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Background Relative to their counterparts in the general population, young people who leave, or transition out of, out-of-home (OOHC) arrangements commonly experience poorer outcomes across a range of indicators, including higher rates of homelessness, unemployment, reliance on public assistance, physical and mental health problems and contact with the criminal justice system. The age at which young people transition from OOHC varies between and within some countries, but for most, formal support ceases between the ages of 18 and 21. Programs designed to support transitions are generally available to young people toward the end of their OOHC placement, although some can extend beyond. They often encourage the development of skills required for continued engagement in education, obtaining employment, maintaining housing and general life skills. Little is known about the effectiveness of these programs or of extended care policies that raise the age at which support remains available to young people after leaving OOHC. This systematic review will seek to identify programs and/or interventions that improve outcomes for youth transitioning from the OOHC system into adult living arrangements. Methods This review will identify programs, interventions and policies that seek to improve health and wellbeing of this population that have been tested using robust controlled methods. Primary outcomes of interest are homelessness, health, education, employment, exposure to violence and risky behaviour. Secondary outcomes are relationships and life skills. We will search, from January 1990 onwards, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, Cochrane CENTRAL, SocINDEX, Sociological Abstracts, Social Services Abstracts, NHS Economic Evaluation Database and Health Technology Assessment. Grey literature will be identified through searching websites and databases, e.g. clearing houses, government agencies and organisations known to be undertaking or consolidating research on this topic area. Two reviewers will independently screen all title and abstracts and full text articles with conflicts to be resolved by a third reviewer. Data extraction will be undertaken by pairs of review authors, with one reviewer checking the results of the other. If more than one study with suitable data can be identified, we plan to undertake both fixed-effects and random-effects meta-analyses and intend to present the random-effects result if there is no indication of funnel plot asymmetry. Risk of bias will be assessed using tools appropriate to the study methodology. Quality of evidence across studies will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Discussion Previous reviews were unable to identify any programs or interventions, backed by methodologically rigorous research, that improve outcomes for this population. This review seeks to update this previous work, taking into account changes in the provision of extended care, which is now available in some jurisdictions. Systematic review registration PROSPERO CRD42020146999

This study aims to understand the role implementation support practitioners can have in supporting the use of research-supported practices, policies, and programs in human service sectors. Through ...

Purpose: Mechanisms of Change (MoC) explain how strategies used to enhance the uptake of evidence in social and human services enable change in the behaviors of individual practitioners, organizational leaders or entire organizations, and systems. One such strategy is the use of implementation support practitioner (ISPs). This study examines the mechanisms through which ISPs facilitate behavior supportive of the implementation of research-supported interventions. Methods: A systematic, integrative review was conducted. The conceptualization of MoCs built on a model by Dalkin and colleagues. Results: Based on a unique combination of knowledge, skills, and attitudes, ISPs install trust in and among their stakeholders and utilize this trust to promote meaningful and relevant learning; provide ongoing opportunities for learning, reflection, and support; help to span boundaries; and positively motivate stakeholders. Discussion: ISPs do not represent a short cut to better implementation. They represent an additional implementation challenge that requires dedicated attention and resources.

Background Workforce development for implementation practice has been identified as a grand challenge in health services. This is due to the embryonic nature of the existing research in this area, few available training programs and a general shortage of frontline service staff trained and prepared for practicing implementation in the field. The interest in the role of “implementation support” as a way to effectively build the implementation capacities of the human service sector has therefore increased. However, while frequently used, little is known about the skills and competencies required to effectively provide such support. Main body To progress the debate and the research agenda on implementation support competencies, we propose the role of the “implementation support practitioner” as a concept unifying the multiple streams of research focused on e.g. consultation, facilitation, or knowledge brokering. Implementation support practitioners are professionals supporting others in implementing evidence-informed practices, policies and programs, and in sustaining and scaling evidence for population impact. They are not involved in direct service delivery or management and work closely with the leadership and staff needed to effectively deliver direct clinical, therapeutic or educational services to individuals, families and communities. They may be specialists or generalists and be located within and/or outside the delivery system they serve. To effectively support the implementation practice of others, implementation support practitioners require an ability to activate implementation-relevant knowledge, skills and attitudes, and to operationalize and apply these in the context of their support activities. In doing so, they aim to trigger both relational and behavioral outcomes. This thinking is reflected in an overarching logic outlined in this article. Conclusion The development of implementation support practitioners as a profession necessitates improved conceptual thinking about their role and work and how they enable the uptake and integration of evidence in real world settings. This article introduces a preliminary logic conceptualizing the role of implementation support practitioners informing research in progress aimed at increasing our knowledge about implementation support and the competencies needed to provide this support.

Background. Qualitative studies, especially those conducted by teams of researchers, may benefit from clearly structured, parsimonious, coding manuals. The process of creating rigorous and robust coding manuals for individual studies is rarely described, and generalizable coding manuals are rare. Normalization Process Theory (NPT) provides conceptual tools to facilitate understanding of the dynamics of adoption, implementation, and sustainment of socio-technical and organizational innovations. As a widely used theory, a generalizable coding manual would be of utility to implementation researchersObjectives. To make the application of NPT simple for the user, to describe the development of a coding manual for qualitative content analytic studies using NPT, and present this for wider use.Method. Concept Selection and Structuring. Qualitative Content Analysis of selected published papers and interview transcripts. Results. All identifiable theoretical concepts (n=149) embedded in papers and chapters that developed NPT between 2006 and 2020 were identified and extracted from their texts. Overlapping, ambiguous, and duplicate versions of concepts were eliminated, as were concepts derived from other theories. This left 38 core concept definitions. These were piloted in coding of qualitative transcripts collected in two implementation studies, and by collaboratively coding papers collected for a systematic review of implementation studies. At the end of this process, a further process of elimination of overlapping or ambiguous concepts was undertaken leaving 12 primary NPT concepts. Conclusion. The process of coding manual resulted in the presentation of NPT concepts according to the Context-Mechanism-Outcomes configuration of realist evaluation research. A coding manual for NPT that is in accordance with realistic evaluation research was successfully produced and is now freely available to researchers who wish to use NPT in primary and secondary research that employs qualitative methods.

Purpose: Skills in selecting and designing strategies for implementing research-supported interventions (RSIs) within specific local contexts are important for progressing a wider RSI adoption and application in human and social services. This also applies to a particular role in implementation, the implementation support practitioner (ISP). This study examines which strategies have been reported as being used by ISPs across multiple bodies of research on implementation support and how these strategies were applied in concrete practice settings. Methods: A systematic integrative review was conducted. Data analysis utilized the Expert Recommendations for Implementing Change compilation of implementation strategies. Results: Studies reported on 18 implementation strategies commonly used by different ISPs, who require mastery in selecting, operationalizing, and detailing these. Two further strategies not included in the ERIC compilation could be identified. Discussion: Given the use of primarily more feasible implementation support strategies among ISPs, their potential as agents of change may be underutilized.

Implementation science has undergone an impressive development in the past two decades. A great many concepts and models have been developed suggesting to include the essentials of high-quality implementation practice; critical discussions have explored the types of measures and designs needed to reliably and validly generate high-quality implementation research that pushes the field forward; and an impressive number of empirical studies have been published, reflecting both an increasing amount of resources invested in implementation science and a growing knowledge base enabling the further development of the discipline. This chapter introduces some of the pertinent questions that researchers, practitioners, and policymakers will face when entering into a new – and third – decade of implementation science. As such, it offers readers a platform from which to start their journey toward implementation science 3.0.

Background & objectives Implementation frameworks are designed to articulate the actions and behaviors considered necessary for successful implementation of interventions, programs or services. Such frameworks have been increasingly used in social services for children, youth and families (which include family and parenting support, out-of-home care (foster care) placements, child protection, family violence, juvenile justice and community services). The purposes of this review were (a) to identify studies employing an implementation framework in this field; (b) map the literature to better understand these frameworks and the ways in which they are being applied; (c) to ascertain the ways in which implementation frameworks are being tested; and (d) to describe the current state of evidence surrounding their use in the field. Method For this scoping review, searches of the literature were conducted within PsycINFO, MEDLINE, CINAHL, ASSIA, Embase, Embase Classic, Social Work Abstracts, ERIC and Sociological Abstracts. Databases were searched for published, peer reviewed English language evaluation studies that applied - and reported on this application - implementation frameworks in the child, youth and family service sector. No limits were placed on years. Any type of study design was eligible from single case studies to randomized controlled trials. Results Out of a total of 8541 publications located, thirty-three met the inclusion criteria. They included eight frameworks that have been applied in the sector. Few of the identified frameworks were based on rigorous research designs. Common strategies used within the frameworks included staging implementation, key influences (e.g., competencies, organizational factors, leadership), stakeholder identification and engagement, and capacity measurement and building. Rarely were these approaches theoretically grounded or fully developed, and limited information was provided about their characteristics, development or interconnectedness. In short, research underpinning frameworks and their use has been meager, especially considering their proliferation in the field. Conclusions This review identifies a need to strengthen the conceptualization of core strategies that are integrated into implementation frameworks, including an articulation of their underlying logic. In the future, implementation science and practice may gain from moving away from comprehensive and complex implementation frameworks towards a more flexible, modular approach to implementation based on the application and combination of effective ‘implementation core strategies’. Future research may also draw a more complete picture of the state of implementation frameworks by expanding search terms to also include other sectors and domains into systematic reviews.

Background While there is some guidance to support the adaptation of evidence-based public health interventions, little is known about adaptation in practice and how to best support public health practitioners in its operationalization. This study explored public health researchers’ and practitioners’ views on available adaptation frameworks, identified potential improvements to increase the application of such guidance and identified opportunities to advance the adaptation literature to improve implementation of public health initiatives and achieve public health outcomes. Methods This qualitative study was undertaken with researchers, methodologists, policy makers and practitioners representing various public health expert organizations and universities internationally. Participants attended a face to face workshop in Newcastle, Australia in October 2018 where structured facilitated focus group discussions and small group activities were undertaken. Two qualitative methods - World Café and Appreciative Inquiry - were used to explore participants’ experiences of and opinions about adaptation frameworks, and to elicit suggestions for practical, detailed solutions to address identified gaps. Results Participants reported a number of limitations with current guidance including a lack of detail on ‘how’ to adapt, limited information on adaptation of implementation strategies and a number of structural issues with the wording and recommended order of adaptation framework elements. Participants noted that the generation of overarching principles that could be applied together with existing frameworks and/or related resources provides a practical way of supporting adaptation decisions in practice. Finally, participants identified a number of opportunities to further advance the field, including the building of an empirical evidence base on adaptation, advancing adaptation methods and developing data collection systems to capture adaptations. Conclusions This study provides an overview of expert views regarding existing frameworks for adaptation and their ability to be applied in practice. It identified a number of limitations, and suggests overarching principles to be applied when adapting public health initiatives.

Over the last 20 years, there has been a growing emphasis on developing and identifying evidence-based programs and practices for children and families and within the last decade an increasing number of federally funded initiatives have been dedicated to replicating and scaling evidence-based programs with the hope of achieving socially meaningful impact. However, only recently have efforts to promote high-fidelity implementation been given the attention needed to ensure evidence-based practices are used as intended and generate the outcomes they were designed to produce. In this article, we propose that the wide-scale implementation of evidence-based practices requires: (1) careful assessment and selection of the "what"; (2) a stage-based approach that provides adequate time and resources for planning and installation activities; (3) the co-creation of a visible infrastructure by a triad of key stakeholders including funders and policymakers, program developers, and implementing sites; and (4) the use of data to guide decision-making and foster curiosity into continuous improvement among grantees. Each of these strategies is explored in greater detail through the lens of the Teen Pregnancy Prevention (TPP) Program, a $100 million initiative overseen by the Office of Adolescent Health (OAH) in the U.S. Department of Health and Human Services.