Implementation Strategies

Systems change involves selection of participants to serve in various roles and then ongoing coordination of their work. Participants likely to be involved in many systems-change efforts are:

• Implementation team members
• Additional partners who assist with the implementation of systems-change strategies
• Individuals responsible for training others (e.g., if using a train-the-trainer model)
• Families or professionals who will be involved in training with the expectation that they will use what they learn to promote specific solutions to systemic problems (e.g., training families to serve as mentors to other families, training professionals to identify and refer children with deaf-blindness)

As you select participants, think about the foundational characteristics you would like them to have in addition to topical expertise, degrees, and certifications. These include: (Active Implementation Hub, n.d.-a):

• Effective facilitation skills
• Leadership skills
• Interpersonal skills
• Comfort with change

Resource: Managing Collaborative Activities

Technical assistance begins with the establishment of relationships. Throughout systems-TA efforts, which may last for several years, relationships must be built with:

• Partners who participate in implementation efforts
• Stakeholders who will be impacted by new policies, programs, and practices
• Administrators and other decision-makers whose support is essential in getting changes enacted
• Implementation team members and other partners who work with you to implement the change

Because lack of trust can be a barrier to implementation, trusting relationships are important. Ways to build trust include frequent communication, developing new relationships, taking advantage of pre-existing personal and professional relationships, and ensuring consistent organizational support (Sarkies et al., 2017). Recommendations are valued more highly when they come from individuals who are seen as trustworthy sources of information (Sarkies et al., 2017). 

Resource: Relationships in Technical Assistance

Dissemination and messaging involves:

• Creation of materials to raise awareness and educate stakeholders about the change you are trying to implement and the solution you are promoting
• Targeted distribution of materials to specific audiences 

The purposes are to persuade “the intended decision-making audience to adopt the solution” (Leeman, Birken, Powell, Rohweder, & Shea, 2017) and keep team members, partners, and other stakeholders informed throughout the implementation process.

Materials Development

Make sure materials are designed to target key audiences that will be impacted by the change (e.g., families, educators). It’s also essential to reach administrators, opinion leaders, and others with decision-making power.  

Resources: 

• Accessibility Toolkit for State Deaf-Blind Projects
• Simply Put: A Guide for Creating Easy-to-Understand Materials
• Federal Plain Language Guidelines
• Making Audio and Video Media Accessible
• Tips for Creating Your Own Video PSA
• Audio Content and Video Content

Messaging

Develop a communication plan that specifies how you will keep team members, partners, and other stakeholders informed throughout the implementation process. The plan does not need to be complicated, but should specify the method (e.g., email, online group space, webinar) and type of information. For example, stakeholders may just need periodic updates about where you are in the process, while implementation team members and others with action plan responsibilities will need more frequent updates about what needs to be discussed and acted upon. 

Resource: Quick-Start Guide to Dissemination for Practice-Based Research Networks

Some systems change activities may involve working with partners to develop materials. This has many advantages including tapping into a large pool of talent and expertise, generating a feeling of ownership in a product, and providing learning opportunities for contributors. It also can also be associated with significant problems, however—primarily poor product quality and an inability to complete a project—unless there is clear communication and planning. 

Note that for state deaf-blind projects, the 2018 request for new awards announcement requires that “any products are first approved by the OSEP project officer and then developed in coordination with the National Center” (U.S. Department of Education, 2018).

Resource: Partnering to Create Tools and Materials

Systems-change efforts typically involve a variety of types of training (in-person or online), including:

• Training about the change being implemented
• Awareness-level training about deaf-blindness for decision-makers, stakeholders, and partners to highlight the crucial need for change (e.g., to make a case for new policies or programs)
• Personnel training to build the knowledge and skills to needed to enact a change (e.g., know when to refer children who are deaf-blind, learn how to implement high-quality practices)
• Train designated individuals to provide training (train the trainer) 

Training is often provided by state deaf-blind projects, but for most systems-change efforts it’s important to also work with partners  (e.g., Part C, LEAs, SEA, VR) to embed training into existing systems to increase the likelihood of it being sustained over time. In some cases, this may involve collaboration with institutes of higher education.

Training type, intensity, and topics vary depending on the outcomes you hope to achieve. When planning training events, include details about the frequency and timing that will be required to implement and sustain change over time.

Resources: 

• Conduct Training (from NCDB’s TA Reference Guide)—this was developed for child-specific TA, but the resources and suggestions are also useful for systems TA
• Leading Groups Online: A Down-and-Dirty Guide to Leading Online Courses, Meetings, Trainings, and Events During the Coronavirus Pandemic
• Improving Human Services using Virtual TA: Summary of Research Findings
• Supporting Virtual Meeting Accessibility 

Systems-change efforts that focus on outcomes related to personnel development and increasing the ability of practitioners to implement instructional practices with fidelity may involve the establishment of coaching programs.

Resource: Coaching Practitioners of Children Who Are Deaf-Blind

Consultation is a common strategy used in virtually all systems TA. For example, it may be provided by:

• A state deaf-blind project to a partner working to implement change 
• An external consultant to the state deaf-blind project, implementation team members, and other partners

In both cases, the purpose is to provide expertise for planning and problem-solving or to help implementation team members and partners acquire the knowledge and skills needed to conduct systems-change activities.

Consultation can occur in-person or from a distance and may involve feedback on videotaped interactions. It should be tailored to the recipient’s (individual or group's) specific needs.

When identifying potential partners, you will likely encounter key councils, committees, task forces, or other decision-making/advisory bodies that are working on similar issues or have influence within the system you are targeting. Because solutions to systemic problems must occur within existing systems, it can be helpful to try to get representation on relevant groups from someone on your project or implementation team, or other individuals who are strong representatives of children and youth who are deaf-blind and knowledgeable about the proposed solution. In many situations, a family member may be the best representative.

Communities of practice (CoPs) are “groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise in this area by interacting on an ongoing basis” (Wenger, McDermott, & Snyder, 2002). They typically require a great deal of facilitation and maintenance by a leader with expertise in the topic area. 

In systems-change efforts, a community of practice would likely be part of the solution to a problem. For example, to increase personnel knowledge and skills by learning from and offering support to one another. They are a useful tool for systems-change efforts that involve implementation of high-quality assessment and instructional practices.

Features of a successful community of practice include (King, 2016):

• A clear focus on a problem or issue
• Active learning based on a process of gathering information, setting goals, action planning, and implementation
• Collective ownership
• Representatives who bring different perspectives
• Commitment
• Effective decision-making structure

Resources:

• NCDB Factsheet – Communities of Practice
• Facilitating Online Communities of Practice

Peer-to-peer TA is the use of a structured approach to sharing expertise among colleagues within a professional community (Annie E. Casey Foundation, 2006; National Association for the Education of Young Children & National Association of Child Care Resource & Referral Agencies, 2011). It may consist of one-time events such as a presentation, meeting, or hands-on site visit, or it may take place within an ongoing mentor/mentee relationship or community of practice.

Peer support can be directional or equal in nature. Directional support is when one party (an individual or group) is the recipient and the other is the provider, with the provider having a more highly developed set of skills (National Center on Deaf-Blindness, 2017). Equal peer support occurs among individuals with similar problems or goals and similar skill sets.

Within the context of systems work, peer support is more likely to be used than mentoring, which focuses primarily on an individual’s overall professional development. Strategies include:

• Facilitating peer matches, such as matching an administrator in a school district that has already adopted an effective solution with an administrator in another district who is considering it (Center for the Study of Social Policy, n.d.)
• Providing logistical support (e.g., online meeting spaces or work areas, webinar hosting) for groups of peers working on the same issue
• Facilitating mentor/mentee relationships between professionals with similar roles
• Arranging site visits to agencies where desired implementation efforts have occurred and been successful (prepare by establishing goals for the visit and select sites with characteristics in common and features related to the change you hope to see implemented) (Powell et al., 2015)

Peer-to-peer support also occurs among state deaf-blind projects working on similar systems-change goals. This is the purpose of many of NCDB’s peer-learning communities.

Resources:

• Tips for Organizing Peer Matches
• Mentoring Factsheet

Early adopters can provide insights and advice based on their experiences with specific systems-change solutions that highlight the effectiveness of the solution or, if necessary, adapt it to help other stakeholders (Powell et al., 2015). They are also a great pool for identifying implementation champions (see below).

Data is essential throughout the implementation process to inform decision-making and action-planning and build buy-in and commitment by celebrating strengths and successes with stakeholders (Active Implementation Hub, 2016). This includes:

• Fidelity data about how well the systems-change solution is being implemented
• Outcomes data (not only ultimate outcomes, but short- and medium-term outcomes along the way)
• Administrative data (e.g., human and fiscal resources)

The National Implementation Research Network (NIRN) suggests that implementation teams develop decision-support data systems (DSDS) to collect, analyze, and share this data over time (Active Implementation Hub, 2016).

The scope of your data collection will depend on the complexity of the systems-change effort and the questions you would like the data to answer. Your project may not require a formal DSDS, but the resource below provides practical information and questions to help you determine what is needed for a given systems-change initiative.

Any evaluation conducted as part of a systems-change project should be related to your overall project evaluation plan. Are relevant systems measures already incorporated into your existing plan or will you need to develop them?

Resource: Drivers ed: Decision-support data systems (DSDS) – Be sure to read the notes for each slide. They provide important information. Also, note that this resource refers to various types of drivers. We have not used “driver” terminology in this guide, but instead refer to them as activities.

Systems change efforts require facilitation in a range of situations including guiding work groups engaged in specific tasks, obtaining input from stakeholders, and building coalitions. Through skilled facilitation, you can (Le, Anthony, Bronheim, Holland, & Perry, 2016):

• Help team members create a shared vision
• Inspire commitment and action
• Encourage the involvement of all members
• Improve communication
• Promote awareness that tasks require collaboration or at least input and support

Systems change activities that involve facilitation include:

• Advisory groups
• Communities of practice
• Creation of products or materials
• Training

As you work with various groups, be aware of how personal (e.g., attitudes, beliefs, expertise, level of influence in an organization) and organizational characteristics (e.g., fiscal and personnel resources, leadership) influence their effectiveness (Le et al., 2016).

Resources:

• NCDB Facilitation Factsheet
• Group Facilitation and Problem-Solving (KU Community Toolbox)

“Facilitative administration” is a term used by the National Implementation Research Network to describe both the key role that administrators—who drive decision-making—have in supporting implementation, as well the “internal processes, policies, regulations, and structures over which a school, district, or implementing organization has some control” (Active Implementation Hub, n.d.-b; Active Implementation Hub, n.d.-c). It’s important to:

• Ensure that administrators are on board 
• Identify processes and structures in the system you are targeting in order to address them when they act as barriers and utilize them when they act as facilitators of the solution you are working to implement

These include such things as referral processes (impacts early identification and referral), job classifications (impacts intervener services), and professional development requirements (impacts personnel training).

Developing an initial site or model of the change you would like to see adopted can help in two ways. First, it provides an opportunity to test and refine what you are working on prior to broader use. Second, it can be used to demonstrate a program’s feasibility and value.

Examples of model programs in deaf-blindness include a district-level model demonstration classroom or intervener services program or a statewide teacher of the deaf-blind pilot program, such the one developed in Texas (see Teacher of Students with Deafblindness Pilot Part 1). In some cases, it may also be possible to use programs implemented in other states as models. Increasing Recognition & Use of Interveners: State Success Stories provides examples of achievements related to the recognition and use of interveners.

The National Implementation Research Network's recommendations regarding "transformation zones" provide helpful advice for increasing the likelihood that models lead to sustainable use (Fixsen, Blase, Horner, Sims, & Sugai, 2013): 

• Don't focus just on interventions—make sure your models also address the underlying infrastructure (e.g., policies, regulations, funding) needed to support effective long-term implementation
• Be sure to keep the entire system (e.g., school, district, state education agency) you hope the model will influence in mind and incorporate factors that allow for expansion and sustainability moving forward
• Collect data as described under "Data Gathering, Analysis, and Sharing" above and use it to improve the model

Identify and prepare individuals who are dedicated to supporting, marketing, and overcoming barriers or resistance to change (Powell et al., 2015). In addition to professionals and individuals within systems, some of your biggest champions will likely be families and individuals who are deaf-blind. Facilitating their participation in committees and organizations within the system can provide them with an opportunity to significantly influence the work being done. Explore the nomination processes and membership guidelines of groups you are interested in to know which ones have these requirements.

This strategy involves providing information and guidance to family organizations, such as a National Family Association for Deaf-Blind Affiliate or other family group in your state, so they can advocate for policies that support children and with deaf-blindness and their families. Advocacy for systemic change that involves policies and regulations is often most effective when conducted by families.