Step-by-Step

Research & Implementation

Whether you are designing a new, innovative program or service from scratch or implementing an existing program or service, it’s important to use effective methods—or evidence-based approaches—to ensure you reach your desired outcomes. A step-by-step systematic framework can help you no matter what stage you are in, be it design, planning, development, research, implementation, evaluation, or sustaining. For Healthy Teen Network, an important component of this step-by-step framework is also to apply a human-centered approach.

Evidence-based strategies and approaches are effective and efficient ways to achieve positive outcomes. Related terms include science-based, research-based, or proven effective. Evidence-based strategies and approaches go beyond simply proven effective programs (also known as evidence-based programs or interventions).

“Evidence” includes a variety of possible strategies and approaches:

  • Using a needs and resource assessment
  • Using a logic model to identify data-driven goals, behaviors, and risk and protective factors (or determinants), based on the assessment
  • Using health behavior change theory/theories
  • Using proven effective, evidence-based, or evidence-informed programs and interventions
  • Using common characteristics of other proven effective, or evidence-based programs
  • Conducting process and outcome evaluation

Innovation is a critical component of a comprehensive strategy to respond to the dynamic lives of adolescents and young adults. Innovation is the creative development or adaptation of something to create something new that adds value or serves a purpose.

To be effective, innovation should apply evidence. For example, assessment findings could inform the development of a new program that will fit its priority population. Or, health behavior change theory, such as social cognitive theory, is used to develop intervention activities for a new innovative program.

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It can become overwhelming to think about everything it takes to integrate evidence-based approaches into program and service delivery.

New or existing, innovative or proven effective, you’ll want to integrate evidence-based (or research-based) approaches, step-by-step. A systematic framework can help you be evidence-based, whether you are…

  1. designing  or developing new, innovative programs or services;
  2. implementing proven effective, evidence-based interventions, programs, or services; or
  3. adapting existing programs or services.

Read more about step-by-step implementation frameworks…

Humancentered design is a creative approach to problem-solving that starts with deep empathy for the people you’re designing for and ends with new solutions tailor made to suit their needs” (www.ideou.com).

Assess

What problem do you want to focus on?

Before getting started, get to know the population you’d like to serve. If you already know them, document it with facts, figures, and data you collect. You can’t find a true solution if you aren’t addressing the real needs of the population and the circumstances that created those needs. A good needs and resource assessment is the foundation in program planning. Once your assessment is complete, you will have identified the behaviors and determinants (sometimes called risk and protective factors) that require your focus as well as the resources that will support the work.

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Goals

What are the goals, priority population, and desired outcomes?

Think of your logic model as your road map, identifying and linking the pathways between your goals and program activities. The BDI (Behavior-Determinant-Intervention) logic model is commonly used in the adolescent sexual and reproductive health field to link activities with goals.

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Evidence & Innovation

What existing evidence-based approaches and best practices worth adopting?

The gold standard for proven effective interventions are usually called Evidence-Based Interventions (EBIs) (also known as evidence-based programs, or EBPs), which are programs that have been rigorously evaluated to show change in sexual risk-taking behaviors (such as having sex, having multiple partners, or using condoms correctly and consistently).

Using an intervention that is proven to work is useful not only because of the potential outcomes for participants, but also because it adds a level of quality assurance when you plan how to spend your resources.

However, not all high quality programs are EBPs. Some interventions simply haven’t been rigorously evaluated yet and that’s ok (depending on what your funding requirements are). Programs like this are sometimes called “innovative” or “promising.” There are ways to review if a program is still both based in what research says works and is a good fit for your population.

Read more about evidence and innovation…

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Fit

What modifications, or adaptations, should be made to fit the program or best practices with your needs?

Reviewing for fit takes the few programs you selected when you looked into best practices (usually 2-4 interventions) and checks if they match the needs and values of participating youth and the surrounding community. Distinguishing a good “fit” involves not only matching a program with the needs of the youth, but also aligning the program with the values of the community (or working with the community to build their support for the programming) and making sure that the program fills a need and doesn’t duplicate programming elsewhere.

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Capacities

What capacities are needed to implement the program or best practices?

With your short list of possible interventions, compare what these programs require in terms of resources, staff time, funds, etc., and what you organization has to offer. Anywhere you identify gaps, decide it makes sense to build those capacities to do that intervention. With this in mind, further narrow your list of programs down to just the one(s) you plan to implement, and make note of areas your organization will need to build its capacity.

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Plan

What is your plan for getting started: who, what, when, where, and how?

The planning process will act as a road map or blueprint to follow to reach the destination of success. How well you plan prior to implementing will determine how smooth the program will run. Before implementation, your plan should include everything from your hiring process to how you plan to train your staff. During implementation, the planning method should include details such as the start date, the responsibility of the staff, and more. Your plan to evaluate the program should include the evaluation methods you plan to use, such as evaluation tools, observation activities, or surveys. Your plan should bring together all of the decisions you’ve made in the previous stages and help get your team ready for implementing, monitoring, and evaluating the selected program. At this point, you should have selected a program, planned adaptations if needed, completed the logic model, and outlined a detailed plan for implementing your program.

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Implement

Track planning and implementation: how did it go?

In this step, you can take all of the hard work you put into making your program perfect and put it into action. At this point, you have selected your program and planned how to implement it, which is a huge accomplishment! However, it is extremely important that the program is being implemented with quality. Monitoring the quality of the implementation process normally includes process indicators (i.e., attendance logs, satisfaction surveys, observation surveys, etc.). While implementing your program, develop a process evaluation plan and monitor the indicators while running your program, measure the quality of activities and program fidelity, and then move onto evaluating the outcome of your program.

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Evaluate

Was the program successful in achieving the desired results?

This is your chance to see if the program you implemented, met the desired goals you set forth. Now ask yourself, how well is the program working?  And what can I do to continuously improve it? Look for changes in knowledge, skills, attitudes, and behaviors of participants as a way to measure the success of your program.

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Improve

How will you continuously improve the quality of the program (CQI)?

Continuous quality improvement (CQI) strategies include using process and outcome evaluation data to make necessary changes to improve your program moving forward.  Regularly consider feedback from evaluation information in order to improve your program’s future contributions. Encourage your staff and participants to be a part of the learning circle, in which everyone is open to sharing, learning, and continuously working to make the program better. Keep in mind, during this time, the results from your process and outcome evaluation will help most.

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Sustain

If your program is successful, how will it be sustained?
This is where you make certain that your program is set up to continuously be offered. Continue to practice the methods that were most successful. Unfortunately, one of the realities you will face is that even successful programs may not continue because funding gets cut. There are several strategies to ensure your program is secure over time including:
  • Program financing: obtain new external funding
  • Program champions: obtain an influential program advocate or champion to generate goodwill
  • Training: train staff so they continue to provide programming and train others
  • Institutional strength: work to maintain organizational capacities and use your Board
  • Integration with existing programs/services and managing controversy: carefully and thoughtfully approach controversy

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Featured Resources

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