Assessing Capacity for the Implementation and Scale-up of Effective Parenting and Family Support Programs in Community Public Health Collaborations

Introduction: Organizational and systems capacity to implement evidence-based prevention programs has been identified as a key factor in the scale-up of prevention science within primary care settings and via public health approaches (e.g., Chinman et al., 2016; Feinberg et al., 2008; Spoth & Greenberg, 2011). Few (e.g., Metz et al., 2014; Ogden et al., 2012) have assessed core implementation components related to implementing or scaling innovative programs. Across two years, investigators from the North Carolina Triple P Implementation Evaluation (TPIE) adapted and repeatedly tested measures of community coalition implementation capacity and individual service agency implementation infrastructure to support the scale-up of a system of evidence-based parenting programs.

Methods: The Coalition Capacity Assessment for Scaling the Triple P System of Interventions (CCA-TP) and the Implementation Drivers Assessment for Agencies Implementing Triple P Interventions (IDA-TP) are facilitated group self-assessments adapted by investigators from prior implementation science tools (e.g., Blase et al., 2013; Van Dyke et al., 2012) and are based on identifications of core implementation components (e.g., Fixsen et al., 2009; Metz & Bartley, 2012). The CCA-TP was administered to coalition lead agencies (N = 2) and the IDA-TP to coalition serviceagencies within two county Triple P coalitions (N = 22 and N = 17 at Time 4) in North Carolina semiannually over two years. Internal reliability, face validity of results among system stakeholders, and predictive validity were or are being examined.

Results: Internal reliability of IDA-TP index scores was good to strong across both counties at Time 4 (α = .75 - .96), though sample variance was insufficient for testing one of nine indices. Using qualitative methods, system stakeholders indicated general agreement between assessment results (CCA-TP and IDA-TP) and their lived experience within the community coalitions. The IDA-TP Agency Implementation Capacity Index and IDA-TP Agency Sustainability Planning Index separately predicted agency continuation of implementing Triple P interventions. Additionally, the paper will report on the relationships between key IDA-TP indices and: (1) percent of Triple P practitioners active within service agencies, (2) percent of practitioners that had delivered Triple P at all, (3) practitioners’ Triple P adherence, and (4) agency implementation climate for Triple P.

Conclusions: The CCA-TP and IDA-TP, particularly when used in combination, offer needed assessments of multi-level implementation capacity within community prevention coalitions. These instruments, though needing additional research, may help fill the assessment gap for understanding systems capacity to scale evidence-based prevention programs.