Cited by 66Health Policy Implementation ScienceSubstance Abuse Treatment and OutcomesEvaluation and Performance Assessment

Conceptualizing and measuring sustainability of prevention programs, policies, and practices

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Palinkas, Lawrence A, Spear, Suzanne E, Mendon, Sapna J, Villamar, Juan, Reynolds, Charles, Green, Costella D, Olson, Charlotte, Adade, Audrey +1 more·2020·Translational Behavioral Medicine

Abstract

A large knowledge gap exists regarding the measurement of sustainability of evidence-based prevention programs for mental and behavioral health. We interviewed 45 representatives of 10 grantees and 9 program officers within 4 Substance Abuse and Mental Health Services Administration prevention grant initiatives to identify experiences with implementation and sustainability barriers and facilitators; what “sustainability” means and what it will take to sustain their programs; and which Consolidated Framework for Implementation Research (CFIR) elements are important for sustainability. Lists of sustainability determinants and outcomes were then compiled from each data set and compared with one another. Analysis of themes from interviews and free lists revealed considerable overlap between sustainability determinants and outcomes. Four sustainability elements were identified by all three data sets (ongoing coalitions, collaborations, and networks and partnerships; infrastructure and capacity to support sustainability; community need for program; and ongoing evaluation of performance and outcomes), and 11 elements were identified by two of three data sets (availability of funding; consistency with organizational culture; evidence of positive outcomes; development of a plan for implementation and sustainment; presence of a champion; institutionalization and integration of program; institutional support and commitment; community buy-in and support; program continuity; supportive leadership; and opportunities for staff training). All but one of the CFIR domain elements (pressure from other states, tribes, or communities) were endorsed as important to sustainability by 50% or more of participants. It may be more important to implement a standardized process of eliciting determinants and outcomes of sustainability than to implement a single standardized instrument.

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Authors
Palinkas, L. A., Spear, S. E., Mendon, S. J., Villamar, J., Reynolds, C., Green, C. D., Olson, C., Adade, A., & Brown, C. H.
Affiliations
  • University of Southern California (US)
  • California State University, Northridge (US)
  • Northwestern University (US)
  • Substance Abuse and Mental Health Services Administration (US)
Corresponding author
Palinkas, Lawrence A
Venue
Translational Behavioral Medicine
Published
2019-11-25
Volume
10
Issue
1
Pages
136-145
ISSN
  • 1613-9860 (ISSN-L)
  • 1869-6716
OpenAlex
W2990046995
Cited by
66
References
14
Citations by year
2026: 4 · 2025: 6 · 2024: 19 · 2023: 11 · 2022: 10 · 2021: 9 · 2020: 7
FWCI
8.54
Type
journal article
Language
en
Open access
Locations
  • Translational Behavioral Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Drug Abuse (1 R34 DA037516-01A1)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Evaluation and Performance Assessment
Keywords
program sustainability, prevention programs, mental health prevention, Consolidated Framework for Implementation Research, implementation barriers and facilitators, sustainability determinants, sustainability outcomes, SAMHSA, organizational culture, community buy-in, leadership, employee training, program evaluation
MeSH terms
Humans, Program Evaluation, Policy

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