Systems Intervention

 
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Implementation takes place in a shifting ecology of agency, community, state and federal social, economic, cultural, political, and policy environments. Even the most effective evidence-based efforts can be overwhelmed by funding, policy and regulatory environments that are at odds with the service delivery expectations and requirements of the program or practice.

Fidelity, intervention outcomes and sustainability are heavily influenced by the degree to which agency, community, state and federal systems are supportively aligned and enabling with respect to implementation. Champions and persons with influence work together to build and sustain the culture, policies, regulatory practices, and funding mechanisms necessary for both the implementation drivers and the intervention practices to thrive. Systems intervention requires attending to multi-level alignment, maintaining leadership and focus, creating and staying connected to champions, intervening to change policies and funding contingencies, and remaining vigilant at local, state and federal levels for both windows of opportunity and threats to fidelity and sustainability are all fertile arenas for systems intervention. Leadership and responsibility for this systems alignment function must be clearly articulated at each level and with an overall structure to support the communication within and among these levels.

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