White Paper: Core Competencies and Functions of Implementation Support Practitioners
By Drs. Sobia Khan, Kimberly Manalili, and Julia E. Moore
35-min read
Key Takeaways
The increasing emphasis on practical applications in implementation science has led to a surge in dedicated implementation support roles - professionals who play a crucial role in facilitating the implementation of programs and practices - contributing to impact within organizations, communities, and systems.
There is a need for an updated set of core competencies and functions specifically for implementation support practitioners.
We have identified and defined 10 core competencies for implementation support practitioners: developing a team; unearthing the problem; selecting the THING; assessing barriers and facilitators; selecting and building change strategies; adapting to the local context; planning for implementation and implementing; engaging in continuous learning for improvement; planning for sustainability and sustaining; planning for and enacting spread and scale.
We have defined five functions of the implementation support practitioner role: connect, understand, inspire, enable, and transform.
Introduction
Over the past few decades, the field of implementation science has been steadily growing. Recently, a surge in its practical application has garnered much attention (Jensen et al., 2023). People are increasingly being hired into dedicated implementation support roles outside of research – these people support the implementation of programs and practices and create impact through their daily work in organizations, with communities, and across systems.
A key practitioner role necessary for local and large-scale implementation is the implementation support practitioner (Albers et al., 2020). People with this role support local implementation teams by building their capacity to implement, are a vital mechanism for spread and scale, and can enable sustainability through their support role. The embeddedness of implementation support practitioners in a system contributes to a well-functioning implementation infrastructure, leading to an ever-increasing demand for support practitioners. At the time of writing, two specialized certificate programs have been developed to formalize this important role, with both certificate programs (through The Center for Implementation (TCI) and the Collaborative for Implementation Practice) experiencing great interest.
With increased attention to the importance of implementation support practitioners and an uptick in people adopting this role, there is a struggle to define the scope of the role. Due to this lack of definition, it has been reported (Metz et al., 2021) that implementation support practitioners do not feel adequately prepared to support the various implementation processes and activities they participate in and often experience "scope creep" given that it is unclear what exactly their roles entail. Because “support” requires diverse knowledge and experience of all aspects of implementation and proper supportive functions that aim to motivate implementation teams and encourage them to develop the right mindsets and capacities for implementation, it is easy for support practitioners to feel spread thin. A set of core competencies can help set boundaries around the role and can describe the knowledge and functions that define what implementation support practitioners do.
These competencies are distinct from the core competencies for implementation scientists, which have been explored in greater depth in the literature (Alonge et al., 2019; Padek et al., 2015; Schultes et al., 2020; Tabak et al., 2021).
Building on the implementation practice core competencies
In 2018, TCI developed a set of core competencies synthesized from the available implementation core competencies (Bayley et al., 2018; Mallidou et al., 2018; Metz & Easterling, 2016; Moore et al., 2018). These competencies did not focus specifically on the role of the support practitioner; instead, our purpose was to describe the technical competencies of implementation practitioners at large. Since then, Metz and colleagues published a set of core competencies (Metz et al., 2020) that focus on the role of the implementation support practitioner; these competencies define processes that support practitioners engage in (co-creation, ongoing improvement, and sustaining change) as well as the core values they hold in their work (commitment; curiosity; methodical, transdisciplinary; empathy). To build on Metz and colleagues' competencies and to honor the unique role that we and so many others that we work and collaborate with hold in the system, we decided to revisit the technical knowledge required from the perspective of implementation support practitioners (which were not the primary focus of the Metz et al. competencies), and also synthesized some of the functions, or “essence” of what the support practitioner role entails that are complementary to the core values.
The purpose of this white paper is to describe our update to the core competencies for implementation support practitioners, outlining both the technical knowledge and functions of this role.
Methods
How did we develop the core competencies?
These competencies build on our previous work to describe core competencies related to carrying out and supporting effective implementation practice, spread, and scale, to focus solely on competencies related to the role of the implementation support practitioner. This work was conducted between April 2023 – January 2024 in three phases: 1) a review of previous work describing core competencies for implementation practice and competency synthesis using concept mapping; 2) identification of high-level categories of core competencies; and 3) refinement of the core competencies.
In the first phase, we reviewed two key sources of work related to the implementation core competencies. The first was our 2020 publication, "Core Competencies for Implementation Practice," a revised version of the implementation practice core competencies developed in 2018 jointly funded by Health Canada and TCI. These competencies outline and describe nine key activities related to effective implementation and associated core competencies for each (thirty-seven total competencies), as well as five overarching guiding principles and values. Note that these competencies were synthesized from six sources during their initial development (Bayley et al., 2018; Mallidou et al., 2018; Metz & Easterling, 2016; Moore et al., 2018). Two additional sources were developed through an international collaboration of implementation experts based at the National Implementation Research Network (NIRN), the University of North Carolina, the European Implementation Collaborative and the Centre for Effective Services (Ireland) in 2020 (Albers et al., 2020a; 2020b). These complementary documents include “A Practice Guide to Supporting Implementation” (Metz, Burke et al., 2020) and “Implementation Support Practitioner Profile” (Metz, Louison, et al., 2020), which focus on the core competencies of implementation support practitioners specifically. The documents describe and organize the core competencies under six principles that underpin the work of an implementation support practitioner and fifteen competencies that fall under three core domains of work done to support implementation. A concept mapping exercise was undertaken (by authors Khan. S, Manalili. K & Moore. J.E.) to group and compare similarities and differences across competencies described by the documents. All authors reviewed, agreed on, and verified groupings of concepts.
In the second phase following the mapping exercise, a series of discussions were held to combine and revise high-level categories of competencies thematically. New concepts were identified to reflect specific competencies or functions needed for more complex or system-level challenges. Based on this newly compiled list of higher-level competencies, initial descriptions were developed, informed by the content of the source documents as well as insights from informal discussions with implementation support practitioners.
The higher-level competencies were further refined and specified in the third development phase through an iterative review and discussion process. Descriptions of the competencies were developed to distinguish between foundational and advanced competencies to capture the range of experiences that an implementation support practitioner may have or need in addressing various levels of complexity associated with different types of initiatives (e.g., local implementation versus system-level implementation).
Results
The Implementation Core Competencies
We identified ten core competencies and their related activities that are essential to the role of the implementation support practitioner. Additionally, we identified five functions that implementation support practitioners serve.
The ten core competencies include:
Develop a team
Unearth the problem
Select the THING
Assess barriers and facilitators
Select and build change strategies
Adapt to the local context
Plan for implementation and implement
Engage in continuous learning for improvement
Plan for sustainability and sustain
Plan for and enact spread and scale
The five functions are:
Connect
Understand
Inspire
Enable
Transform
Below we describe each competency and function. Each description includes a definition, associated activities, and examples related to that competency or function. We have also included a section on "Practitioner Levels" for each competency and function to distinguish between foundational level competency (Level 1) and more advanced level of competency (Level 2).
Core Competencies of an Implementation Support Practitioner
These implementation support competencies are the technical knowledge and skills needed to support implementation teams at any stage of their implementation journey.
1. Develop a team
Support and/or develop a diverse implementation team that facilitates the initiative's planning, implementation, and sustainability.
Implementation support practitioners work collaboratively with those responsible for implementing the change and supporting its implementation across the system. Their objectives may include identifying suitable team members, providing role clarity, and developing effective decision-making and communication processes, goals, and work plans to ensure successful implementation.
They can foster equity by encouraging the implementation team to include people with diverse perspectives, experiences, and strengths.
Depending on the complexity of the initiative, implementation support practitioners may assist in establishing several different implementation teams based on levels of implementation or to support various aspects of the initiative.
Practitioner Levels:
The foundational level involves providing input on the implementation team composition and processes.
The advanced level involves facilitating discussion and co-designing team composition and processes.
2. Unearth the problem
Identify problems or gaps and assess needs and assets in collaboration with implementation teams to promote equitable outcomes.
Implementation support practitioners collaborate with the implementation team, those initiating the change, and those affected by the change to understand the problem or gap and assess population or community needs.
To achieve these goals, they must critically reflect on these challenges and examine them from multiple perspectives to understand the core issues and potential root causes, ensuring that there is a gap between the best available evidence on what should be done and what is currently happening and a need for a solution.
The use of data supports the exploration of the problem or gap and the assessment of needs and assets. This might include (but is not limited to) conducting a needs assessment, gap assessment, stakeholder analysis, environmental scan, scoping or systematic reviews, personal experiences, and stories and art. It is essential that implementation support practitioners consider specific population and community needs through an equity lens to promote equitable outcomes for underserved, under-represented, or marginalized populations or communities.
Practitioner Levels:
The foundational level consists of collecting and interpreting data from diverse perspectives and data sources to understand the problem, gap, and need.
The advanced level builds on the foundational level by examining the complexity of problems, gaps, and needs and understanding the many upstream and downstream root causes that can be addressed.
3. Select the THING
Select the THING (e.g., the program, practice, policy) in collaboration with implementation teams to address the identified problem or gap, connect to the WHY of the implementation effort, and consider the fit of the THING in the local context.
Implementation support practitioners collaborate with implementation teams and those impacted by the change to select the THING based on the best available evidence. Depending on the nature of the problem or gap, they may be able to select an evidence-based program, practice, or guideline. In other situations, they may be implementing a THING that does not yet have a strong evidence base; in this case, they may facilitate more robust conversations around why this THING best addresses the WHY, gap and need.
To select the THING, implementation support practitioners support implementation teams to reflect on the WHY of their efforts, including the intended outcomes and impact and the deeper value of this work.
When selecting the THING, implementation support practitioners must consider the identified problem, gap, and needs while leveraging available assets. The THING should be co-designed to reach intended outcomes and impact and align with the WHY of their efforts. In addition, it is essential to consider the logistical and cultural fit of the THING for the local context.
Depending on their role, implementation support practitioners may appraise and synthesize the available evidence (including evidence drawn from multiple sources, not only research evidence), facilitate knowledge and information exchange and ensure a shared understanding among those implementing the initiative and those directly impacted by the change.
Practitioner Levels:
The foundational level consists of critically appraising potential THINGs and facilitating discussion, sensemaking, and consensus building to select THINGs that address gaps, needs, the WHY, and fit.
The advanced level involves understanding systems of change and supporting teams in selecting the THING based on levers for change and the connectedness of the THING with other implementation efforts at multiple system levels.
4. Assess barriers and facilitators
Assess barriers and facilitators at individual and contextual levels; apply theories, models, and frameworks to inform multiple implementation aspects, in collaboration with teams.
Implementation support practitioners support implementation teams to understand the importance of barriers and facilitators assessments and integrate these into implementation plans. They encourage the use of appropriate theories, models, frameworks, and approaches through co-learning and collaboration with those implementing or impacted by the change.
The role of an implementation support practitioner is to co-lead or support different types of barriers and facilitators assessments that look at: a) individual barriers and facilitators to change for unearthing individual capabilities, opportunities, and motivations; b) contextual-level barriers for generally understanding the context as well as specific considerations for readiness, fit and sustainability; c) individual and contextual-level barriers to implementing the change strategies.
Barriers and facilitators may be collected formally or informally and may draw from various methods to understand and capture this information (e.g., literature reviews, surveys, interviews, conversations, and meetings). Throughout the process, implementation support practitioners should ensure the embodiment of equity through participatory approaches of engaging people during these assessments and in critically reflecting on how individual and contextual-level barriers within the local context (e.g., structural or institutional racism) may impact implementation and outcomes for different populations/communities.
Practitioner levels:
The foundational level consists of exploring individual barriers/facilitators with high proficiency and generally capturing individual and contextual barriers/facilitators.
The advanced level involves a deeper understanding of the types of context assessments and the relatedness of barriers/facilitators across multiple levels of implementation.
5. Select and build change strategies
Collaboratively apply theories, models, frameworks, and approaches to select and build change strategies that address identified barriers and facilitators in alignment with implementation goals and the context.
Implementation support practitioners collaborate with the implementation team to apply appropriate theories, models, frameworks, and approaches to select change strategies that address the underlying individual and contextual barriers and facilitators to change. They support implementation teams to critically review and reflect on the identified barriers and facilitators and consider the implementation context to select and prioritize the most promising change strategies at both the individual and contextual levels.
They facilitate discussions with those involved in the change process to ensure that the most suitable (e.g., feasible, sustainable) strategies are selected and later enacted, aligning with the values, culture, and implementation goals of those impacted by the change. They also support the implementation team in articulating each selected strategy's underlying mechanism of change or function, linking them back to behavior change theory.
Once the change strategies have been selected, implementation support practitioners may assist with building tools, training, resources, and support to operationalize the change strategies. For example, if a champion strategy is selected, their role is to support the development of materials (e.g., tools and training) for the champions to provide a deep understanding of the initiative and the identified barriers and facilitators.
Practitioner levels:
The foundational involves supporting implementation teams to use theories, models, frameworks, and approaches that focus most prominently on individual-level change.
The advanced level consists of supporting implementation teams to select contextual strategies and consider enacting strategies for initiatives with more complex challenges/system-level change.
6. Adapt to the local context
Collaboratively assess fit and strategically adapt change initiatives for the local context, ensuring equity and maintaining the initiative's effectiveness.
Implementation support practitioners support the implementation team by using information about contextual barriers and facilitators to understand the initiative's fit and identify areas where adaptations may be needed during implementation, scale or spread. This includes adapting components of the THING being implemented and the associated change strategies to address local needs.
Throughout the adaptation process, implementation support practitioners facilitate discussions about how these changes may impact different populations and work to ensure equity in the adaptation process. Their goal is to support an inclusive initiative that meets the needs of those impacted by the initiative and those implementing it.
When making adaptations, implementation support practitioners encourage the implementation team to reflect on the reasons adaptations are being considered and systematically and strategically approach the process of making adaptations to ensure that the underlying functions or components of the initiative are not drastically changed. They help the team balance adapting the initiative to local needs while considering the potential impacts on effectiveness. They also serve as a resource for the implementation team, providing guidance and support as they work to adapt the initiative within the local context.
Practitioner Levels:
The foundational level involves supporting the implementation team in making essential cultural and logistical adaptations and monitoring these.
The advanced level involves supporting implementation teams to plan for adaptations at scale and to be able to grasp better/anticipate the impact of adaptations on effectiveness.
7. Plan for implementation and implement
Develop and enact comprehensive implementation plans that align steps/stages, roles, and activities with appropriate process models and theories, frameworks, and approaches while addressing individual and contextual-level barriers and devising action plans for potential challenges.
Implementation support practitioners support the team in developing the implementation plan and may also be involved with planning and co-design. Drawing from an appropriate process model, they assist in outlining the steps/stages, activities/tasks, roles, and responsibilities for implementation. They enable the implementation team to understand the roles of those within the system who are directly or indirectly involved in or impacted by the initiative, which is an essential component of the implementation plan and moving the work forward.
They are also critical in supporting the enactment of the plan through planning for iterative implementation and devising action plans to overcome any unforeseen challenges that may arise during implementation.
Experienced implementation support practitioners may take a “meta” approach to their own planning efforts by working within their own support teams to apply the appropriate theories, models, frameworks, and approaches that can identify optimal support strategies to deliver throughout implementation..
Practitioner Levels:
The foundational level consists of supporting the implementation team in using a process model to identify the essential components of an implementation plan and co-design/support the development of task lists and role descriptions.
The advanced level involves supporting the development of plans for multi-level and/or complex initiatives rooted in theories, models, frameworks, and approaches and accounting for flexibility/resilience/agility. They can also serve a “meta” support role in developing and executing internal plans to support the central team in continuing to move the work forward.
8. Engage in continuous learning for improvement
Foster a learning system mindset when approaching implementation, utilizing improvement cycles and data-driven assessment to enhance implementation quality, address equity issues, and facilitate communication to drive continuous improvement.
The role of an implementation support practitioner is to promote a learning system mindset. This includes encouraging the implementation team to value anticipated and and unanticipated learning and to use that knowledge to improve implementation.
They work with the implementation team to co-design and conduct implementation cycles to critically reflect on and iteratively improve the implementation plan and strategies. They support teams in evaluating implementation quality using multiple relevant metrics and diverse data sources. They encourage teams to track adaptations and assess their potential impact on outcomes while reflecting on sustainability, spread, and scale implications, and they consider equity gaps and how they can be addressed to ensure equitable implementation and achieve desired outcomes for all populations.
Implementation support practitioners facilitate communication among team members and those impacted by the change by encouraging the exchange/sharing of different perspectives on improvement needs, establishing feedback loops to ensure progress is communicated across the implementation system between those implementing and supporting the change initiative, those impacted, and decision-makers, and tailoring communication based on the audience.
Practitioner Levels:
The foundational level involves supporting the implementation team in conducting cycles, guiding an appropriate monitoring plan, and supporting reflection on adaptations.
The advanced level consists of making increasingly complex decisions around the cycles, such as start and stoppage, adding or changing the length of cycles, more complex course corrections and adaptations, and facilitating feedback loops across the system.
9. Plan for sustainability and sustain
Co-create and enact a sustainability plan while considering equity, providing analytic and adaptive capacity, and building motivation for long-term sustainability.
Implementation support practitioners collaborate with the implementation team to develop a sustainability plan. This involves defining sustainability and assessing how well the initiative fits or can be integrated into a typical way of working and living within the local context and a barriers and facilitators assessment rooted in theories, models, frameworks, and approaches related to sustainability, and assessing factors that can impact sustainability.
Implementation support practitioners also support the implementation team in making sense of the collected data (e.g., exploring root causes and unpacking factors that affect sustainability) and leveraging their existing capacity to help develop and execute the sustainability plan.
To promote sustainability, they play a crucial role as a sustainability agent by reflecting on the equity implications of the initiative, building general and initiative-specific capacity (potentially at multiple levels of the system), and motivating those involved in implementing the change.
Practitioner Levels:
The foundational level consists of supporting the implementation team to define sustainability, assess barriers and facilitators to sustainability, and develop a plan.
The advanced level involves acting as an agent of sustainability (i.e., reflecting on their own role in sustainability efforts and thinking about how to sustain this support role), building capacity and motivation, monitoring and reflecting on adaptations during sustainability and planning for sustainability at multiple levels.
10. Plan for and enact spread and scale
Co-create and enact a plan for the spread and scale of the initiative, considering contextual factors, equity, and engaging with people across the system while also building capacity and motivation for successful spread and scale.
Implementation support practitioners support the implementation team in developing a plan for spreading and scaling the initiative by encouraging the team to differentiate between spread and scale mechanisms, defining spread and/or scale goals, assessing barriers and facilitators to spreading and/or scaling the change initiative, understanding the contextual-level factors that could influence spread and/or scale and ensuring equity in the spread or scale of the initiative.
They engage with those implementing or impacted by the change, decision-makers, leaders, and champions to understand the contextual factors involved in scaling and/or spreading the initiative. They support the implementation team in critically reflecting on the context and system assessment and leveraging the existing capacity to develop and execute the scale and spread plan.
To promote the scaling and spreading of the initiative, implementation support practitioners play a vital role as a spread and scale agent by building general and initiative-specific capacity, defining the spread and/or scale support infrastructure, and motivating those who facilitate or support the change initiative's spread and/or scale.
Practitioner Levels:
The foundational level involves working with partners to define and develop spread and/or scale goals, understand barriers/facilitators and contexts in which spread and/or scale occurs, and develop and execute a foundational plan.
The advanced level consists of building the support infrastructure and capacities, co-creating a comprehensive set of support strategies for spread/scale, considering more adaptive approaches to spread and/or scale for large-scale implementation, and acting as an agent of spread and scale (i.e., reflecting on their own role in spread and scale efforts).
Functions of an Implementation Support Practitioner
The five functions of an implementation support practitioner describe the essence and attributes of the role, and the purpose of implementation support. These functions are the ways in which implementation support practitioners enact and support implementation and become proficient at many of the knowledge and skill sets in the implementation support core competencies. These functions are not discrete; they mutually reinforce one another so there is conceptual overlap between them.
A. Connect
Facilitate effective collaboration between individuals involved in the implementation process by building and sustaining trusting relationships and alliances.
The role of an implementation support practitioner is to help identify the individuals who are part of the implementation system and facilitate effective collaboration between them. By co-creating a collective vision and shared mental models, common goals can be achieved.
They emphasize building and sustaining trusting relationships and partnerships. To do so, they must understand that relationships are fundamental to the success of implementation work. They help to convene, broker, and build connections with those involved in the implementation process and the broader community impacted by the change. They approach relationships with openness, empathy, and respect, valuing differing perspectives, experiences, and expertise.
Implementation support practitioners build trust by being authentic, making connections, and highlighting competence in others. They create safe spaces for discussions and encourage dialogue and new ideas. Using their understanding of team dynamics, they can address power imbalances that arise.
Practitioner Levels:
The foundational level consists of supporting the development of healthy relationships and connections with implementation teams and partners within the specific initiative.
The advanced level involves playing a more systemic convening role, bringing people together and/or brokering more relationships across the system.
B. Understand
Promote a deep comprehension of diverse perspectives and co-create a shared sense of problems and solutions.
An implementation support practitioner uses strategies to unearth different perspectives and gain a better understanding of people, places, systems, and the self. In their support work, they promote sharing views and collective sensemaking. They also help uncover mental models, aim to support equitable decision-making throughout the implementation journey and encourage mutual understanding that honors and reconciles these mental models. They approach the world with curiosity and deep reflection.
Implementation support practitioners use various strategies to promote shared understanding. They practice and encourage active listening. They focus on mental models and support people to consider, discuss, and describe their mental models. They co-create space and allow the time and space for people to express their thoughts, understanding not only the words but also the underlying message. They value evidence, recognizing that evidence and expertise may come from many sources that can be used to inform implementation.
In their role, they also work to recognize the complexity of challenges that may arise and seek to understand power structures. In complex situations, with no solutions or too many solutions with no clear choices, they pursue information about individuals with influence and power within and outside the organization and implementation unit. They also assess power dynamics and differentials within and between the implementation team and others in the organization/system to create adaptive solutions to complex problems.
Practitioner Levels:
The foundational level involves providing a facilitation role to enhance a shared understanding among those involved in the change.
The advanced level consists of deeply understanding the mental models component and comprehending both systems and the nature of power dynamics.
C. Inspire
Inspire, influence, and motivate the implementation team, engage and cultivate implementation champions and leaders, and foster leadership behavior among all individuals involved in implementation.
Implementation support practitioners are crucial in motivating and influencing people to join a cause or make changes by highlighting and affirming strengths and successes. They act as a cheerleader for the implementation team, keeping them motivated.
They inspire and influence people at various levels within and outside the implementing system and organization. Implementation support practitioners help people feel a sense of ownership over the implementation effort, have deep knowledge of the individuals and workflow affected by the change, and demonstrate grit and tenacity in the face of setbacks. They are influential to a range of individuals and understand different perspectives. They also foster leadership behavior among all relevant individuals involved in implementation, regardless of whether they are formal or informal leaders, and create space for new and emerging implementation leaders. They draw from behavioral science when enacting change strategies to motivate the implementation team, champions, and the leaders around them.
Practitioner Levels:
The foundational level involves embedding inspiration and motivation principles into change strategies and support work with teams and initiative partners.
The advanced level consists of inspiring people who move the work forward along with organizations, communities, and systems at large.
D. Enable
Identify and remove obstacles, leverage resources, and build capacity.
Implementation support practitioners collaborate with implementation teams to remove obstacles that may hinder the change process and to foster the right conditions to supportchange rather than force change. Their role often entails enabling a sense of agency and ownership over the implementation process and proceeding with a positive mindset to help identify true facilitators for change.
Their role enables implementation teams to make changes by supporting knowledge exchange and information sharing among those involved. This helps to increase understanding of diverse perspectives related to the design and implementation of the change. They also help pool information and resources to enable decision-making and facilitate timely communication between those involved and impacted by the change at every implementation stage, leveraging existing resources and avoiding duplication of efforts.
Implementation support practitioners help build the implementation team's capacity by fostering partnerships and linkages to existing circles of support. Doing so creates the opportunity to influence policy, research agendas, and practice-based work.
Practitioner Levels:
The foundational level consists of creating connections to draw on circles of support, exchange knowledge, and remove fundamental barriers through the support work.
The advanced level involves fostering agency and ownership, showing up as a co-leader with positive relational energy, and focusing on leveraging facilitators.
E. Transform
Reflect on their contributions, manage distress, plan for uncertainty, and support people to be agile and adaptive during implementation.
Implementation support practitioners reflect on their contributions and reactions to the implementation process. They zoom in and out to understand the problems and solutions and persevere in facing challenges. This process includes managing distress and addressing conflicts that may arise during implementation.
To achieve this, they conduct ongoing self-assessments and consider the strengths and weaknesses of their relationships with the implementation team and others involved in the system. They also evaluate how their contributions may affect the group's implementation and capacity-building.
Implementation support practitioners plan for uncertainty and remain resilient in the face of adversity and the unexpected. They also help those involved in or impacted by the change manage any discomfort or distress they may experience during the implementation process. In particular, they support people in being agile and adaptive when facing challenges throughout the implementation process. They approach implementation with a mindset of lifelong learning.
Practitioner Levels:
The foundational level involves reflecting on contributions, relationships, and roles in implementation, as well as encouraging perseverance in the face of anticipated or unanticipated challenges.
The advanced level consists of supporting implementation teams to navigate and persevere through more complex, system-level, or adaptive challenges.
Discussion
The core competencies for implementation support practitioners include developing a team; unearthing the problem; selecting the THING; assessing barriers and facilitators; selecting and building change strategies; adapting to the local context; planning for implementation and implementing; engaging in continuous learning for improvement; planning for sustainability and sustaining; planning for and enacting spread and scale. The five functions are to connect, understand, inspire, enable, and transform.
The competencies and functions describe the scope of the implementation support practitioner role from the perspective of the technical knowledge required to support implementation work and how the implementation support practitioner can enact the supportive aspects of their role effectively. These core competencies are meant to build on TCI’s previous work and are harmonious with Metz et al.'s core competencies for implementation support practitioners.
It is essential to note that one role may only require some of these competencies. Depending on the stage of implementation, the scope of a position, and the other roles on a team, an implementation support practitioner may be expected to have more proficiency in some areas than others. Therefore, these competencies are seen as being dependent on the implementation stage and on the mix of team skills and functions.
The core competencies have many applications beyond an exercise in role clarity and definition. Our initial interest in core competencies at TCI was rooted in our training needs. The core competencies guide the content of TCI’s Certificate Program, where Level 1 Implementation Support Specialists have the foundational elements of applying implementation science to co-design, implement, spread, and scale the use of evidence. Level 2 Implementation Support Specialists will have more advanced skills in navigating trust and power, implementing in complex systems, motivating, and inspiring, and handling more challenging implementation issues (e.g., those related to adaptations and addressing contextual factors).
Course development, particularly for implementation support, is a difficult task given the broad scope of knowledge and skills required to fulfill the role adequately; therefore, a set of core competencies can inform us of what specific knowledge sets implementation support practitioners would benefit from and what the essence of a support role is. Metz and colleagues' core competencies can be used in addition to TCI's to elaborate on the processes of support (e.g., co-creation), which are touched upon in our competencies but better described in our collaborator's document.
Beyond TCI's use of the implementation support practitioner core competencies, there are other key applications. With the growth of the implementation support practitioner role, many seek guidance on defining the role and what skills and knowledge are needed to excel at the role. Many individuals have questions about what specific competencies can enable them to enhance or upskill their current role to emphasize the implementation support components. Individuals have also seen that with increased attention to, formalization of, and demand for the implementation support practitioner role, there is an opportunity for overall career growth; therefore, being proficient at the core competencies of the implementation support practitioner can aid in their career trajectory.
We at TCI have also fielded questions from leaders who are looking to hire implementation support practitioners but need help defining the role or the competencies explicitly required. In other words, these leaders know that implementation support practitioners are needed. However, because of the novelty of the role in the current context, there is little guidance on how job descriptions for the role should be written and what a successful candidate looks like. These core competencies can help leaders decide what specific competencies would benefit their implementation initiatives and further their collective goals, thereby clarifying what the organization needs, informing selection criteria during the hiring process, and informing performance evaluations after hiring. Leaders can also use the core competencies to identify how current support practitioner staff can be assessed and supported to improve their skills related to implementation support.
Overall, the implementation support practitioner core competencies are not a "holy grail" document but an attempt to rein in and elaborate on this vital role's diverse knowledge and underlying functions. We anticipate organizations may adapt the competencies to fit their context. These core competencies serve as a practical guide for individuals and organizations involved in implementation work. They provide a structured approach not only for training and career development but also for leaders who aim to utilize the skills of support practitioners to drive implementation projects forward. As we better understand the crucial role of implementation support practitioners, these competencies highlight our shared commitment to enhancing implementation practice within our systems and organizations, promoting continuous improvement and effectiveness.
References
Albers, B., Metz, A., & Burke, K. (2020a). Implementation Support Practitioners – a proposal for consolidating a diverse evidence base. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05145-1
Albers, B., Metz, A., Burke, K., Bührmann, L., Bartley, L., Driessen, P., & Varsi, C. (2020b). Implementation support skills: Findings from a systematic Integrative review. Research on Social Work Practice, 31(2), 147–170. https://doi.org/10.1177/1049731520967419
Alonge, O., Rao, A., Kalbarczyk, A., Maher, D., Marulanda, E. R. G., Sarker, M., Ibisomi, L., Dako-Gyeke, P., Mahendradhata, Y., Launois, P., & Vahedi, M. (2019). Developing a framework of core competencies in implementation research for low/middle-income countries. BMJ Global Health, 4(5), e001747. https://doi.org/10.1136/bmjgh-2019-001747
Bayley, J., Phipps, D., Batac, M. A., & Stevens, E. D. (2018). Development of a framework for knowledge mobilisation and impact competencies. Evidence & Policy: A Journal of Research, Debate and Practice, 14(04), 725–738. https://doi.org/10.1332/174426417x14945838375124
Jensen, T. M., Metz, A., Disbennett, M., & Farley, A. B. (2023). Developing a practice-driven research agenda in implementation science: Perspectives from experienced Implementation Support Practitioners. Implementation Research and Practice, 4. https://doi.org/10.1177/26334895231199063
Mallidou, Α., Atherton, P., Chan, L., Frisch, N., Glegg, S., & Scarrow, G. (2018). Core knowledge translation competencies: a scoping review. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-3314-4
Metz, A., Albers, B., Burke, K., Bartley, L., Louison, L., Ward, C., & Farley, A. B. (2021). Implementation practice in human service systems: Understanding the principles and competencies of professionals who support implementation. Human Service Organizations: Management, Leadership & Governance, 1–22. https://doi.org/10.1080/23303131.2021.1895401
Metz, A., Burke, K., Albers, B., Louison, L., Bartley, L., (2020). A Practice Guide to Supporting Implementation. National Implementation Research Network, University of North Carolina, Centre for Effective Services, & European Implementation Collaborative. https://nirn.fpg.unc.edu/resources/practice-guide-supporting-implementation
Metz, A., & Easterling, D. (2016). Using implementation science to translate foundation strategy. The Foundation Review, 8(2). https://doi.org/10.9707/1944-5660.1302
Metz, A., Louison, L., Burke, K., Albers, B., & Ward, C. (2020). Implementation Support Practitioner Profile: Guiding principles and core competencies for implementation practice. Chapel Hill, NC: National Implementation Research Network, University of North Carolina at Chapel Hill. https://nirn.fpg.unc.edu/resources/implementation-support-practitioner-profile
Moore, J. E., Rashid, S., Park, J. S., Khan, S., & Straus, S. E. (2018). Longitudinal evaluation of a course to build core competencies in implementation practice. Implementation Science, 13(1). https://doi.org/10.1186/s13012-018-0800-3
Padek, M., Colditz, G. A., Dobbins, M., Koscielniak, N., Proctor, E. K., Sales, A., & Brownson, R. C. (2015). Developing educational competencies for dissemination and implementation research training programs: an exploratory analysis using card sorts. Implementation Science, 10(1). https://doi.org/10.1186/s13012-015-0304-3
Schultes, M., Aijaz, M., Klug, J., & Fixsen, D. L. (2020). Competences for implementation science: what trainees need to learn and where they learn it. Advances in Health Sciences Education, 26(1), 19–35. https://doi.org/10.1007/s10459-020-09969-8
Tabak, R. G., Bauman, A. A., & Holtrop, J. S. (2021). Roles dissemination and implementation scientists can play in supporting research teams. Implementation Science Communications, 2(1). https://doi.org/10.1186/s43058-020-00107-4
How to cite this white paper (APA format)
Khan, S., Manalili, K., & Moore, J. E. (2024). Core competencies and functions of implementation support practitioners [White paper]. The Center for Implementation. https://www.centerforimplementation.com/toolbox/white-paper-core-competencies-and-functions-of-isps
