Building Pathways of Change: Using Implementation Science to Advance Social Work Practice

Overview: This presentation will highlight why implementation science is relevant to the advancement of the social work profession and to addressing the research-to-practice gap. A practical pedagogical approach that combines and applies implementation science models, theories, and frameworks to improve the uptake and use of evidence-based practices will be discussed.Proposal text:

Background:
To advance the future of social work, it is critical that evidence be effectively integrated into practice settings to promote diversity, equity, and inclusion. Bridging the gap between research and practice has been a long-standing problem in the profession (Thyer, 2015). Past approaches have lacked a clear understanding of the context and realities that shape the use of research in practice settings, including the lack of attention to cultural contexts, thereby inhibiting access to programs, services, and supports (Epstein, 2015).

Implementation science is an interdisciplinary field studying the methods and mechanisms to adopt, adapt, and sustain research evidence. This requires understanding how individuals, organizations, and systems change their behavior through application of models, theories and frameworks (MTFs) (Nilsen, 2015). While implementation science provides a set of methods and approaches to improve the dissemination, implementation, and scale-up of evidence-based interventions, using implementation science in practice can be challenging, because researchers have not emphasized how to effectively apply MTFs. Implementation science is an applied science; therefore, describing and understanding its real-world applications is critical to advancing the field and moving effective interventions into practice.

Methods:
Based on a synthesis of the literature, we developed and administered an approach to combine MTFs to apply implementation science in practice within a DSW program.

Results:
Step 1. Select a process model. First, implementation efforts should be guided by a process model that describes the actionable steps required to close the evidence-to-practice gap. There are several well-established process models, each offering unique features that make them particularly relevant for specific situations (Aarons, Hulbert & Horwitz, 2011). Step 2. Select a theory of change. At its core, implementation science is about creating individual, organizational, and/or systems change. Therefore, implementation efforts require a theory of change at each level of change (individual, team, organization, community, system). (Michie, 2014; Powell et al., 2015). Step 3. Select frameworks that align with the objectives of each process model stage. There are over 150 frameworks used in implementation science (Striffler et al., 2018); therefore, it can be challenging to select an appropriate framework. Framework selection should be guided by what is intended in each process model stage. Most implementation efforts require the use of multiple frameworks, for example a framework to consider individual barriers and facilitators to change (Cane, O’Connor & Michie, 2012), contextual factors (Damschroder et al., 2009), and implementation outcomes (Proctor et al., 2011).

Conclusions and Implications:
This pedagogical approach to practice implementation provides a roadmap for understanding and organizing implementation science MTFs in a practical and applied manner. It affords social workers the skills, tools, and knowledge to facilitate the integration and adaptation of evidence-based practices and interventions thereby bridging the research-to-practice gap. By integrating implementation science into social work curriculum and practice environments, we increase our ability to understand and address factors and processes that influence uptake, use, accessibility, and sustainability of evidence-based practices across multiple sectors (Proctor et al., 2009) and advance the profession’s efforts to reduce disparities for historically underserved populations (Cabassa, 2016).