Methods for Evaluating Effectiveness of Implementation Strategies
Using a Randomized Implementation Trial
C. Hendricks Brown, Ph.D.
Department of Epidemiology and Public Health
University of Miami Miller School of Medicine
Prevention Research Center/
Methodology Center Presentation
Wednesday, March 2, 2011
Abstract
Implementation research involves "the use of strategies to adopt and integrate
evidence-based health interventions and change practice patterns within specific
settings" (Chambers 2008). As an important part of translational science,
implementation research is in the process of defining the scientific paradigms
guiding this young field. There are three important, interrelated methodologic
areas that need development in order to advance the field: measures to monitor
the implementation process, models to represent and analyze implementation, and
tests to evaluate implementation strategies. One ongoing study is the CAL-40
Randomized Implementation Trial, involving 40 counties in California that have
been assigned one of two implementation strategies to promote the adoption,
delivery with fidelity, and sustainability of an evidence-based foster care program,
Multidimensional Treatment Foster Care (MTFC). Using this trial as a model, we
discuss 1) a Stages of Implementation Completion (SIC) measure that can be used
to monitor the implementation process, 2) DATI, a computational representation of
an implementation strategy that permits modeling, and 3) the conduct of a
randomized implementation trial that compares a Community Development Team
approach to that of a standard implementation strategy.