title: From a "perfect storm" to "smooth sailing": policymaker perspectives on implementation and sustainment of an evidence-based practice in two states.
abstract: Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems.
authors.affiliation: Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, Albuquerque, NM, USA Department of Anthropology, University of New Mexico, Albuquerque, NM, USA cwillging@pire.org.
authors.forename: Cathleen E
authors.initials: CE
authors.lastname: Willging
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Green
authors.affiliation: Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, Albuquerque, NM, USA Department of Anthropology, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Gunderson
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Chaffin
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Aarons
mesh_terms: D026683:Advisory Committees; D002648:Child; D002649:Child Abuse / Q000517:prevention & control*; D002669:Child Welfare / Q000706:statistics & numerical data*; D003299:Cooperative Behavior; D055317:Evidence-Based Practice / Q000458:organization & administration*; D006284:Health Plan Implementation; D006285:Health Planning / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D011050:Policy Making; D014481:United States
keywords: child maltreatment; child welfare services/child protection; dissemination/implementation; evidence-based practice; home visiting; qualitative research