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Putting Implementation Science into Practice: Lessons from the Creation of the National Maternal and Child Health Workforce Development Center

  • W. Oscar Fleming
  • Alexsandra A. ApostolicoEmail author
  • Amy J. Mullenix
  • Katie Starr
  • Lewis Margolis
From the Field

Abstract

Purpose This article describes how implementation science informed the design of a national training and technical assistance (TA) center, and how implementation best practices have been used to improve the quality of training and technical assistance services offered to states/jurisdictions. Description An existing tool, based on the Implementation Drivers Framework (in: Fixsen et al., Implementation research: a synthesis of the literature, University of South Florida, The National Implementation Research Network, Tampa, 2005), was adapted to assess efforts of the National MCH Workforce Development Center (the Center) against known implementation best practices. Staff identified specific examples of effective practice and gaps for inclusion in this article. Assessment Using implementation science to establish, assess and improve Center practice was both feasible and practical, requiring intentionality, dedicated time, and staff committed to deepening their understanding of implementation science. The Implementation Drivers framework proved useful for creating a shared approach to analysis and identification of opportunities for improvement of Center practice. Conclusion Policymakers and funding agencies should consider how training and technical assistance programs demonstrate knowledge and use of implementation science best practices among other evidence based practices in their work. Increasing attention to the use of implementation science can contribute to a higher quality of service among technical assistance centers, with the long term goal of improving outcomes for training and assistance recipients and the communities they serve. Establishing the link between customer satisfaction and quality of technical assistance, on the one hand, and long term outcomes, on the other, remains a challenge and an area of focus and learning for the Center.

Keywords

Implementation science Workforce development Maternal and child health Title V workforce 

Notes

Acknowledgements

The National MCH Workforce Development Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant Number UE7MC26282 for $1,740,000 with no support from nongovernmental sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. government. We thank Michelle Tissue, the project officer, for her thoughtful guidance and contributions to the Center.

References

  1. Acosta, J., Chinman, M., Ebener, P., Malone, P. S., Paddock, S., Phillips, A., … Slaughter, M. E. (2013). An intervention to improve program implementation: Findings from a two-year cluster randomized trial of Assets-Getting to Outcomes. Implementation Science.  https://doi.org/10.1186/1748-5908-8-87.Google Scholar
  2. Albers, B., Mildon, R., Lyon, A. R., & Shlonsky, A. (2017). Implementation frameworks in child, youth and family services—Results from a scoping review. Children and Youth Services Review, 81(July), 101–116.  https://doi.org/10.1016/j.childyouth.2017.07.003.CrossRefGoogle Scholar
  3. Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science (Additonal File 4). Implementation Science, 4(50), 40–55.  https://doi.org/10.1186/1748-5908-4-50.
  4. Durlak, J. A., & DuPre, E. P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41(3–4), 327–350.CrossRefGoogle Scholar
  5. Eccles, M. P., & Mittman, B. S. (2006). Welcome to implementation science. Implementation Science, 1(1).  https://doi.org/10.1186/1748-5908-1-1.
  6. Erwin, P. C., & Brownson, R. C. (2017). The public health practitioner of the future. American Journal of Public Health, 107(8), 1227–1232.  https://doi.org/10.2105/AJPH.2017.303823.CrossRefGoogle Scholar
  7. Fixsen, D., Blase, K., Naoom, S., & Duda, M. (2013). Implementation drivers: Assessing best practices (pp. 1–49). Retrieved from http://implementation.fpg.unc.edu/sites/implementation.fpg.unc.edu/files/resources/NIRN-ImplementationDriversAssessingBestPractices.pdf.
  8. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2017a). Coaching. Retrieved October 25, 2017, from http://implementation.fpg.unc.edu/module-2/coaching.
  9. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2017b). Decision support data system. Retrieved October 25, 2017, from http://implementation.fpg.unc.edu/module-2/decision-support-data-system.
  10. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2017c). Facilitative administration. Retrieved October 25, 2017, from http://implementation.fpg.unc.edu/module-2/facilitative-administration.
  11. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2017d). Leadership drivers. Retrieved October 25, 2017, from http://implementation.fpg.unc.edu/module-2/leadership-drivers.
  12. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2017e). Selection. Retrieved October 25, 2017, from http://implementation.fpg.unc.edu/module-2/selection.
  13. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2017f). Systems intervention. Retrieved October 25, 2017, from http://implementation.fpg.unc.edu/module-2/systems-intervention.
  14. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2017g). Training. Retrieved October 25, 2017, from http://implementation.fpg.unc.edu/module-2/training.
  15. Fixsen, D. L., Naoom, S. F., Blase, K., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).Google Scholar
  16. Flaspohler, P. D., Meehan, C., Maras, M. A., & Keller, K. E. (2012). Ready, willing, and able: Developing a support system to promote implementation of school-based prevention programs. American Journal of Community Psychology, 50(3–4), 428–444.  https://doi.org/10.1007/s10464-012-9520-z.CrossRefGoogle Scholar
  17. Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381.  https://doi.org/10.1016/j.jbi.2008.08.010.CrossRefGoogle Scholar
  18. Heifetz, R., Grashow, A., & Linksy, M. (2009). The practice of adaptive leadership. Boston: Harvard Business Press.Google Scholar
  19. Hofler, L. G., Cordes, S., Cwiak, C. A., Jamieson, D. J., Kottke, M., & Goedken, P. (2017). Implementing immediate postpartum long-acting reversible contraception programs. Obstetrics & Gynecology, 129(1), 3–9.  https://doi.org/10.1097/AOG.0000000000001798.CrossRefGoogle Scholar
  20. Kogan, M. D., Dykton, C., Hirai, A. H., Strickland, B. B., Bethell, C. D., Naqvi, I., … Lu, M. C. (2015). A new performance measurement system for maternal and child health in the United States. Maternal and Child Health Journal, 19(5), 945–957.  https://doi.org/10.1007/s10995-015-1739-5.CrossRefGoogle Scholar
  21. Kroelinger, C. D., Rankin, K. M., Chambers, D. A., Roux, A. V. D., Hughes, K., & Grigorescu, V. (2014). Using the principles of complex systems thinking and implementation science to enhance maternal and child health program planning and delivery. Maternal and Child Health Journal, 18(7), 1560–1564.  https://doi.org/10.1007/s10995-014-1586-9.CrossRefGoogle Scholar
  22. Le, L. T., Anthony, B. J., Bronheim, S. M., Holland, C. M., & Perry, D. F. (2016). A technical assistance model for guiding service and systems change. The Journal of Behavioral Health Services & Research, 43, 380–395.  https://doi.org/10.1007/s11414-014-9439-2.CrossRefGoogle Scholar
  23. Lu, M. C., Lauver, C. B., Dykton, C., Kogan, M. D., Lawler, M. H., Raskin-Ramos, L., … Wilson, L. A. (2015). Transformation of the title V maternal and child health services block grant. Maternal and Child Health Journal, 19(5), 927–931.  https://doi.org/10.1007/s10995-015-1736-8.CrossRefGoogle Scholar
  24. Margolis, L., Mullenix, A., Apostolico, A. A., Fehrenbach, L. M., & Cilenti, D. (2017). Title V workforce development in the era of health transformation. Maternal and Child Health Journal.  https://doi.org/10.1007/s10995-017-2335-7.Google Scholar
  25. Metz, A., Bartley, L., Ball, H., Wilson, D., Naoom, S., & Redmond, P. (2015). Active implementation frameworks for successful service delivery: Catawba county child wellbeing project. Research on Social Work Practice, 25(4), 415–422.  https://doi.org/10.1177/1049731514543667.CrossRefGoogle Scholar
  26. Meyers, D. C., Durlak, J. A., & Wandersman, A. (2012). The quality implementation framework: A synthesis of critical steps in the implementation process. American Journal of Community Psychology, 50(3–4), 462–480.  https://doi.org/10.1007/s10464-012-9522-x.CrossRefGoogle Scholar
  27. National Consortium for Public Health Workforce Development. (2017). Building skills for a more strategic public health workforce: A call to action (pp. 1–18). Retrieved from http://www.debeaumont.org/wordpress/wp-content/uploads/Building-Skills-for-a-More-Strategic-Public-Health-Workforce.pdf.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • W. Oscar Fleming
    • 1
    • 2
  • Alexsandra A. Apostolico
    • 2
    Email author
  • Amy J. Mullenix
    • 2
    • 3
  • Katie Starr
    • 2
  • Lewis Margolis
    • 2
    • 3
  1. 1.The National Implementation Research Network, FPG Child Development InstituteUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.The National Maternal and Child Health Workforce Development Center, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Department of Maternal and Child Health, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA

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