From a “Perfect Storm” to “Smooth Sailing”: Policymaker Perspectives on Implementation and Sustainment of an Evidence-Based Practice in Two States

Willging, Cathleen E.; Green, Amy E.; Gunderson, Lara; Chaffin, Mark; Aarons, Gregory A.

doi:10.1177/1077559514547384

Cited by 66Health Policy Implementation ScienceChild Welfare and AdoptionPublic Policy and Administration Research

From a “Perfect Storm” to “Smooth Sailing”: Policymaker Perspectives on Implementation and Sustainment of an Evidence-Based Practice in Two States

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Willging, Cathleen E., Green, Amy E., Gunderson, Lara, Chaffin, Mark, Aarons, Gregory A.·2015·Child Maltreatment

DOI 10.1177/1077559514547384PMC PMC4381926

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Abstract

Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems.

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Funding is often identified as the major barrier to program sustainment.
“Funding is often identified as the major barrier to program sustainment [20, 31, 55].”
From Using qualitative comparative analysis to uncover multiple pathways to program sustainment: implications for community-based youth substance misuse prevention (2022) · cites this paper as [20]
The Results section (“Variability in Funding”; page unavailable) describes funding problems in systems where SafeCare was only partially sustained or not sustained. The Discussion says short-term grants could not support long-term sustainment. These passages support funding as a barrier, but do not identify it as the major barrier to program sustainment generally. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Most prior sustainability studies included small, homogeneous samples and based conclusions mostly on qualitative retrospective assessments rather than statistical tests of association.
“However, this knowledge is greatly limited because most studies included small, homogeneous samples, and their conclusions were mostly based on qualitative retrospective assessments of individuals’ beliefs about what led to sustainment success or failure, rather than based on statistical tests of their association [17–22].”
From Using qualitative comparative analysis to uncover multiple pathways to program sustainment: implications for community-based youth substance misuse prevention (2022) · cites this paper as [20]
The Methods describe a purposive sample of 24 policymakers and qualitative coding of interviews, while the Limitations say some participants relied on retrospective accounts (page numbers unavailable). This paper exemplifies several features in the claim, but it does not establish that most prior sustainability studies had those features, and it says the retrospective accounts were corroborated with other data. (LLM, conf=0.83)
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Authors: Willging, C. E., Green, A. E., Gunderson, L., Chaffin, M., & Aarons, G. A.
Affiliations: University of New Mexico (US)
University of California San Diego (US)
University of Oklahoma Health Sciences Center (US)
Corresponding author: Willging, Cathleen E.
ORCID: Willging, Cathleen E.
Green, Amy E.
Gunderson, Lara
Chaffin, Mark
Aarons, Gregory A.
Venue: Child Maltreatment
Publisher: SAGE Publications
Published: 2014-08-14
Volume: 20
Issue: 1
Pages: 24-36
ISSN: 1077-5595 (ISSN-L)
1552-6119
DOI: 10.1177/1077559514547384
PMC: PMC4381926
OpenAlex: W2161343637
Cited by: 66
References: 49
Citations by year: 2026: 3 · 2025: 2 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 10 · 2019: 7 · 2018: 7 · 2017: 5 · 2016: 5 · 2015: 6
FWCI: 9.63
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Child Maltreatment (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute of Mental Health (R01MH092950, R01MH072961)
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Safety Research › Child Welfare and Adoption
Social Sciences › Public Administration › Public Policy and Administration Research
Keywords: evidence-based practice, policy implementation, child welfare, policy makers, implementation barriers, stakeholder collaboration, financing strategy, leadership
MeSH terms: Child, Child Abuse, Child Welfare, Cooperative Behavior, Health Plan Implementation, Health Planning, Humans, Interinstitutional Relations, Policy Making, United States, Advisory Committees, Evidence-Based Practice

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From a “Perfect Storm” to “Smooth Sailing”: Policymaker Perspectives on Implementation and Sustainment of an Evidence-Based Practice in Two States

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