Many of the most promising and effective evidence-based interventions are not used regularly in the front lines of practice because the process of transporting them from the research setting to community agencies can be quite complex. This is true for many evidence-based interventions and is particularly true for those few culturally informed and evidence-based interventions that currently exist.
There tends to be a very long lag time between the development of a new intervention and its widespread use to help citizens in the community. This happens in many areas including treatments for drug-involved patients, health promotion, community preventive services, and mental health services.
There are many reasons for this substantial delay in reaching the community.
1. Training of providers has tended to be in small doses rather than at the intensity needed for them to become fully competent in the utilization of a new treatment.
2. There has been little attention to the fact that different treatments such as medicines, simple behavioral interventions and intensive combined interventions, may require very different training and funding mechanisms to sustain the practice.
3. The communication between researchers and service providers has been limited and failed to focus on the real barriers to implementation in the front lines of practice.
In summary, we have too often ignored or missed the complexities and barriers to implementation of evidence-based practices.
Our CEDI Core works with the community to identify treatments and practices that are relevant, timely, useful, attractive, and feasible.
This is often followed by workgroups with representation from the Core and from the community that identify national trainers and plan training activities to build agency capacity.
To help agencies sustain capacity we look to: 1) use “train the trainer models”, 2) identifying champions in the community for a specific type of evidence-based practice, 3) work together on issues of feasibility, and fidelity, and 4) create local resource support networks to help support the continued implementation of the new intervention.