Barriers and Facilitators to Program Evaluation and Dissemination: A Qualitative Study to Inform Implementation Strategies

Abstract

Implementation strategies support the adoption, implementation, and maintenance of evidence—based interventions in community settings. However, strategies often conclude when funding ends, leaving implementers without assistance to maintain interventions. Implementation strategies focused on program evaluation and dissemination—factors that lead to program maintenance—are needed. The goal of this study was to understand barriers and facilitators to evaluation and dissemination in community-based organizations to inform relevant implementation strategies. Semi-structured interviews were conducted using an interview guide based on Consolidated Framework for Implementation Research (CFIR) constructs hypothesized to influence evaluation and dissemination: complexity, self-efficacy, culture, available resources, leadership engagement, organizational incentives and rewards, external policies and incentives, reflecting and evaluating, and champions. The guide also queried implementation strategy preferences. A rapid deductive approach was used to analyze the data through a template aligned with the interview guide. Nine interviewees shared barriers around reflecting and evaluating (e.g., data collection challenges), available resources (e.g., organizational capacity), and organizational incentives and rewards (e.g., lack of recognition). Interviewees favored ongoing consultation, tools or plans, problem-solving support, and peer sharing. Based on these results, a technical assistance (TA) protocol was developed to include monthly consultation meetings and quarterly learning collaboratives to build capacity in project partner (UnitedHealthcare) grantees. Future work should evaluate the TA protocol for effectiveness in alleviating the identified barriers and improving program implementers’ evaluation and dissemination capacity. If successful, this model could be used in other community settings experiencing similar barriers, ultimately leading to improved maintenance of evidence-based interventions.