Implementation

Implementation is where the rubber hits the road — where communities do what they’ve said they’re going to do. When implementing substance abuse prevention programs, practices, or strategies, it is important to consider the following:

Action plan development: An action plan is a written document that lays out exactly how a coalition will implement the selected prevention program, policy, or strategy. It describes what a coalition expects to accomplish, the specific steps they will take to get there, and who will be responsible for doing what. Action plans are often laid out in a table format and they serve to keep staff and coalition members on track and focused. The most effective action plans have achievable, short-term projects with agreed-upon dates for accomplishments.  When coalition members see their accomplishments as part of a road map to success, they will be more committed and motivated to continue their work. Further, when they feel accountable, they understand the importance of their role to the success of the project.

Fidelity and adaptation: Fidelity refers to the degree to which a program is implemented as its original developer intended. Adaptation refers to how much, and in what ways, a program, practice, or strategies is changed to fit local circumstances.

When a program is implemented with fidelity, it increases the likelihood of effectiveness. However, adaptation can make a program more responsive to a target population and can increase its cultural sensitivity and its fit within the implementation setting. Documenting the adaptations to the program throughout the implementation phase is important. The rationale for the adaptations and the precise changes that were made to the program need to be described and monitored as part of the evaluation of the program, and always check with your technical assistance specialist before adapting an evidence-based program or practice.

Identifying Best Fit Interventions: Throughout the implementation phase, the logic model can be used to check the conceptual and practical fit of interventions considered for the comprehensive community plan. The logic model identifies points of intervention and helps plan for prevention strategies for a particular community based on the best available evidence and practices. The logic model can also help periodically check on interventions’ appropriateness to the community and cultural contexts. This is key because if the prevention program, policy, or practice does not fit the community’s capacity, resources, or readiness to act, then the community is unlikely to implement the intervention effectively.
Below is a list of utility and feasibility checks to consider in selecting and implementing prevention strategies.

Utility Checks:

  • Is the intervention appropriate for the population identified in the community needs assessment and community logic model? Has the intervention been implemented successfully with the same or a similar population? Are the population differences likely to compromise the results?
  • Is the intervention delivered in a setting similar to the one planned by the community? In what ways is the context different? Are the differences likely to compromise the intervention’s effectiveness?
  • Is the intervention culturally appropriate? Did members of the culturally identified group participate in developing it? Were intervention materials adapted to the culturally identified group?
  • Are implementation materials (e.g., manuals, procedures) available to guide intervention implementation? Are training and technical assistance available to support implementation? Are monitoring or evaluation tools available to help track implementation quality?

Feasibility Checks:

  • Is the intervention culturally feasible, given the values of the community?
  • Is the intervention politically feasible, given the local power structure and priorities of the implementing organization? Does the intervention match the mission, vision, and culture of the implementing organization?
  • Is the intervention administratively feasible, given the policies and procedures of the implementing organization?
  • Is the intervention technically feasible, given staff capabilities, time commitments, and program resources?
  • Is the intervention financially feasible, given the estimated costs of implementation (including costs for purchase of implementation materials and specialized training or technical assistance)?

Each of the points in the checklist warrants thoughtful consideration among those involved in planning, implementing, and evaluating the prevention strategies in the comprehensive community plan.

Prevention Framework

Implementation Resources