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Barriers and facilitators to implementing evidence-based interventions among third sector organisations: A systematic review

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Bach-Mortensen, Anders Malthe, Lange, Brittany C. L., Montgomery, Paul·2018·Implementation Science
DOI 10.1186/s13012-018-0789-7PMC PMC6065156
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Abstract

BACKGROUND: The third sector is becoming a growing provider of public, social, and health services. However, there is little evidence on the effectiveness of third sector organisations (TSOs), and their capacity to implement evidence-based interventions (EBIs). Understanding implementation aspects of service delivery remains an important issue in clinical practice, but is poorly understood in the context of TSOs. This is problematic, since implementation issues are known to be critical for effective intervention outcomes. OBJECTIVES: To identify and synthesise existing research on what barriers and facilitators influence the implementation process of TSOs delivering EBIs. METHODS: This review is reported according to PRISMA guidelines and was pre-registered in PROSPERO. Key databases were searched using relevant terms, experts in the field were contacted, and websites were reviewed. All identified studies were double-screened, and data were extracted independently by two authors. Included studies were synthesised using thematic analysis and were quality appraised. RESULTS: Thirty-one studies were included, most of which were conducted in North America. The thematic synthesis identified resource limitations, in particular staff and finance, to be the most reported barrier to TSOs implementing EBIs. Organisational culture, including factors such as alignment between the mission of the TSO and EBI, and support/prioritisation of the implementation process were the most reported facilitators. These findings generalise across the included studies and are robust to study quality assessment. CONCLUSIONS: While it is often assumed that good outcomes follow when implementing interventions that have been developed and tested according to best practice, little attention has been paid to how EBIs are best transported, contextualised, and implemented by third sector providers. This systematic review found that TSOs faced considerable challenges in implementing EBIs, which were primarily a lack of support and expertise, and unclear/insufficient guidelines on how to adapt EBIs to different populations. To address these challenges, it is important to engage with central stakeholders, such as funders, researchers, policymakers, and practitioners, to discuss how these needs can be met. TRIAL REGISTRATION: PROSPERO: CRD42017073090 .

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  • A major determinant of program effectiveness throughout the youth service field is the degree of professional learning and support provided to staff.

    “A major determinant of program effectiveness throughout the youth service field is the degree of professional learning and support provided to staff (Bach-Mortensen et al., 2018;National Research Council (NRC), 2015).”

    From Improving relationship quality in group care settings: The impact of implementing the CARE model (2020) · cites this paper as Bach-Mortensen et al., 2018

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Cited by

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Authors
Bach-Mortensen, A. M., Lange, B. C. L., & Montgomery, P.
Affiliations
  • University of Oxford (GB)
  • University of Birmingham (GB)
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2018-07-30
Volume
13
Issue
1
Pages
103-103
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/s13012-018-0789-7
PMC
PMC6065156
OpenAlex
W2887990108
Cited by
253
References
16
Citations by year
2026: 20 · 2025: 25 · 2024: 31 · 2023: 62 · 2022: 31 · 2021: 45 · 2020: 28 · 2019: 10 · 2018: 1
FWCI
3.77
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
Funders
  • TrygFonden
  • Economic and Social Research Council (ES/N012267/2)
  • Clarendon Fund
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Evaluation and Performance Assessment
Keywords
third sector organizations, evidence-based interventions, implementation barriers, implementation facilitators, organizational culture, resource constraints, mission alignment, stakeholder engagement, service delivery, nonprofit organizations
MeSH terms
Health Services, Health Services Research, Humans, Organizations, Nonprofit, Organizational Culture, Evidence-Based Practice

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