What are some of the Policy Implications of Readiness?

Our team and colleagues published a brief for the U.S. Department of Health and Human Services a few years ago (HHS; Dymnicki, Wandersman, Osher, Grigorescu, & Huang, 2014) which defines the policy implications of readiness. There are three implications listed which we believe are very important for the implementation of readiness! In this blog, we discuss these implications, what they are, and what you can do.
**note: this post was written by Lauren Hurley, an undergraduate working with us in the Spring 2019 semester. It's critically important that implementation ideas be accessible to a broad audiences. This is one student's translation of some earlier work we did.*** 

​We know that evidence-based interventions (EBIs) are a major factor for improving health outcomes. However, readiness for implementing EBIs is often overlooked. This is where policy implications of readiness come in! We recommend that policymakers 1) include questions about readiness in funding opportunity announcements (FOAs), so that it can be a factor in selecting grantees, 2) work to understand grantee readiness because it may also impact technical assistance (TA) funders' plan to provide, and 3) partner with organizations in settings with limited capacity and willingness to implement an EBI.

The first policy implication is assessing implementation readiness through FOAs. This isn’t as scary as it sounds! Questions can be asked using an FOA to specifically target a company’s readiness using various subcomponents, such as observability and relative advantage. We are suggesting that a new Government Performance and Results Act indicator for organizational functioning be produced as a separate form for all federal organizations to fill out. This would help us determine and assess readiness in all federal organizations- what a dream!

The second policy implication, the role of training and technical assistance (TTA) in supporting implementation readiness, is vital for implementation to stick. We believe that organizational staff need to assess the readiness of their organization to develop offer the specific support needed. Now, this can look different for companies that operate differently! This is not a “one-size-fits-all” plan. TTA providers need to ask organizational staff to answer a variety of questions which will assess what subcomponents need strengthening. This individualized plan will lead to a more successful implementation with better outcomes.
The third policy implication is partnering with and fostering readiness in settings with limited capacity and willingness. Unfortunately, some organizations don’t have the capacity to implement quality EBIs. To solve this issue, we must work with these organizations to build capacity through readiness development. How do we do this? By developing trusting relationships between federal staff/TA providers and grantees. This doesn’t come easily and only happens over time with a lot of hard work and dedication.

We can’t forget that readiness isn’t just important at the start of implementation! Each of the four stages of implementation are equally important: (1) exploration – when people explore the use of an innovation, (2) installation – where the goal is to acquire or repurpose the resources needed to do the work ahead, (3) initial implementation – when the innovation is being used for the first time, and (4) full implementation – when 50% or more of the intended practitioners, staff, or team members are using an effective innovation with fidelity and good outcomes (Dymnicki, Grigorescu, Huang, Osher, & Wandersman, 2014). We believe that key stakeholders should be discussing their organization’s readiness throughout implementation because of the dynamic nature.

The brief was published in 2014 by the Office of the Assistant Secretary for Planning and Evaluation. Feel free to check out the article for more detailed information on evidence-based interventions and how readiness can be used as a tool for organizations looking to implement new policies, practices, or processes!
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What’s new with readiness and policy?
· Our work with the Centers for Disease Control (CDC) has focused on training Project Officers to implement readiness-focused technical assistance with grantees from the Office on Smoking and Health. Grantees have chosen an initiative related to the policies their states are implementing to focus on improving with readiness. Keep an eye out for updates on this project! We are working on a manuscript.
· The Farley Health Policy Center has partnered with our team to assess readiness of cross-sector agencies to implement integrated policy in the state of Colorado.
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Source: Dymnicki, A., Grigorescu, V., Huang, L., Osher, D., & Wandersman, A. (2014). Office of the Assistant Secretary for Planning and Evaluation. Basics and Policy Implications of Readiness as a Key Component for Implementation of Evidence-Based Interventions,1-17.