- Housing First
- Multidimensional Family Therapy (MDFT)
- Multisystemic Therapy (MST)
- Treatment Foster Care Oregon (TFCO)
The Universal SIC, developed to address the need for a general measure of implementation process, has demonstrated applicability across a range of EBPs and service sectors.
The Cost of Implementing New Strategies (COINS)
The Cost of Implementing New Strategies (COINS) is a cost-mapping tool developed as an adjunct to the SIC, as a method to disentangle implementation from intervention costs. The COINS tool has demonstrated success in identifying cost and resources differences between implementation strategies and is currently being utilized in a number of studies and implementations.
Click here for more information about the COINS approach and system.
References and Publications
Saldana, L., Bennett, I., Powers, D., Vredevoogd, M., Grover, T., Schaper, H., & Campbell, M. (2020). Scaling implementation of Collaborative Care for depression: Adaptation of the Stages of Implementation Completion (SIC). Administration and Policy in Mental Health and Mental Health Services Research, 47, 188-196.
Eisman, A. B., Kilbourne, A. K., Dopp, A. R., Saldana, L., & Eisenberg, D. (2020). Economic evaluation in implementation science: Making the business case for implementation strategies. Psychiatry Research, 283, 112433.
Nadeem, E., Saldana, L., Chapman, J., & Schaper, H. (2018). A mixed methods study of the stages of implementation for an evidence-based trauma intervention in schools. Behavior Therapy, 49, 509-524.
Palinkas, L., Campbell, M., & Saldana, L. (2018). Agency leaders’ assessments of feasibility and desirability of implementation of evidence-based practices in youth-serving organizations using the Stages of Implementation Completion. Frontiers in Public Health, 6, 161.
Palinkas, L. A., Saldana, L., Chou, C., & Chamberlain, P. (2017). Use of research evidence and implementation of evidence-based practices in youth-serving systems. Children and Youth Services Review, 83, 242-247.
Palinkas, L., Brown, C., Saldana, L., & Chamberlain, P. (2015). Association between inter-organizational consensus on use of research evidence and stage of implementation of an evidence-based practice. Implementation Science, 10(Suppl 1), A20–21.
Brown, C. H., Chamberlain, P., Saldana, L., Padgett, C. Wang, W., & Cruden, C. (2014). Evaluation of 2 implementation strategies in 51 child county public service systems in 2 states: Results of a cluster randomized head-to-head implementation trial. Implementation Science, 9, 134–149.
Saldana, L. (2014). The stages of implementation completion for evidence-based practice: Protocol for a mixed methods study. Implementation Science, 9, 43–54.
Saldana, L., Chamberlain, P., Bradford, W. D., Campbell, M., & Landsverk, J. (2014). The Cost of Implementing New Strategies (COINS): A method for mapping implementation resources using the stages of implementation completion. Children and Youth Services Review, 39,177-182.
Saldana, L., & Chamberlain, P. (2012). Supporting implementation: The role of community development teams to build infrastructure. American Journal of Community Psychology, 50(3–4), 334–346.
Saldana, L., Chamberlain, P., Wang, W., & Brown, C. (2012). Predicting program start-up using the stages of implementation measure. Administration and Policy in Mental Health, 39, 419–425.