Implementation Science: Closing the Gap Between Innovation and Practice

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1 2013 Leadership Symposium on Evidence Based Practice Implementation Science: Closing the Gap Between Innovation and Practice January 8, :30 am 4:30 pm Presented with collaboration among University of California, Davis Conference Center & Alumni Center

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3 Implementation Science: Closing the Gap Between Innovation and Practice Opening Comments from the Planning Committee 9:30 am Stuart Oppenheim, Child and Family Policy Institute of California CFPIC) Barrett Johnson, California Social Work EducationCenter (CalSWEC) Evolution of the Conversation Evolution of the California Implementation Science Collaborative Goals and Objectives for Today and Future Activities State of the Science Plenary Session Moderator: Thomas E. Backer, Human Interaction Research Institute John Landsverk, Child and Adolescent Services Research Center (CASRC) Dean Fixsen, National Implementation Research Network (NIRN) Larry Palinkas, School of Social Work, University of Southern California 10:00 am In this interview style discussion session, three of the pioneers in implementation science will talk about some of the key questions on which the entire Symposium turns: What are the main models of implementation, and how have they evolved as the field has grown? How can science contribute to improving the definition of EBPs in human services, health, and related fields? What are the most frequently used and best validated methods for promoting implementation of EBPs? What are the most important challenges the field faces at this point in time? What are the most important future directions for the field? Table Talk Q&A for Presenters LUNCH Workshops (Descriptions and bios begin on page 3.) 1. Leadership in Evidence Based Practice Implementation Greg Aarons 11:00 am 11:30 am 12:00 pm 1:00 2:30 pm AGR Hall Alumni Center [1]

4 2. Key Steps in Implementing an EBP: Exploration and Preparation Jennifer Rolls Reutz and John Landsverk 3. Community Development Team: Building Organizational Infrastructure to Help Support Implementation Lynne Marsenich and Todd Sosna 4. A Community Corrections Journey Toward Effective Practice: Blending Community Corrections Research Principles with Implementation Science Robert Edmisten 5. Social Networks and Implementation of Evidence Based Practices Lawrence A. Palinkas BREAK 6. Implementation Science as a Guide to Design and Operation of a Professional Development System Dean Fixsen, Norm Gold, Erin Vidal, and Yee Wan 7. Implementation Tools and Practices to Support Student Success in a Large School District A Trainer of Trainers Approach Virginia Davis and Sara McClellan 8. Re purposing an EBP: Adapting and Implementing the Multifamily Group Program Alex Kopelowicz and Thomas E. Backer Facilitated Discussions by Discipline Ballroom C Conference Center Ballroom A Conference Center Allewelt Conference Room Alumni Center Conference Room A Conference Center Ballroom B Conference Center Conference Room B Conference Center Founders Board Room Alumni Center Attendees from the Child Welfare, Education, Human Services, Mental Health, and Corrections/Probation disciplines will reflect and discuss current and future strategies to improve implementation. Room listings for the afternoon Facilitated Discussions by Discipline: Education Mental Health Child Welfare Services Other Human Services Criminal Justice/Probation Report Out, Closing, and Next Steps 2:30 pm 2:45 3:30pm Ballroom C, Conference Center Conference Room A, Conference Center AGR Hall, Alumni Center Conference Room B, Conference Center Allewelt Conference Room, Alumni Center 3:45 pm [2]

5 Descriptions of Workshops 1. Leadership in Evidence Based Practice Implementation Room: AGR Hall, Alumni Center Presenter: Greg Aarons, Ph.D., Psychologist and Professor of Psychiatry, University of California, San Diego Description: Leadership is often identified as an important factor in system and organizational change. There is increasing evidence that strong and effective leadership is a key factor in successful evidence based practice implementation efforts. This presentation will address what we know about leadership in implementation and provide an example of a National Institutes of Health funded project that is developing solutions for effective leadership and organizational change strategies to improve the implementation and sustainability of evidence based practices in mental health, child welfare services, and alcohol/drug treatment. 2. Key Steps in Implementing an EBP: Exploration and Preparation Room: Ballroom C, Conference Center Presenters: Jennifer Rolls Reutz, M.P.H., CEBC Research Coordinator, and John Landsverk, Ph.D., CEBC Scientific Director Description: This workshop will focus on the earliest stages of implementation the exploration and preparation phases which build the foundation for successful implementation. The California Evidence Based Clearinghouse for Child Welfare (CEBC) has been working with child welfare systems to evaluate the level of evidence for programs in their systems. Through this process, the CEBC has developed a pathway to help navigate the exploration and preparation phases of implementation and to assist counties in determining where and how to implement new practices. 3. Community Development Team: Building Organizational Infrastructure to Help Support Implementation Room: Ballroom A, Conference Center Presenters: Lynne Marsenich, LCSW, and Todd Sosna, Ph.D. Description: The Community Development Team (CDT) Model has been used to support and sustain 10 evidence based programs in 38 of California s 58 counties. In addition, the model has been tested in a random controlled trial (RCT) funded by the National Institute of Mental Health. This workshop will focus on our experiences using the CDT to help child serving systems and agencies overcome common but thorny barriers to successful implementation. We will cover organizational and administrative supports; workforce development including training, coaching, and supervision; planning for turnover; fidelity; flexibility; and fit with state policy initiatives. [3]

6 Description of Workshops (cont d) 4. A Community Corrections Journey Toward Effective Practice: Blending Community Corrections Research Principles with Implementation Science Room: Allewelt Conference Room, Alumni Center Presenter: Robert Edmisten, Supervising Probation Officer, Sacramento County Probation Department Description: Approximately nine years ago, the Sacramento County Probation Department initiated the implementation of evidence based practices within the organization. The department educated staff/managers/community stakeholders, began using risk/need assessment instruments, and initiated evidence based interventions targeting criminogenic needs. In the years since, it became apparent that implementation is much more than just putting a new program/strategy in place and calling it a day. Ongoing training in evidence based principles, keeping current on evidence based research/techniques, utilizing internal/external expertise, maintaining continuous quality improvement, and coaching in evidence based skills are crucial for sustainability and effectiveness. This workshop will discuss the Probation Department s implementation experience and how we are looking to the emerging field of implementation science as we move toward being effective in reducing crime and enhancing public safety. 5. Social Networks and Implementation of Evidence Based Practices Room: Conference Room A, Conference Center Presenter: Lawrence A. Palinkas, Ph.D., School of Social Work, University of Southern California Description: This workshop will examine the structure and operation of social networks of information and advice and their role in making decisions about whether to adopt new evidence based practices (EBPs) among agency directors and other program professionals in 12 California counties participating in a large randomized controlled trial (RCT). Interviews were conducted with leaders in county probation, mental health, and child welfare departments. A mixed methods approach was used for the examination of associations between advice seeking and network structure. Collaboration was viewed as critical to implementing EBPs, especially in small, rural counties. Other immediate and follow up findings will be presented during this workshop. [4]

7 6. Implementation Science as a Guide to Design and Operation of a Professional Development System Room: Ballroom B, Conference Center Presenter(s): Dean Fixsen, Co Director, National Implementation Research Network (NIRN), Norm Gold, Ed.D., Sacramento, Evaluation Consultant to A.L.L.; Erin Vidal, Administrator of Special Programs GATE & Equity Coaching, Campbell Union School District; and Yee Wan, Ed.D., Project Lead, A Look at Learning (A.L.L.), and Multilingual Programs Coordinator, Santa Clara Office of Education Description: This workshop describes how implementation science has guided the development of A Look at Learning (A.L.L.) a comprehensive professional development (PD) system for teachers of English Learners (ELs) now reaching 24 school districts across 12 counties. For three years, A.L.L. has employed features of the Active Implementation Frameworks (Fixsen et al., 2005). The system makes use of structures that foster development of within district implementation teams as well as cross district collaboration among implementers. The PD system itself and the core A.L.L. team make frequent use of cycles of improvement and focus on careful attention to stages of implementation and the core implementation drivers. The workshop will be of interest to education leaders working at university, county, and school district levels, as well as to leaders in other practice areas who are working to implement and scale up major professional development initiatives. 7. Implementation Tools and Practices to Support Student Success in a Large School District A Trainer of Trainers Approach Room: Conference Room B Conference Center Presenter(s): Virginia Davis, M.A., WestEd Senior Research Associate/San Diego Project Manager, and Sara McClellan, Ph.D., WestEd Organizational Consultant Description: This workshop is intended for those interested in applying implementation frameworks to guide large scale improvement initiatives. It will draw from the Active Implementation Frameworks developed by Fixsen et al. and focus primarily on the exploration stage of implementation, providing concrete strategies and tools that purveyors and staff can use to establish and strengthen implementation teams, identify evidence based programs and practices to support success, and disseminate implementation frameworks on a wide scale. WestEd has been partnering with a large urban school district to prioritize improvement initiatives, strengthen leadership teams, and make programmatic decisions based on compelling evidence of increased student achievement. They advocate a train the trainer model that provides tools and practices that leaders can use to train others. [5]

8 Description of Workshops (cont d) 8. Re purposing an EBP: Adapting and Implementing the Multifamily Group Program Room: Founders Board Room, Alumni Center Presenter(s): Alex Kopelowicz, M.D., Human Interaction Research Institute and UCLA Department of Psychiatry, and Thomas E. Backer, Ph.D., Human Interaction Research Institute Description: This workshop will provide an overview of two related research based implementation programs focused on adaptations of a well validated EBP, the Multifamily Group (MFG) program, originally designed for use with families of adults with serious mental illnesses. The MFG program has been re purposed in two researchbased implementation efforts: (1) the Latino MFG (a Spanish language culturallyadapted EBP for Latino families, the focus of a seven year large randomized controlled trial (RCT) study funded by the National Institute of Mental Health and a five year implementation effort supported by the Annie E. Casey Foundation), and (2) the Employment MFG (an adaptation to empower families of people often, but not always, with mental health problems, and some also Spanish speaking dealing with long term unemployment, also supported by Casey). [6]

9 Biographies of Keynote Speakers Thomas E. Backer, Ph.D., is President of the nonprofit Human Interaction Research Institute, which celebrated its 50th anniversary in He also is Associate Clinical Professor of Medical Psychology at the UCLA School of Medicine and was a Senior Fellow at UCLA s School of Public Affairs in He is the author of more than 500 publications, including the recent books Evaluating Community Collaborations and The Expanding Universe: New Directions in Nonprofit Capacity Building. Dr. Backer Has conducted research for more than 40 years on dissemination and implementation of innovations. Dean L. Fixsen, Ph.D., began his career in human services in 1963 as a psychiatric aide in a large state hospital for children with developmental delays. He received his doctorate in experimental psychology from the University of Kansas in Dr. Fixsen has spent his career developing and implementing evidence based programs, initiating and managing change processes in settings serving children, families, and adults. He is Senior Scientist at the Frank Porter Graham Child Development Institute at the University of North Carolina, Chapel Hill and Co Director of the National Implementation Research Network. John Landsverk, Ph.D., has a doctorate in sociology and advanced training in epidemiology and mental health services research. He is Director of the Child and Adolescent Services Research Center and Scientific Director for the Chadwick Center for Children and Families, both at Rady Children s Hospital in San Diego. Dr. Landsverk also holds appointments as Senior Scholar at the Brown School of Social Work at Washington University in St. Louis, Senior Research Professor at the School of Social Work at the University of Southern California, and Research Scientist at the Oregon Social Learning Center. Lawrence Palinkas, Ph.D., is the Albert G. and Frances Lomas Feldman Professor of Social Policy and Health in the School of Social Work at the University of Southern California. He also directs the school s Behavioral Health Research Cluster and is Professor in USC s Departments of Anthropology and Preventive Medicine and Adjunct Professor of Medicine and Family and Preventive Medicine at the University of California, San Diego. Dr. Palinkas is a medical anthropologist, with primary areas of expertise in preventive medicine, cross cultural medicine, and health services research. [7]

10 Biographies of Presenters Greg Aarons, Ph.D., is a psychologist and Professor of Psychiatry at the University of California, San Diego. His current work, funded by the National Institutes of Health and the Centers for Disease Control, focuses on developing and testing approaches to evidence based practice implementation and sustainability in health, mental health, and social service settings. With NIH funding, Dr. Aarons is developing an intervention to improve leadership and organizational strategies to promote effective evidence based practice implementation in healthcare and allied healthcare settings. Dr. Aarons latest NIH study is the examination of system, organizational, and individual factors that impact evidence based practice sustainability across multiple public sector service systems in two states. Virginia Davis, M.A., has a lengthy career working with school districts to implement and sustain quality instruction. Her areas of expertise include facilitation and support to district and site leadership for leading change initiatives. She is also experienced in preparing, delivering, and leading communication processes for community groups and school boards, and has served as the public relations contact for several districts. Ms. Davis has been a secondary school teacher, elementary school principal, and countyand district level administrator. Rob Edmisten has worked in the Sacramento County Probation Department for 15 years in various assignments. For the past several years, he has been the department s Evidence Based Practices Coordinator, guiding the implementation of evidence based practices across all divisions within the Department. He has developed expertise in the areas of assessment, evidence based programming, outcome measurement, and fidelity. Currently Mr. Edmisten is pursuing his Master s degree in Criminal Justice at the University of Cincinnati with an emphasis on Corrections and Offender Rehabilitation. Norm Gold, Ed.D., is a consultant specializing in systems development for education, with an emphasis on language, learning, and equity. He has over 35 years of experience in the field of English learner (EL) schooling, 21 of those with the California Department of Education. His background includes graduate studies in language, linguistics, and curriculum and evaluation; extensive on site monitoring and coaching for schools and school districts; and several years of work and study outside the U.S. Alex Kopelowicz, M.D., is Vice Chair of the Department of Psychiatry and Biobehavioral Sciences at the UCLA School of Medicine; Medical Director of the San Fernando Mental Health Center; Chief of Psychiatry at the UCLA Olive View Psychiatric Hospital; and Senior Research Scientist at the Human Interaction Research Institute. He is an internationally recognized expert on the uses of the Multifamily Group program with [8]

11 Latino populations, both youth and adults, and has conducted research and published widely in this area. Dr. Kopelowicz is also President of the Latino Behavioral Health Institute. Lynne Marsenich, LCSW, has worked for the California Institute for Mental Health for the past 10 years. Prior to joining CiMH, she spent 20 years working in both public and private child welfare and mental health organizations, where she held a variety of positions, from line practitioner to senior manager. Ms. Marsenich leaves CiMH in January 2013 to continue her work helping organizations implement and evaluate evidence based practices and programs. Sara McClellan, Ph.D., is an organizational change consultant with WestEd and an Adjunct Professor at the University of Southern California s Price School of Public Policy. She earned her doctorate in Organizational Communication at the University of Colorado, Boulder and her Master s in Public Administration from USC. Previously, Dr. McClellan worked as a Deputy County Administrative Officer, Personnel Director, and First 5 Director in northern California Jennifer Rolls Reutz, M.P.H., is a Research Coordinator with the Child and Adolescent Services Research Center (CASRC) and the California Evidence Based Clearinghouse for Child Welfare (CEBC). Her work has focused on evidence based practices and how to more effectively implement them in real world settings. Another emphasis is on children receiving services through public sectors of care, including the child welfare and mental health systems. Todd Sosna, Ph.D., has worked in the human services field for the past 20 years, with extensive experience as a clinician, manager and administrator, for both public and private agencies. He has brought these diverse perspectives to his work helping agencies develop, implement, and evaluate interagency systems of care, family partnership and wrap around programs, and evidence based practices. Mr. Sosna is a Senior Vice President with Children s Institute, Inc., responsible for agency wide program evaluation and improvement activities. He is a former Deputy Director for the California Institute for Mental Health, where he was responsible for evidence based practice dissemination and implementation, including support for 12 evidence based practices implemented and established in over 200 sites by counties and private provider agencies throughout the state. Mr. Sosna was a co developer of the Community Development Team model, a proven strategy for implementing and sustaining evidence based practices. Prior to his work with CiMH, he was the Assistant Director of Mental Health for Santa Barbara County responsible for directing implementation of its SAMHSA funded Multiagency Integrated System of Care and for overseeing the establishment of its Mental Health Medi Cal Plan. Erin Vidal is the Administrator of Special Programs for Equity Coaching and GATE for the Campbell Union School District. Over the past eight years, she has worked as a teacher and instructional coach. She is currently leading the Campbell Union School District in [9]

12 Biographies of Presenters (cont d) transforming instructional practices through targeted coaching and professional development using A Look at Learning. Yee Wan, Ed.D., currently leads the A Look at Learning (A.L.L.) collaborative. She is a former bilingual teacher and assistant professor. The California School Boards Association presented the 2011 Golden Bell Award to the A.L.L. collaborative in recognition of its success and impact in addressing districts needs to increase academic achievement of English learners. Dr. Yee is a Board Member of the National Association for Bilingual Education. [10]

13 Maps of Venues Conference Center Alumni Center [11]

14 California Implementation Science Collaborative The California Implementation Science Collaborative began meeting in 2012 to plan the Symposium. It is comprised of representatives from various human services practice areas. The mission of the Collaborative is to audaciously drive change within the larger human services field and promote aligned, systematic implementation to increase effective outcomes for diverse populations served in areas such as health care, older adults, corrections, children, and adolescents. Additional participation is welcome. For more information please contact Stuart Oppenheim at the Child and Family Policy Institute of California: Acknowledgments We acknowledge the following people and agencies that have made this event possible: Greg Aarons UC San Diego Sharon Aungst California Forward Thomas Backer Human Interaction Research Institute Sevaughn Banks California Social Work Education Center (CalSWEC) Susan Brooks Northern Training Academy Sarah Carnochan Bay Area Social Services Consortium (BAASC) Khush Cooper Holarchy Consulting Dean Fixsen National Implementation Research Network (NIRN) David Foster Central CA Training Academy Ken Futernick WestEd Norm Gold WestEd Karen Gunderson California Department of Social Services (CDSS) Karen Howard UC Davis Extension Barrett Johnson California Social Work Education Center (CalSWEC) John Landsverk Child and Adolescent Services Research Center (CASRC) Lynne Marsenich California Institute for Mental Health (CiMH) Christine Mattos California Department of Social Services (CDSS) Sara McClellan WestEd Stuart Oppenheim Child and Family Policy Institute of California (CFPIC) Thomas Packard CSU San Diego Lawrence Palinkas USC Anthony Provenzano Independent consultant Fred Tempes WestEd Kate Welty Stuart Foundation Rachel White Holarchy Consulting In addition, we give a special recognition to the following for their generous financial support: CDSS WestEd CalSWEC Zellerbach Family Foundation [12]

15 Notes

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