Innovation
Each attempted implementation of evidence-based practices and programs presents an opportunity to learn more about the program itself and the conditions under which it can be used with fidelity and good effect. New staff members working under different conditions within uniquely configured community circumstances present implementation challenges. They also present opportunities to refine and expand both the treatment practices and programs and the implementation practices and programs. Some of the changes at an implementation site will be undesirable and will be defined as program drift and a threat to fidelity (Adams, 1994; Mowbray et al., 2003; Yeaton & Sechrest, 1981). Others will be desirable changes and will be defined as innovations that need to be included in the “standard model” of treatment or implementation practices (Winter & Szulanski, 2001).
When attempting to discriminate between drift and innovation, the Dissemination Working Group (1999) advised to first implement the practice or program with fidelity before attempting to innovate. In that way, it is clear that “innovation” is not an attempt to escape the scrutiny of fidelity assessments and that the innovation is based on a skillful performance of the program or practice.
In addition, Winter & Szulanski (2001) noted that adaptations made after a model had been implemented with fidelity were more successful than modifications made before full implementation.
The Dissemination Working Group also encouraged “innovation with scrutiny over a long enough period of time to see if the innovation is beneficial to children, families, the organization, or community.”
Of course, at some point, innovations may sufficiently change the definition and operations of an evidence-based program to merit a new round of experimental outcome studies to confirm the overall benefits of the revised program.
