Table 1 Summary of case studies
Case number and title | 1. Contracting arrangements | 2. Policy-driven fiscal incentive | 3. Community-academic partnerships in a LMIC | 4. START model partnerships | 5. Earmarked taxes | 6. State-wide interagency collaboration | 7. Data sharing process | 8. Partnership between state and local child welfare agencies | 9. Site-level accreditation process | 10. Individual as a bridging factor | |
|---|---|---|---|---|---|---|---|---|---|---|---|
Study details | |||||||||||
Intervention "The thing" | SafeCare® | Multiple EBPs | Healthy Beginnings | START model | Not EBP specific | EBPs for autism spectrum disorder | Evidence-based HIV interventions | R3 supervision focused implementation approach | SafeCare® | Programming for incarcerated pregnant and postpartum women | |
Bridging factor | Contracting arrangements between public sector child welfare systems and organizations delivering the EBP | Policy-driven fiscal incentive that connected a public sector mental health system and organizations delivering the EBPs | Partnership between the local government in LMIC setting and churches | Partnership between substance use treatment organizations and local child welfare agencies | Earmarked taxes that connected states with public sector mental health systems and organizations delivering the EBPs | Interagency collaboration among a state and organizations delivering the EBPs | Data sharing process that connected local and state health departments with organizations delivering the EBPs | Partnership between state and local child welfare agencies | Site-level accreditation process that connected program developers with organizations delivering the EBP | An individual who connected a university medical center with a state-run prison | |
Function dimensions | |||||||||||
1 | Type | Formal arrangement | Formal arrangement | Relational tie | Relational tie | Formal arrangement | Relational tie | Process | Relational tie | Process | Relational tie |
2 | Outer context | Public sector child welfare system | Public sector mental health system | Local government in LMIC setting | Substance use treatment organizations in the community | State(legislators and voting constituents) | State (policymakers) | Local and state health departments | State (system leadership) | Program developers | University medical center |
3 | Inner context | Organizations delivering the EBP | Organizations delivering the EBPs | Churches | Local child welfare agencies | Public sector mental health systems, organizations delivering the EBPs | Organizations delivering the EBPs | Organizations delivering the EBPs | Local child welfare agencies | Organizations delivering the EBP | State-run prison |
4 | Capital exchanged | Money, EBP expertise, institutional knowledge, training/coaching capacity, flow of eligible clients, social capital with program developer | Money, EBP expertise, institutional knowledge, training/coaching capacity, flow of eligible clients, social capital with program developer | Money, EBP expertise, training | Money, referrals, case-level client information, social norms, staff | Money | Social capital, involvement of sources of power, strategic alignment with existing infrastructure and resources | Data/information, money | Money, policies and procedures, required expectations, performance reviews (job security, opportunities for promotion) | EBP information, implementation data, social norms and sense of community, networking opportunities | Provider time, free access to experts, positive publicity for the university, tangible resources |
5 | Impact on outer and inner contexts | Outer and inner: provides structure for measuring, reporting, and providing the EBP | Outer and inner: provides structure for measuring and reporting clinical outcomes, and providing the selected EBPs | Outer and inner: provides care pathway to increase screening and retention in care | Outer and inner: provides a care pathway; Inner only: expands staff, provides structure for data management | Outer and inner: money flow from taxpayers to local jurisdictions | Outer and inner: synergy across state-wide policy, existing resources and organizations, infrastructure for sustainable training | Outer only: public health mission and ability to obtain financial resources; No direct benefit to inner | Outer and inner: bridging factor failure contributed to implementation failure in both inner and outer contexts | Outer only: see rationale. Inner only: can help secure contracts, provides outward legitimacy, information sharing across sites, may increase awareness around internal processes | Outer only: community impact, access to new sources of grant money and other research resources Inner only: generation of program data and information about the target population |
Form dimensions | |||||||||||
1a | Rationale | Community- academic partnerships | Political | Public health concern | Public health concern, model requirement | Political, public health concern | Political, regulatory, and community need | Regulatory, public health concern | Existing system structure | Program developers’ needs including the desire to better track implementation across sites | Individual’s decision-making and action |
1b | Implementation strategy | No | No | Yes | No | Yes | Not explicit | No | No | No | No |
1c | Regulatory context | Enforceable | Enforceable, voluntary | Encouraged, voluntary | Encouraged | Mandatory, enforceable | Voluntary | Mandatory | Mandatory, enforced | Voluntary but required if you want to provide SafeCare | Voluntary, unenforced |
2a | Duration | Varied by system | Short-term | Long-term | Long-term | Short-term | Both | Long-term | Long-term | Long-term | Long-term |
2b | Changes across implementation phases | Yes | Yes | Maybe | Maybe | Ideally | Yes | No | Yes | If program developer changes requirements | If policies change |
2c | Supports | Contracting person in service system, existing resources | Service system division, existing resources | NGO, existing and new resources | Training from model purveyors, Regional Behavioral Health Boards, money, existing and new resources | Legislation, existing and new resources | Implicit support from state government, high degree of collaboration, existing resources | Legislation, new resources | Existing resources rather than specific supports | Varies by site, some existing some new | Flexibility that comes with an academic position and the ability to print program materials |
3a | Multiple systems | Yes | No | Yes | Yes | No | Yes | Yes | Yes | Yes | Yes |
3b | General or specific | General | General | Specific | General | General | General to EBPs for ASD | General | General | General | General |
3c | Outcomes | EBP adoption, implementation and sustainment, staff turnover | EBP sustainment, staff retention | EBP sustainment | EBP fidelity, penetration, service outcomes (esp. timeliness) | EBP adoption and sustainment, workforce capacity, downstream clinical improvements | EBP adoption, implementation and sustainment | Equity, reduced number of new infections, EBP sustainment | Forced partnership led to failed EBP implementation, discontinuation of trainings, discontinuation of sustainment plan | EBP sustainment, “fidelity to the implementation process” | Reduced recidivism, improved infant health and bonding, increased client engagement, sustainability, reduced legal risk for the prison |