Thank you all for sending your suggestions about which sessions you wish you could have attended. I of course wasn’t able to attend them all, but I went to the ones that got the most ‘votes.’ Below are my “big take-home” notes for the sessions I attended, they were gathered and written throughout the conference and here and there these past two weeks. I know there is a lot there, skim for BOLD words for big ideas or cool tidbits. Email me with questions, ideas, or share a comment below!
Global Collaboration (Pre-session)
- Teams from around the globe presented their progress, their challenges, and their goals for the future. These were groups that formed since GIC in 2011, there were two US groups (CO, NC), Australia, and Europe. Australia began a national conference for their region—EpisCenter leader, Brian Bumbarger was their keynote speaker, he has spearheaded a state-wide implementation of use of evidence based or evidence informed practices with systematic review and evaluation of program quality. The US groups have created ‘working groups’ and ‘learning communities’ and Colorado has created some training available for a larger group.
- Globally these organizations are struggling with gaining ongoing engagement and took lessons and strategies from the other groups to create strategies for their future group plans.
Advanced Implementation (Pre-session): Changing Human Service Systems Through Implementation Teams
Robyn Mildon, Terje Christiansen, Katie Burke, Melanie Barwick
Robyn Mildon is a very dynamic presenter and she told the store of her agency trying to get resources and training to understaffed, underfunded, extremely rural areas (like, only accessible by plane), she spoke about the challenges in these systems and the need for a team to push through, lead, and ensure all of the different aspects of implementing interventions are continued over time. Melanie Barkwick had a national system of child welfare services that were being re-coordinated through implementation teams, her agency’s website www.effectiveservices.org/implementation holds not only information about Ireland’s work, but also has an extensive library and series of podcasts available for the public.
GIC 2013 Opening Session
- Dean Fixsen spoke about the founding of the idea of GIC and the goals for the future of the Global Implementation Initiative which emerged as an organization after the first GIC. They presented the 2020 vision (in the shared files)
Poster Presentations happened on day 1 and Day 2
- Crowds of people walking, milling, snacking, talking, and asking questions. If you’ve never been to a Poster presentation before, they are really neat events. Individuals (or small groups) create posters about a project, investigation, initiative, or other research they have done. Almost as much as a full report could be up on their board, or as little as you’d see in a power point presentation, but the best part is that you can ask the presenter individually about things you were specifically interested about.
- The most interesting poster, I think was from the University of North Carolina. This group functions as technical assistance and capacity builders for regional and local leaders and focused on something that resonated with me because of the agencies competencies: Implementation workforce development: Creating competent implementation specialists. They explained how they were able to go in and build local specialists and began by meeting the staff where they were in terms of skills and implementation competency. Then once they were trained, they would be the local experts and guides with ongoing technical assistance from the team.
Morning Plenary: Sonja Schoenwald
- Professor, Family Services Research Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (United States) Schoenwald is one of the primary developers of MST and spoke a bit about the use of Fidelity measures over time and what they mean in terms of helping create sustainable programs and implementation success.
Capacity Building and the Crucial Role of Middle Managers in Implementation,
- GIC tried to create interactive break-out sessions between the big group plenaries and meetings. These sessions included several different, unrelated presenters talking about their own project, how they fit together, and how they fit within implementation science. This session had two presenting groups taking turns offering their piece of the story. First, Henna Hasson from the Karolinska institute (in the same institution as where the Nobel Prize is presented!), and her co-facilitator, talked about their study of ‘middle-managers’ or people that work with ‘frontline’ staff. They talked about the different pressures and realities that are faced and how these effect decision making about program implementation. Ron Dughman from Mountain Plains Regional Resource Center then talked about the Communication Protocol and the Hexagon Tool, both based on NIRN work (National Implementation Resource Network). These two could function to help ensure that lines of communication in all levels of an organization are kept open and clear and programs fit the realities that organizations are facing. After going back and for ‘piggy-backing’ on each other’s ideas, they had the audience do small group discussions and brainstorm alternative ways of using these tools such as using the Hexagon Tool for hiring, using the hexagon tool as an ad hoc assessment of programs to understand how to move forward, and using the Communication Protocol Worksheet on a small scale, then working on scaling up and into other departments. During this meeting, I worked in a group with two people from Los Angeles child services, and a woman who does international work, ensuring use of research in health interventions.
Implementation Science Synthesis: Practical Implementation Science: Tools, Processes, and Evaluation
- This was the best session overall. The room was packed, people were sitting on the floor, standing on the edges of the rooms, and listening intently as Abe Wandersman, Joie Acosta and their colleagues discussed how Getting To Outcomes works, is experienced by groups, and has had research done to show its effectiveness. Getting To Outcomes is an organizational intervention, sort of how any intervention our staff do with our clients. It has a manual, online training, worksheets and tools all available for free and the possibility of technical assistance and consultation. The intervention works on creating a system and environment that helps organizations implement a new practice, usually an evidence based practice. It helps prepare for all of the logistics and all of the less tangible aspects of implementing a new program, OR, and here was the most exciting piece, ensuring that an existing practice can remain sustainable and evidence informed over time. This program has been used by CDC, SAMSHA, and Rand Health initiatives and has had research done to back-up its effectiveness. The people that work on GTO had implemented the program in the field and were also technical assistance for groups. A second set of presenters talked about a New York state initiative to implement health intervention in schools, this is being done by ACT for Youth, based out of the Bronfenbrenner Center at Cornell (yes, the place where TCI came from!). If you want to learn about these, let me know!
There’s more below!
Afternoon Plenary: Dr. Tony Bates
Founder Director, Headstrong: The National Centre for Youth Mental Health (Ireland)
Dr. Bates gave a delightful presentation that I already wrote about in the Blog. Here is what I said:
One of the workshops I attended really focused on a protocol to work through Adaptive and Technical Problems by first identifying what type of problems we were facing. All of these ideas were very nicely illustrated by Dr. Tony Bates’ wonderful (and inspiring) plenary presentation. What struck me (more than the AWESOME use of data to plan and make decision making, the involvement of stakeholders (=youth), and the beautiful application of the vision of providing accessible mental health services to young people) What really blew my mind, was a slide that showed that it took 3 years for the program to reach stability. If you are familiar with Implementation Science, that is very often repeated, you aren’t truly doing your program full justice the first few years, but seeing Dr. Bates present a success and hearing how it really did take three years (three years on the edge of chaos, possibly) was inspiring and energizing. (Some of you may have seen the extra skip in my step when I got back?)
Learn more about the program: http://www.headstrong.ie/ look for “Jigsaw”
Their DATA: https://jigsaw.reachoflouisville.com/Infographics/
Morning Plenary: Richard Spoth Iowa State University (United States)
Richard Catalano University of Washington (United States)
- · The final plenary was shared by Dr. Spoth and Dr. Catalano, they both worked on similar research on systems to implement community interventions, PROSPER and Communities that Care. The remarked on the need for community leadership and training to help sustain long-term success along with monitoring of model fidelity and of monitoring what adaptations are made and how. All the while monitoring outcomes to truly understand what is/isn’t working and how this can be replicated or scaled up in the future.
Block 1: Building the Infrastructure for Implementation and the Capacity to Lead Within
- This was my second favorite session, this was more fun, practical, hands on, and really had the power to change the perspectives of the audience. I was a volunteer and got to be part of the demonstration! Two different groups came and presented on internal leadership and how it championed and moved forward initiatives. A team from the University of Texas implemented Wraparound in the State Mental Health system. Not a small feat considering not only the population of the state, but the geographic breadth, and cultural … stubbornness (they were more diplomatic about it), that is found in Texas. They took turns relaying their stories, techniques. The most intriguing ‘revelation’ was that there is the need for two types of changes in an organization, adaptive and technical. These two type of changes then fit in the Implementation Drivers Triangle, Technical needs are easy to deal with there is a practical solution that may require special knowledge or skills, but it can be done and effect the organization positively. Adaptive changes are the most difficult to complete, these involve changing culture, ideas, minds, and habits and require not only an increase in knowledge or skills, or one person to have special skills, but for a whole system to give up either power, habits, loyalty to how things were, material things, or even lose the feeling of knowing what’s best. These are absolutely normal reactions that once compounded by an organization can delay growth and change.
- After the teams took a few turns relaying information and facilitating discussion, they tested out the techniques that West Wind (consultants in education policy) use with their clients to help solve organization issues. We tried to help the UT team understand their real-life problem better to help them move forward and plan strategically how to sustain their partnership with Texas Mental Health. If you want to see the protocol we used, or hear more about it, let me know!! We can try it, too, to see if you want to implement this with your teams. The tool is called the Collaborative Inquiry Protocol, try a quick internet search or email me for a copy!