Implementation Through Community Coalitions: The Power of Technology and of Community-Based Intermediaries.

Abstract

The measurement and monitoring of implementation fidelity or of adaptations to interventions in the ways described by the innovative papers in this special issue implies the need for an 'implementation infrastructure' to help assure the quality and hence impact of prevention delivery systems. In our work in Australia through schools and government-funded community services in socially disadvantaged communities we have begun to build such an infrastructure, which we call a Prevention Translation and Support System (PTSS). We offer our methodologies not as a template but as an illustration of one approach, designed for use with community coalitions. We aim to work in respectful partnerships with frontline professionals to construct, test, modify, and implement measurement tools and other electronic resources that can facilitate data-driven decision making and evidence-based practice, and generally promote the translation of prevention science into routine practice. The development and use of these technological resources are supported by community workers called Collective Change Facilitators, who act as a 'human bridge' between the worlds of research and practice. They serve as a critical friend to community coalitions, while also translating the needs of service deliverers back to the researchers and practitioners building the PTSS. One example of this engagement was the development and use of a multidimensional measure of coalition function, the Coalition Wellbeing Survey, that helps coalition leaders plan responsive action to overcome identified areas of difficulty and strengthen coalition function. The need for such a tool, accompanied by comprehensive resources, was identified early in our work as essential for the high-quality implementation by community coalitions of evidence-based services. We conclude that implementation of preventive innovations on a large scale, especially those in which technology is embedded to support measurement and monitoring, calls for the creation of new kinds of intermediate organizations that can help sustain a continuous process of research and quality improvement in the field.