Designing and Redesigning Technical Assistance Systems to Support Evidence-Based Programs: Sharing Challenges and Solutions

Although the field of prevention science has made great strides in recent years in the development and evaluation of effective public health programs, the full potential of these interventions has yet to be achieved. Recent advances in translational science have sought to address these barriers by identifying factors that contribute to high-quality implementation and sustainability of evidence-based interventions. Among these advances include the use of collaborative, community-based coalitions to deliver and monitor programs, as well as the provision of technical assistance (TA) to program implementers, and collaborative community coalitions, overseeing evidence-based interventions.

The goals of TA are complementary at the program- and coalition-levels. At the level of the evidence-based program, TA provides supports to local implementers that positively contribute to the implementation quality and the effectiveness of interventions. The goal of TA at the community coalition-level is to increase the capacity of a collaborative body to successfully embed implementation of selected evidence-based programs within a larger sustained community-systems change effort. Together, TA at the program- and collaborative/system-levels supports the sustainability of high-quality implementation of evidence-based programs to maximize their public health impact, and often TA providers to coalitions have generalizable knowledge and skills that enables them to provide TA at both levels, the program-level and the coalition-level.

 Recent research suggests that implementing evidence-based programs within the context of a proactive TA model may be more cost-effective than implementing a single stand-alone program; in other words, the cost per program “graduate” is lower when supported by a proactive TA model. Yet, the resources required to build and maintain the TA infrastructure tend to be difficult to raise. Consequently, technical assistance providers have to make adjustments from the ideal TA model to one that they believe will be effective, despite some changes. This roundtable brings together key investigators and leaders of five different community-prevention systems within the United States and in the international community that are actively experiencing this struggle. Specifically, this session will provide a forum for discussing these challenges, decisions, and the thought processes that led to decisions. The chair of the roundtable will begin with a 5-minute overview followed by 5-minute highlights from each panelist, including their unique perspectives. The remaining hour will be used for dialogue with session attendees regarding challenges and solutions to gaining support for technical assistance, and will share some of the unique strategies that have been used to create compromise given current funding limitations.