Determine the Capacities Needed for Implementation

Determine the Capacities Needed for Implementation

step 5 graphic

Assessing the fit of your top program choices from Step 4 has helped you better understand if your plans are compatible with your community's characteristics. Next, you want to consider if you have the funds, staff, skills, facilities, and other resources to carry out the program or programs you are considering. We call all of these organizational structures, skills, and resources, "capacities." Having the right capacities ensures that you will be able to implement your program with sufficient quality to produce the measurable outcomes you are trying to achieve.

Overview of capacities

A capacity assessment will show you whether you have what you need to carry out the program(s) you selected as well as what you might need to improve before you start. We have provided you with a starting point in Tip 5-1 by linking to descriptions of the various capacities required for selected evidence-based home visiting programs. You might also investigate any additional capacity requirements you need by reviewing the available materials associated with the program you are considering.

This step lays out key capacity areas that are important for you to assess as you continue to refine your list of potential home visiting programs. The tasks in this step will help you to:

  • Understand the key capacities you need to support the program
  • Assess whether you have the right levels of capacity needed to implement your potential program(s)
  • Determine which capacities need to be further developed so you can move ahead with your programming
  • Further narrow your choice of candidate programs to implement.

What are the different capacities to consider?

Staff capacities

You will need different people to carry out your program. This might include home visiting staff; community volunteers; other support staff, such as drivers or child care workers; and evaluators to help you evaluate your program. A program may require certain experience or educational qualifications to run effectively. Under-qualified staff, even those who've been trained in a program's specifics, may make the program less effective.

Keep in mind that home visiting staff will not only be responsible for delivering services, they will also need to document their work (for example, number of visits, content discussed) by entering data in either a local program, county, state, and/or funder database. The quantity and depth of data entry will vary depending on the program model and your funders. To do this, staff will need training or skills in data entry. Program managers should also have the skills to pull relevant data from the database and use it to monitor program performance (performance monitoring will be explained in greater detail in Steps 7 and 8).

To learn more about training staff, you might take a look at Chapter 10 of the University of Kansas's "Community Tool Box," titled "Hiring and Training Staff" (http://ctb.ku.edu/en/tablecontents/chapter_1009.aspx), noted in Tip 5-1 later in this section.

It is also especially important to make sure that all staff and volunteers are working in culturally competent ways. "Culture" refers to a group or community that shares common experiences that shape the way its members understand the world (University of Kansas, 2012). It includes groups that we are born into, such as race, national origin, gender, or class. It can also include a group we join or become part of, such as members of our profession or residents of our neighborhood. When we think of culture this broadly, we realize we all belong to many cultures at once.

Working in culturally competent ways, then, means that the program you are considering should have specific materials related to relevant cultural issues, and additional knowledge and training will also help you understand how best to deliver a program specifically to your priority population. Culturally adapted, or culturally sensitive, programs have been found to increase recruitment and retention compared with generic multicultural versions of evidence-based programs (Kumpfer, Alvarado, Smith, Bellamy, 2002).

To learn more about cultural competence, you might take a look at Chapter 27 of the University of Kansas's "Community Tool Box," titled "Cultural Competence in a Multicultural World" (http://ctb.ku.edu/en/tablecontents/chapter_1027.aspx), noted in Tip 5-1.

Leadership capacities

Cultivating leadership is an important way to build your capacity and strengthen both your program and your organization. All programs and organizations benefit from having strong leadership, but it is important to think about leadership in a variety of ways. You will want to get support from leadership within your community, as they can help find the resources you'll need. You'll need leaders to help you get started, but you'll also need the kind of leaders who'll stay involved over the long haul to ensure that the program sustains itself.

Consider looking for different kinds of thinkers, because you need people with a variety of perspectives and skills to be engaged in leading this effort. You will want leaders among your staff and volunteers, but you also want to get people involved who are not necessarily thought of in the traditional leadership sense such as community members themselves. Leadership helps build sustainability, especially shared leadership so that a variety of people feel ownership of the work you are doing.

To learn more about developing leadership capacities, you might take a look at Chapter 13 of the University of Kansas's "Community Tool Box," titled "Orienting Ideas in Leadership" (http://ctb.ku.edu/en/tablecontents/chapter_1027.aspx), noted with some other useful Community Tool Box resources in Tip 5-1.

Technical capacities

You'll need basic tools to help you do your work no matter what the program. This is likely to include technology, such as computers, Internet access, and spreadsheet programs. You'll want original copies of the program materials. You may also need to have some administrative capacities, such as Human Resources procedures, in place before you can begin. Do not forget to think about all the specific, technical requirements you might need to conduct your activities, e.g., access to training, food, supplies, notebooks, videos, and TV/DVD/video players.

Fiscal capacities

Adequate funding is needed to ensure successful implementation of a home visiting program, especially because many evidence-based programs can be expensive to purchase and then require additional resources for training and technical assistance.

When considering how much money it is going to cost to run the program, think ahead. Staff turnover may require additional staff training down the line. Increased participation in a new program may result in increased needs and costs in other areas, such as utilities. For specific segments of your work, you may also need to consider hiring an evaluator with the technical expertise to help you.

Key to home visiting programs is having enough funding to support the costs of travel to clients' homes. Travel time should be calculated and budgeted into staff work time. Recruiting staff that are able to drive and have reliable transportation is critical. An additional consideration is that staff will also need to receive training and supervision, and they will need to document their work, so budgeting for staff to spend time performing these activities in addition to visiting homes should be considered.

Below is a list of potential resources for funding a home visiting program. It is best to pursue many funding streams at once, as you may need more than one to adequately support a program:

  • Grants: Either through government (federal, state, county, city) or through private foundations and corporations, grants can provide a great deal of resources during a time-limited period (usually anywhere from one to five years). However, they are difficult to obtain, and doing so requires grant-writing expertise. Grant applications often require a large effort for an uncertain payoff. Often, grants ask for a specific type of proposal (described in a request for proposals, or "RFP"), and you may have to fit your project into what the funder is looking for. Professional grant writers are available, but many charge a fee (sometimes a flat fee, sometimes a percentage of funded grants). Some university or private evaluators will write a grant or part of a grant for free, if they will receive an evaluation subcontract—if the grant is funded. Thinking through the 10 GTO steps before writing a grant proposal can greatly increase the likelihood of obtaining grant funds, since funders will want the kind of information described in the steps (what are the needs, what is the plan, how will you evaluate, etc.). Note that funders often have their own interests and reporting requirements that may or may not fully overlap with the program's existing goals and documentation.
  • Gifts: Direct types of donations or contributions (often from individuals) can be solicited in many ways, such as a direct mail campaign and public service announcements. Certain gifts can be earmarked for certain one-time purchases (e.g., a van, new office equipment).
  • Sponsorships: Sponsorships are funds that help pay for one-time or recurring events. Sponsors receive "positive press" in exchange for their contributions.
  • Fund-raising events: Activities such as bake sales, golf tournaments, and car washes not only can raise funds—if they are high-profile enough (e.g., involve a celebrity), they can also raise awareness of the group's mission.
  • Sale of products: Sales of t-shirts, bumper stickers, pins, etc., can be a source of funds.
  • Special tax set-asides: Voters, through a ballot initiative, may earmark special funds. A legislative effort is required to get such an initiative on the ballot. These funds usually come with certain requirements from the funder, such as having official nonprofit status. In addition, different funders offer different types of funds. For example, paying "core" expenses, such as rent and overhead costs, may require a different kind of funding than funding to implement specific programming.

Very often, when making a request for funds, whether through a grant or other funding source, there is only one opportunity to make the request. Therefore, it is critical to build in as many types of costs as possible, because it is unlikely that there will be a later opportunity to ask for more. This list serves as a reminder of various types of costs to keep in mind as you budget (for more detailed information, see Tip 6-1 in the next chapter):

  • Personnel (e.g., program director, program coordinator) and benefits
  • Transportation
  • Special trips (training, consultation)
  • Printed materials
  • Participant incentives
  • Food
  • Program curriculum
  • Overhead (rent, utilities)
  • Equipment (cell phones, computers, notebooks)
  • Training and meetings (space, materials, trainer stipend)
  • Evaluation (data collection, data entry, following participants over time).

Partnership/collaboration capacities

Partnerships and collaboration are important for many reasons. For example, collaborating with community agencies can facilitate outreach to families that you wouldn't otherwise reach and facilitate referrals for other services not provided by the program you plan on offering.

Partnerships and collaboration can also help you use available resources wisely and build support for your work by involving more people. Cultivating partners takes time and often involves significant changes in everyone's thinking about how the work gets done. Generally, there are four levels of collaboration, each with certain requirements and benefits (Chinman, Imm, & Wandersman, 2004; Himmelman, 1996). The four levels are described below, with an example based on a community agency implementing a home visiting program:

  1. Networking: the exchange of information for mutual benefit. The most informal type requires little trust or time, although these factors may create barriers to expanded collaboration. An example: The community center implementing home visiting provides information about its programs to the service providers in the area to facilitate referrals.
  2. Coordinating: the exchange of information and change in activities for mutual benefit and common purpose. This type of relationship involves somewhat more trust and time than networking. An example: The community agency coordinates the hours of its program's operation to be consistent with local public preschool hours.
  3. Cooperating: the exchange of information, change in activities, and sharing of resources for mutual benefit and a common purpose. This requires
    • more organizational commitment than networking and coordinating
    • shared resources, such as human, technical, or financial capacities
    • high amounts of trust, time, and access to each other's "turf"
      An example: The community agency provides office space to allow a nurse from the local community clinic to be on-site to provide well-child examinations to participants.
  4. Collaborating: a formal, sustained commitment by several organizations to enhance each other's capacity for a common mission by sharing risks, responsibilities, and rewards. An example: The community agency and the local preschool provide joint professional development opportunities to staff.

It is important to acknowledge some of the potential barriers you could face—such as turf issues and limited resources—when working with another organization or group. You may have to slow down and take some time to build relationships. Use the capacity assessment (see the link to information about capacity requirements in Tip 5-1 and Tool 5-1: Capacity Assessment) to determine who from your program or organization knows someone from another organization you want to partner with, and then reach out to start developing a good working relationship with that key person. Be specific about what you want—specific commitments are sometimes easier to negotiate than open-ended ones—and consider how you may be able to help them in return.

Tip 5-1. Links to Capacity Building Resources in the Community Tool Box

Staff capacities

http://ctb.ku.edu/en/tablecontents/chapter_1009.aspx

This Community Tool Box chapter, "Hiring and Training Key Staff of Community Organization," describes how to develop and implement a plan for hiring and/or training staff.

Cultural sensitivity

http://ctb.ku.edu/en/tablecontents/chapter_1027.aspx

This Community Tool Box chapter, "Cultural Competence in a Multicultural World," describes how to build relationships across cultures and how to develop and maintain your organization's cultural competence.

Leadership capacities

http://ctb.ku.edu/en/tablecontents/chapter_1027.aspx

This Community Tool Box chapter, "Orienting Ideas in Leadership," can help you develop a plan for building leadership capacity in your organization and community among citizens and staff of all ages and at all levels.

Fiscal capacities

http://ctb.ku.edu/en/tablecontents/chapter_1043.aspx

The Census Bureau website includes Census data for cities, counties, and states. The QuickFacts tool provides easily accessible reports on Census data at different levels. The Census Bureau may be a helfpul source of data on family economic self-sufficiencey and the maternal and child health domains listed in Tip 1-1.

Collaboration capacities

http://ctb.ku.edu/en/tablecontents/chapter_1016.aspx

This Community Tool Box chapter, "Group Facilitation and Problem Solving," will help your organization plan for effective meetings and group discussions, and it outlines means to developing effective group facilitation skills.

Assessing your community's capacities

In this section, we present the Capacity Assessment Tool, which will help you through the process of identifying whether your agencies and community has the required capacities to implement each of your narrowed list of evidence-based home visiting programs. You can use this tool to help you examine capacities for the program(s) you are considering, or, if you are already running a program, you can use the tool to identify capacities that are lacking that would help the program run more smoothly.

Tool 5-1. Capacity Assessment

Instructions for using the Capacity Assessment Tool:

  1. First, you need to gather materials about the program you are considering in order to understand the following:
    • Requirements for each type of capacity (i.e., human, fiscal, and technical)
    • Whether your organization has the ability to meet those requirements.

    There are separate capacity worksheets for each of these areas:

    • Staff capacities
    • Leadership capacities
    • Technical capacities
    • Fiscal capacities
    • Partnership/collaboration capacities.
  2. Gather together information describing what is required to implement the program you are considering, including costs, staffing levels and requirements, training needs, materials, facilities, and other fiscal and resource capacities. If the information you need isn't clearly spelled out in the materials, you may need to do some additional investigation. This might include Internet searches, talking to the home visiting program's national office, or talking to other communities currently implementing the program. Just remember that some home visiting program information is copyrighted, so there might be a limit on what information program developers can provide without a fee.
  3. For each of the programs you are considering, go through the capacity worksheet and answer the questions about capacity requirements, whether you think your organizational capacity is adequate in each area, and what your plan is to increase the capacity if you need to. You might consider using the Community Tool Box resources listed in Tip 5-1 to come up with ideas about how to increase capacity. Start with the programs that are the highest-ranked on your list. If it looks like you are able to implement one of the highly ranked programs with nothing more than slight modifications to your existing capacity, it might not be worth doing this activity for the other, lower-ranked programs.
  4. Fill out the Capacity Assessment Tool separately for each program that you are considering. If filling out all the worksheets for several programs seems like a lot of work, you might consider splitting the tasks up among several people. You could divide the task by each program you are reviewing or have one person responsible for finding out all about one capacity area, such as technical expertise, for all of the programs you are considering.

Once you complete the Capacity Assessment Tool, you'll have a better idea about whether you can implement the program you are considering with enough fidelity to achieve your desired outcomes. The most revealing part of this task may be the gaps that appear. These gaps may be capacities you can build to implement the program, or they may indicate that you need to select another program.

If you do not have the necessary capacities, it is important to think through how and whether you can develop them. You may find that it is going be very hard to improve your capacity in some areas. This is the reality for many organizations. Do not be discouraged. You can think of creative ways to get what you need, or your assessment may help you see more clearly that the program you are considering is not the right one for you.

If you cannot achieve sufficient capacity for the program you are considering, you can return to the short list of evidence-based programs that you created in Step 3 and select another one to consider that might work better with your capacities. Alternatively, you may decide that you can adapt the program to fit your existing capacities if the adaptations are not too drastic (i.e., mostly green and yellow light). If you would like to investigate adapting the program, revisit Step 4 on fit.

Capacity Assessment
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Townville Example 5-1. Townville's Capacity Assessment for
Program XYZ

In Step 3, Townville's community coalition decided to continue to investigate two programs, the ABC and XYZ programs. In Step 4, they decided that they wouldn't be able to implement the ABC program with fidelity. So, in Step 5 they looked at the capacity requirements for the XYZ program.

The Townville coalition looked carefully at the XYZ program website and called up someone at the XYZ program office to help them understand exactly what would be required.

The XYZ program developers recommend caseloads no larger than 20:1 (20 families per one staff person) for their six-month program. Because Townville wanted to serve 100 families in a year and the lead agency only had three staff on board with the required qualifications, they knew they needed to hire two more staff in order to serve 100 families (100 families, five staff = 20:1).

In addition, the XYZ program includes referrals to well-child visits. The Townville community coalition had a member of one community health clinic on their coalition already! However, they decided that they would need to develop additional relationships with other clinics prior to implementing the program. The coalition worked on setting up memoranda of understanding between the lead agency and clinics located in the targeted geographical area so that required referrals to well-baby visits could be easily incorporated into the curriculum and feasible for families to receive.

Townville's sample capacities assessment tool includes only the sections for the two capacity shortcomings discussed above.

Capacities

Requirements for Program XYZ

Is current level of community/organization capacity sufficient for each program identified?

If capacity is inadequate, what will have to be done to enhance it?

Staff and leadership capacities

Number of staff and qualifications

1 staff per 20 families, so 5 staff for 100 families

No, we have only 3 qualified staff

Hire 2 more staff

. . .

Partnership/collaboration capacities

Collaboration with external partners

Provide referrals to well-child vists

Only one community health clinic in coalition

Develop relationships with additional clinics in the area

There were a couple of capacities that Townville really needed to develop, but with staff and leadership buy-in, they were confident that they could plan to overcome these hurdles!

Checklist 5-1. Completion of Step 5

When you finish working on this step, you should have done the following:

  • Developed an understanding of the key capacities you need to support your programming.
  • Assessed whether you have the right levels of capacity needed to implement your potential programs.
  • Determined which capacities need to be further developed so you can move ahead with your programming.
  • Further narrowed your choice of programs to implement.

Before moving on to Step 6

You've now reviewed one and maybe more evidence-based programs for their potential to meet your goals and desired outcomes; their fit with your community and priority population; and your capacity to implement them.

It is possible that none of the programs on your list were feasible given the significance of some capacity gaps. This is because capacity gaps in people, in agencies, or in the general community can prevent good implementation. If this is the case, you can either circle back to Step 3 to find more suitable programs or decide to take a break from this process while you work to develop the required capacities. Remember, capacity-building is a long-term process but can yield important gains for an organization or community. The capacity you build for a specific program may also be useful for other programs.

It is also possible that you are now left with more than one program that meets your needs, fits with your community and agency, and is possible given your capacity. If this is the case, one approach to finalizing program selection would be to convene a meeting of the community coalition and present all of the information gathered in Steps 1 through 5. The community agencies involved in the coalition can discuss the findings together and the pros and cons of each program. By iterating with the community coalition in this way, you might be able to identify which of the handful of remaining programs fit the best with your community.

After selecting a program and determining that you have the capacities to implement the program well, you are in the position to develop an implementation plan (Step 6). Plans for filling gaps in capacity will be addressed as part of this plan.