Barriers and Facilitators to Sustainment of an Evidence-Based Supported Employment Program
Abstract
Large-scale initiatives to expand evidence-based practices are often poorly implemented and rarely endure. The purpose of this study was to identify the perceived barriers and facilitators to sustainment of an evidence-based supported employment program, Individual Placement and Support (IPS). Within a 2-year prospective study of sustainment among 129 IPS programs in 13 states participating in a national learning community, we interviewed IPS team leaders and coded their responses to semi-structured interviews using a conceptual framework adapted from another large-scale implementation study. Leaders in 122 agencies (95%) that sustained their IPS programs identified funding, prioritization, and workforce characteristics as both key facilitators and barriers. Additional key factors were lack of local community supports as a barrier and leadership and structured workflow as facilitators. Within the IPS learning community, team leaders attributed the sustainment of their program to funding, prioritization, workforce, agency leadership, and structured workflow. The actions of the learning community's leadership, state governments, and local programs together may have contributed to the high sustainment rate.
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The challenge of sustainability is a factor to consider in RCT research, where well-funded and managed trials are successful for the duration of implementation but are not integrated into mainstream services.
“The challenge of sustainability is a factor to consider in RCT research, where well-funded and managed trials are successful for the duration of implementation but are not integrated into mainstream services [82–84].”
From An enhanced individual placement and support (iPS) intervention based on the model of human occupation (MOHO); a prospective cohort study (2020) · cites this paper as [83]
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- Authors
- Noel, V. A., Bond, G. R., Drake, R. E., Becker, D. R., McHugo, G. J., Swanson, S. J., Luciano, A. E., & Greene, M. A.
- Affiliations
- Dartmouth Institute for Health Policy and Clinical Practice (US)
- Westat (United States) (US)
- Duke University (US)
- Corresponding author
- Noel, Valerie A.
- Venue
- Administration and Policy in Mental Health and Mental Health Services Research
- Published
- 2016-11-28
- Volume
- 44
- Issue
- 3
- Pages
- 331-338
- ISSN
- 0894-587X (ISSN-L)
- 1573-3289
- OpenAlex
- W2553557590
- Cited by
- 42
- References
- 17
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 13 · 2023: 3 · 2022: 2 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 1 · 2017: 3
- FWCI
- 4.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Administration and Policy in Mental Health and Mental Health Services Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Disability, Independent Living, and Rehabilitation Research (H133G110161)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Keywords
- Individual Placement and Support, supported employment, program sustainment, barriers and facilitators, evidence-based practice implementation, mental health services, funding, workforce characteristics, leadership, community support, learning communities
- MeSH terms
- Government Agencies, Humans, Leadership, Prospective Studies, Residence Characteristics, United States, Program Evaluation, Program Development, Employment, Supported, Workflow
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