What strategies are used to build practitioners’ capacity to implement community-based interventions and are they effective?: a systematic review

Abstract

BackgroundNumerous 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.MethodsPubMed, 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.ResultsThe 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.ConclusionsBased 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0272-7) contains supplementary material, which is available to authorized users.

Use of Quality Improvement Strategies Among Small to Medium-Size US Primary Care Practices

“…Primary care practices use quality improvement (QI) strategies, such as monitoring and assessing outcomes, having skilled QI teams, and using system redesigns to improve patient and population health outcomes, system performance, and clinician experience, and to reduce health care costs. [2][3][4][5][6] Implementing QI strategies can help practices deliver appropriate health services efficiently and improve health outcomes, [7][8][9][10] yet much of what we know about the use of QI strategies in medical care comes from surveys conducted mostly in hospitals and health systems.…”

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Public health nutrition capacity: assuring the quality of workforce preparation for scaling up nutrition programmes

“…The review (40) recommended that community-based programmes should be inserted into the wider health system and that CHW be included in health human resource planning. A recent systematic review of strategies used to build practitioners' capacity to implement community-based interventions found them to be effective at increasing practitioners' adoption and implementation of evidence-based interventions (41) .…”

Impact of the Cancer Prevention and Control Research Network: Accelerating the Translation of Research Into Practice

“…Multiple centers have built on the workgroup’s curriculum to deliver and test local capacity-building interventions. 12–14 Workgroup members collaborated a literature review to guide the design of capacity-building interventions 15,16 and collaborated on an NCI grant (4R01CA163526-05) to develop and test an online tool (IM Adapt) based on Intervention Mapping framework 17 that guides practitioners through a systematic process of selecting and adapting evidence-based interventions (EBIs) to fit their local community and context. 18 This project formed an advisory group with representatives from multiple CPCRN sites and is being beta tested.…”