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Step 5 - Adoption, Implementation & Sustainability (Tasks (state…
Step 5
- Adoption, Implementation & Sustainability
Tasks
identify potential program users
adopters
implementers
maintainers
you want enthousiastic AND critical people
state
program use outcomes & performance objectives for program use
(adoption,implementation & sustainability)
WHO
needs to do
WHAT
and WHEN in order to be sure that your program is used
COMPLETE
and with
FIDELITY
and
SUSTAINED
dissemination
= spreading the program, making people aware that it exists -->
done by planning group
adoption
= decision to use program
sustainability
= maintenance and institutionalization of progam
implementation
= use of program
construct
matrices of change objectives for program use
(adoption, implementation & maintenance)
design
implementation interventions
specifiy determinants of program adoption, implementation & sustainability
re-evaluate planning group
select
methods
& practical applications
planning for program use is essential
impact
of health education program will be
determined by...
quality of program implementation
is program used completely & fidel?
effectiveness of interventions
how many people received the program?
population exposed to program
partly based on implementation of IM Steps
Program use over time
dissemination
= aware
implementation
= actual use
adoption
= intention to use
sustainability
= maintained use
Diffusion of Innovation Theory
innovators
early adopters
early majority
late majority
laggards
Questions
Who will decide to use the program?
Which stakeholders will these decision makers need to consult?
Who will make resources available to implement the program?
Who will implement the program?
Will the program require different people to implement different components?
who will ensure that the program continues as long as it is needed?
Again,
Core processes!
brainstorm
answers
ask
questions
look for
evidence
perform
additional research
if necessary & possible
formulate
answers
Barriers
for decision makers
imposition of programs from the outside
competing demands
unstable finances or organizational structure
limited staff time
Program use outcomes
Adoption
=
Someone adopts the program as indicated by the evidence to indicate adoption
...e.g: The curriculum commitee of the School District adopts the sexual health program as indicated by the superintendant signing the program adoption form
Implementation
=
The organization/individual will implement program with completeness and fidelity (according to guidelines)..
.e.g.: The health teachers in the Netherlands will implement Long Live Love completely (all lessons) and with fidelity (according to teacher manual)
Maintenance/Sustainability
=
decide on type of outcome to be achieved (maintenance of program, institutionalization, continuation of health effects, some combinations)
...e.g.: The Dutch schools will incorporate the LLL program into school organizational routines (Institutionalization)
Determinants of Adoption & Implementation
Characteristics of Innovations
relative advantage, compatibility, complexity, observability, impact on social relations, required time, risk & uncertainty, ability to be modified, response of target group to program
Organizational constraints
time, resources, social support, reinforcement, leadership & vision, absorptive capactiy,
no space, no support etc.
Determinants of Actors
knowledge, self-efficacy, attitude, risk perceptions, ,
outcome expectations