Project Summary/Abstract
For implementation (and sustainment) of new interventions to be successful, it is critical that barriers are
identified and addressed prior to change. It is challenging, however, for agencies to independently assess their
own strengths and weaknesses and to develop plans for organizational improvement. Furthermore, the sheer
number of strategies to promote implementation makes it difficult for agency leadership to decipher which are
most appropriate for their own contexts and needs. This application proposes to develop and pilot test Mapping
Approaches to Prepare for Implementation Transfer (MAP-IT), an organizational intervention that includes four
key elements: (1) guidelines on forming an implementation workgroup to inform and promote implementation
efforts, (2) instruction on mechanisms known to impact implementation, (3) tools and instruction for conducting
an agency-driven diagnosis of potential implementation barriers, and (4) tools for developing an
implementation blueprint to address identified barriers (including instruction on strategies for addressing
potential barriers prior to implementation). The premise of this application is significant in that MAP-IT would
provide a low-cost (agency-driven opportunity for deliberate implementation preparedness, without ongoing
external coaching) and sustainable (skill development for multiple individuals within the organization that can
be applied to future implementation efforts) alternative to promoting organizational adoption of new practices.
The specific aims of the proposed research are as follows: Aim 1 – developing a comprehensive
implementation intervention to promote deliberate agency implementation preparation, MAP-IT, that builds on
our previous work by adapting and integrating three established lines of research – organizational assessment
and feedback; taxonomy of implementation strategies; and visual-spatial decision making techniques, and
AIM 2 – conducting a 2-arm cluster randomized efficacy trial of the MAP-IT intervention, with 12 substance
abuse treatment agencies randomized to either MAP-IT (EBP and MAP-IT trainings) or the control condition
(EBP training only). Successful completion of the aims is expected to (1) establish preliminary evidence for the
efficacy of a low-cost, sustainable alternative for improving implementation preparation that agencies can use
to support and expedite implementation transfer, (2) shift the current paradigm by encouraging researchers
(designing uptake studies) and health care agencies (independently striving to implement new practices) to
place greater emphasis on pre-implementation preparations for change, (3) provide an empirical examination
of how exploration and preparation can support implementation, using established measurement platforms and
theoretical frameworks, and (4) provide documentation of agency selection of implementation strategies for
promoting change in real-world settings. Findings from the proposed R21 will inform intervention effectiveness
testing and implementation strategy selection in a future R01 aimed at improving uptake of best practices
within behavioral healthcare delivery services using a full-scale randomized control trial.