Table 2 Implementation strategies Applied in communities (ISAC), with definitions and examples

Conduct pragmatic evaluation

Evaluate success through methods that fit the evidence-based intervention (EBI), personnel, and setting

• Used validated simplified instruments

• Shorten survey to maximize the amount of time people are spending in the EBIs

• Don’t evaluate “all of the things” to show EBI effectiveness

• Collect data that’s important to community partners

Provide training

Train staff, volunteers, or partner organizations on the EBI

• Hold booster trainings to help implementers adhere to curriculum

• Offer web-based training that can be used to house materials and send reminders

• Train implementers on community engagement and diversity, equity, and inclusion

• Provide policy training to teach organizations how to better advocate at policy levels for their organizations and EBIs

Change adaptable program components

Tailor the program through fidelity-consistent changes to meet the needs of the priority population or setting

• Change physical activities to accommodate the weather and time of day

• Use virtual instead of in-person programming when it best meets participants’ needs

• Work with the intervention developer to reduce the number of weeks and session time

• Reduce elements of complex tobacco policy from 13 to three

Leverage funding sources

Access new funding, use creative or untraditional funding sources, or combine funding sources

• Connect communities to other partners that have grants and funding (e.g., department of transportation)

• Find funding for one portion of the priority population (e.g., kids in an intergenerational program) to match funding availability and interests

• Write a planning grant

• Use supplemental COVID funding to do additional outreach and become better integrated in the community

Structure grant requirements

Develop requests for applications that prioritize EBIs with high reach to priority populations

• Create funding applications that are friendlier to rural areas with less resources

• Designate grantee funding eligibility depending on the EBI’s potential reach

• Identify priority populations through the funding application process (e.g., by listing eligible counties)

• Work continuously with a core set of grantees to help with continuity

Tailor recruitment strategies

Use and adapt multiple recruitment methods to align with the priority populations’ language, culture, or preferences

• Use postcard mailers for recruitment of populations who often do not have cell phones or computers

• Have a community contact to ensure that language and recruitment strategies make sense for the priority population

• Find out what participants want out of the program, and advertise those benefits (e.g., social vs. physical activity benefits for older adults)

• Translate materials into multiple languages

Provide technical assistance

Offer guidance (including through external organizations) on implementing an EBI

• Use an external organization to help with scientific background and evaluation

• Bring in an external technical assistance provider to hold a Walkability Institute

• Connect grantees with EBI-specific technical assistance providers

• Hold monthly technical assistance calls to troubleshoot challenges with core components

Change delivery agent roles

Alter roles and responsibilities of staff and volunteers to enhance EBI fit and support implementation

• Find alternate roles for volunteers to support the program from behind the scenes

• Use community health workers to support the work and recruit participants

• Shift practitioners’ focus from direct education to supporting policy, systems, and environmental changes

• Allow middle managers to choose which EBIs to implement and evaluate

Leverage program champions

Identify and prepare staff and volunteers with high readiness (e.g., influence and attitude)

• Have a community member ‘host’ an event and invite community members to improve recruitment

• Identify staff who are passionate about the EBI and can take on more responsibility

• Rely on a program champion to initiate activity breaks during meetings

• Provide materials and information to guide churches in choosing the right program champion

Choose strategic partner organizations

Partner with organizations that have complementary expertise to share resources

• Partner with an organization that excels in training and engaging volunteers

• Look for community partners who may be better equipped to deliver programs

• Partner with organizations that can offer insurance (if the implementing organization) is unable to do so

• Partner with National Heritage Sites that are also interested in implementing Complete Streets

Provide resources

Develop and share resources to enhance program delivery

• Provide expert recommendations on child feeding practices

• Develop a website with all program resources

Change program delivery site

Move programs to different locations or partner organization sites to improve EBI fit or reach

• Implement EBIs in a new area with fewer similar EBIs

• Choose a new location based on income, race, or ethnicity to better reach the priority population

Develop a coalition or workgroup

Build diverse groups, including partner organizations, community members, and elected officials

• Develop groups of community based organizations representing diverse populations who often don’t have a voice

• Develop local coalitions that look like the priority population

Facilitate implementation

Offer assistance on the implementation process through an interactive, supportive relationship

• Hold frequent formal and informal conversations with delivery agents to determine what’s working and what’s not

• Maintain an ongoing, close working relationship with grantees to help with their needs (e.g., program evaluation)

Design pragmatic programs

Develop programs that are low cost, easy to implement, and relevant to multiple populations

• Design simple interventions to avoid fidelity issues

• Develop programs that are free and/or use existing resources

Assist with dissemination

Offer coaching, mentoring, or other support to aid in sharing results through multiple channels

• Develop a strategic communications and marketing plan

• Hold a virtual writing workshop including how to submit manuscripts and go through peer review process, write brief reports, and incorporate visual elements

Use technology for evaluation

Use or develop apps, websites, or databases to facilitate improve data collection and sharing

• Use online platform to reduce data issues

• Build website to show local elected officials the EBI’s impact on economic indicators

Change programming focus

Collaboratively prioritize EBIs that align with priorities and can demonstrate impact

• Change priorities to implement programs that can be evaluated and show impact

• Implement policy, systems, or environment-level interventions for longer-lasting impact

Conduct fidelity checks

Measure fidelity to assess whether the EBI is being implemented as designed

• Conduct in-person site visits

• Assess fidelity (whether core components were done) in program evaluation

Meet community partners’ needs

Select or adapt programs to respond to community partners’ needs, concerns, or resources

• Get buy-in from the community and work to meet community partners’ objectives

• Meet communities where they are at, and start from there to implement feasible EBIs

Connect practitioners with experts

Facilitate external connections to help with program implementation or evaluation

• Connect communities with universities, researchers, or students to get help with evaluation metrics

• At the outset, sit down with experts ask what program components can’t be changed

Assist with selecting EBIs

Provide options and assistance for choosing the best-fit EBIs

• Offer a menu of interventions for implementers to choose from

• Help grantees select interventions that are needed and a good fit

Conduct needs assessment

Use qualitative or quantitative methods to understand needs of the priority population and EBI implementers

• Hold focus groups with residents to understand views of built environment and important destinations that could be linked

• Conduct survey with staff, administrators, and parents asking about needs, interest, and how can they be supported

Engage potential partners

Use networking, relationships, or outreach events to share information about the EBI with potential partners

• Present at statewide meetings to gain buy-in

• Find schools that may be willing to participate through personal, informal networks

Enhance staffing

Consider a staffing plan that facilitates high-quality, consistent delivery of the EBI.

• Hire at a local level (people who represent the priority population) to work on the EBI

• Use a project manager to coordinate among multiple organizations working together to deliver the EBI

Meet participants’ needs

Address participants’ needs to increase engagement

• Making programming engaging and learner-centered

• Ensure participants have transportation

Create program guide

Create a playbook, blueprint, or guide describing how to implement the EBI

• Build and maintain protocols to hand off to new staff

• Create a blueprint to give leaders more information upfront on what to expect

Use formal agreements with partners

Establish memorandums of understanding (MOUs), policies, or other agreements to share space and ensure supports are available.

• Create a commitment form for leaders who are essential to program success.

• Develop an MOU with after school programs to ensure staff are available during EBI delivery

Use reimbursement systems

Advocate for or establish systems for payors (insurers, employers) to reimburse EBI costs

• Help worksites to explore insurance coverage or worksite benefit

• Advocate for legislation to get Medicaid to reimburse for the EBI

Engage community members

Share information about the EBI and seek community member input

• Create a survey for community members to give input on the proposed EBI

• Ask for input on adaptable program components (e.g., music, language, images) to enhance cultural appropriateness

Plan for sustainability

Set up funding structures to support program maintenance, and work with implementing sites to provide resources and support to continue the EBI

• At the conclusion of the EBIs, work with faith-based organizations to develop a plan for the next year

• Continue institutional support by providing resources

Build partner relationships

Invest time to build long-term relationships with community partners

• Hold multiple conversations or meetings to build trust and long-term relationships

• Come in to partnerships with an open mind, not a set agenda

Train the trainer

Train implementers or volunteers to train others to implement EBIs.

• Train master trainers who train coordinators who train volunteers

• Train Master Wellness Volunteers to do content education and technical assistance

Facilitate peer learning

Set up networking and collaborating opportunities for implementers to learn from peers

• Serve as a convenor to help organizations learn from each other

• Use a peer learning collaborative model, including monthly reflection prompts and goal setting

Reassess inclusion criteria

Promote broad reach by reducing exclusion criteria

• Lift inclusion requirements as programs are scaled

• Reduce EBI exclusion criteria (compared to other EBIs) to increase participation

Review performance and provide feedback

Review performance or evaluation results and provide feedback to facilitate improvements

• Use audit and feedback to evaluate teachers against their own goals

• Report state-level feedback so missing data points are easy to see

Develop structured curriculum

Develop structured curriculum, including lessons plans and other content, for program implementers

• Include recipes that align with nutrition guidelines and the EBI curriculum

• Develop lesson plans and other content for internal staff and other program implementers

Develop adaptable programs

Ensure programs are adaptable to meet the needs of organizations and priority populations

• Develop programming as a package so worksites can choose what they want to implement given employees’ needs

• Create adaptable EBIs so implementers can make changes based on community and staffing needs

Incentivize delivery agents

Incentivize program implementers through payment structures or other rewards

• Pay trainers to be certified and deliver program sessions

• Offer credits to students who volunteer

Conduct demonstration events

Short-term environmental changes to assess use and gather community member feedback

• Host a temporary “pop-up” demonstration event to get feedback on proposed environmental changes