title: What strategies are used to build practitioners' capacity to implement community-based interventions and are they effective?: a systematic review.
abstract: BACKGROUND
  Numerous agencies are providing training, technical assistance, and other support to build community-based practitioners' capacity to adopt and implement evidence-based prevention interventions. Yet, little is known about how best to design capacity-building interventions to optimize their effectiveness. Wandersman et al. (Am J Community Psychol.50:445-59, 2102) proposed the Evidence-Based System of Innovation Support (EBSIS) as a framework to guide research and thereby strengthen the evidence base for building practitioners' capacity. The purpose of this review was to contribute to further development of the EBSIS by systematically reviewing empirical studies of capacity-building interventions to identify (1) the range of strategies used, (2) variations in the way they were structured, and (3) evidence for their effectiveness at increasing practitioners' capacity to use evidence-based prevention interventions.
  
  
  METHODS
  PubMed, EMBASE, and CINAHL were searched for English-language articles reporting findings of empirical studies of capacity-building interventions that were published between January 2000 and January 2014 and were intended to increase use of evidence-based prevention interventions in non-clinical settings. To maximize review data, studies were not excluded a priori based on design or methodological quality. Using the EBSIS as a guide, two researchers independently extracted data from included studies. Vote counting and meta-summary methods were used to summarize findings.
  
  
  RESULTS
  The review included 42 publications reporting findings from 29 studies. In addition to confirming the strategies and structures described in the EBSIS, the review identified two new strategies and two variations in structure. Capacity-building interventions were found to be effective at increasing practitioners' adoption (n = 10 of 12 studies) and implementation (n = 9 of 10 studies) of evidence-based interventions. Findings were mixed for interventions' effects on practitioners' capacity or intervention planning behaviors. Both the type and structure of capacity-building strategies may have influenced effectiveness. The review also identified contextual factors that may require variations in the ways capacity-building interventions are designed.
  
  
  CONCLUSIONS
  Based on review findings, refinements are suggested to the EBSIS. The refined framework moves the field towards a more comprehensive and standardized approach to conceptualizing the types and structures of capacity-building strategies. This standardization will assist with synthesizing findings across studies and guide capacity-building practice and research.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA. jleeman@email.unc.edu.|Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, CB #7424, Chapel Hill, NC, 27599, USA. jleeman@email.unc.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Leeman
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2200 McGavran-Greenberg Hall, CB #7461, Chapel Hill, NC, 27599, USA. lcalancie@unc.edu.
authors.forename: Larissa
authors.initials: L
authors.lastname: Calancie
authors.affiliation: Department of Behavioral Sciences and Health Promotion, University of Texas School of Public Health, 7000 Fannin, Houston, TX, 77054, USA. Marieke.A.Hartman@uth.tmc.edu.
authors.forename: Marieke A
authors.initials: MA
authors.lastname: Hartman
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1519 Clifton Road, NE, 5th Floor, Atlanta, GA, 30322, USA. cescoff@emory.edu.
authors.forename: Cam T
authors.initials: CT
authors.lastname: Escoffery
authors.affiliation: UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health, University of California, Los Angeles, CA, USA. aherrmann@ucla.edu.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Herrmann
authors.affiliation: Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, CB #7424, Chapel Hill, NC, 27599, USA. ltague@live.unc.edu.
authors.forename: Lindsay E
authors.initials: LE
authors.lastname: Tague
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, CB# 7295, Chapel Hill, NC, 27599, USA. Alexis_Moore@unc.edu.
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Moore
authors.affiliation: Division of Epidemiology, Analysis and Library Services, Community Guide Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-69, Atlanta, GA, 30333, USA. kwilson@cdc.gov.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Wilson
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA. mschrein@email.unc.edu.
authors.forename: Michelle
authors.initials: M
authors.lastname: Schreiner
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2200 McGavran-Greenberg Hall, CB #7461, Chapel Hill, NC, 27599, USA. cdsamuel@email.unc.edu.
authors.forename: Carmen
authors.initials: C
authors.lastname: Samuel-Hodge
mesh_terms: D057191:Capacity Building / Q000458:organization & administration*; D055317:Evidence-Based Practice / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009042:Motivation; D016730:Program Development; D011635:Public Health Administration