Learn how the work of Dean Fixsen and Karen Blase evolved into the independent Active Implementation Research Network®, advancing implementation science and building systems for sustainable, large-scale change.
WRITTEN BY DEAN FIXSEN & KAREN BLASE
In 2001, we (Dean Fixsen and Karen Blase – yes, we are married) took a self-funded sabbatical. We purchased a motorhome and drove around the US and Canada seeing family and friends and enjoying the people and places along the way. Driving 15,000 miles gave us a lot of time to talk about all kinds of things – what is love, what does forgiveness mean, what makes a good relationship, and so on. We often would strike up a conversation with the next family, friends, and others we met to carry on the discussion and get their thoughts.
Dean and Karen, ready to depart on their sabbatical in 2001.
A Cross-Country Turning Point
One of our topics was, what’s next? Where do we park the motor home and what should we do? We had focused on developing and expanding the Teaching-Family Model for many years. We also had gained a broad perspective from working with applied researchers and the developers of other evidence-based programs in the U.S. and Canada. As we continued the discussion intermittently for a few months, we decided there was a need to focus on the common factors related to developing and scaling various evidence-based programs.
Joshua Tree National Park, November 1, 2001
The Florida Mental Health Institute and the Birth of an Idea
With this loosely defined idea floating in our heads, in 2001 we stopped for Thanksgiving with our family in St. Petersburg, Florida. In the 1990s people on the faculty at the Florida Mental Health Institute (FMHI) had replicated the Teaching-Family Model in some homes on the University of South Florida (USF) campus in Tampa. We visited our colleagues at FMHI, our what’s-next discussion came up in the conversations, and they invited us to join them at FMHI while we decided what to do. We said OK, they provided some office space, and we lived in the motorhome for the next several months.
Bob Friedman, the Director of Child and Family Studies at FMHI, was a leader in the movement toward systems of care in the provision of mental health services for children and families. Mario Hernandez was a leader in racial and cultural equity. Greg Teague was an expert on evidence-based programs for adults in mental health service systems and had developed a fidelity assessment for Assertive Community Treatment when he was at Dartmouth University, and David Shern was the head of FMHI and a national leader in mental health policies and advocacy. Under Bob Friedman’s leadership, the Research and Training Center for Children’s Mental Health at FMHI organized and hosted an annual research meeting that attracted colleagues from many fields and featured a number of evidence-based programs.
Founding the National Implementation Research Network (NIRN)
In this collegial and idea-rich environment we continued the discussion of what’s next and evolved the idea of a National Implementation Research Network. In 2002, we presented the idea to the leaders and faculty of FMHI, wrote a brief prospectus, and received $25,000 in funding from FMHI. The National Implementation Research Network (NIRN) was born!
In 2003, with support from the Annie E. Casey Foundation, NIRN organized a meeting of leaders of cultural advocacy groups and developers of evidence-based programs leading to a consensus statement on cultural competence and evidence-based program development and use.
Implementation Research: A Synthesis of the Literature (2005)
Early Research and the Rise of Implementation Science
In 2003, the W. T. Grant Foundation funded our proposal to conduct a review of the implementation literature and a practice review of implementation approaches with developers and users of evidence-based programs. In 2005 the monograph Implementation Research: A Synthesis of the Literature was published, and NIRN was established as a leader in implementation science.
Early Development of the Active Implementation Frameworks™
In 2004 FMHI organized meetings with experts on complexity theory from the Santa Fe Institute. Walter Nord from the School of Business at USF attended and he introduced us to his and others’ evaluations of implementation in business and industry. Melissa Van Dyke was working with Bob Friedman at FMHI and was a proponent of complexity theory. She subsequently joined in NIRN’s work to establish processes to change human service systems.
In 2005 and 2006, funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) supported meetings to explore the commonalities among evidence-based approaches to human services. Nominal Group Processes and concept mapping processes were used for discussions with evidence-based program developers and users along with family and cultural representatives to identify and explore commonalities. Subsequent meetings with researchers explored the challenges of applied research where the interactions among people are too fast to easily capture and the implementation processes are too slow to readily measure over long periods of time.
Our experience with the Teaching-Family Model, the examination of the implementation evaluation literature, and the experiences shared by many colleagues during the Practice Review informed the first version of the Active Implementation Frameworks.
Scaling Impact: SISEP and Systems Change in Action
In 2007, with funding from the Office of Special Education Programs (OSEP) in the US Department of Education, we established the State Implementation and Scaling up of Evidence-based Program (SISEP) Center to engage state education systems in systemic change efforts.
SISEP provided the opportunity to test the Active Implementation Frameworks and provided many opportunities to learn how to develop implementation teams as part of the implementation capacity needed to create and sustain change in large systems. As we worked to solve problems as they arose, we were exposed to more of the literature and experiences in other fields (business, manufacturing, cybernetics, systems theory, complexity theory).
Expanding the Field: Collaboration, Complexity, and Global Reach
In 2008, Dean Fixsen was recruited by the University of North Carolina’s Frank Porter Graham Child Development Center (FPG), then directed by Sam Odom, to lead their nationally recognized National Early Childhood Technical Assistance Center (NECTAC). With continued SISEP funding while at FPG, we continued work related to system change, evaluation, collaboration, and international leadership in Implementation Science. Leadership efforts were capped by organizing the first Global Implementation Conference in 2011 which was held in Washington, DC and attended by over 800 participants from around the globe.
Establishing the Active Implementation Research Network
With a commitment to the development of the “Implementation Specialist” workforce, Dean Fixsen, Karen Blase, and Melissa Van Dyke recognized that their accumulated knowledge and experience needed to be integrated into revisions of the Active Implementation Frameworks. They left UNC to establish an independent and flexible organization to facilitate these efforts. In 2018, the Active Implementation Research Network, Inc. was born!
Continuing the Work
In 2019 the book Implementation Practice and Science was published to describe and operationalize the Active Implementation Frameworks and to summarize the related evidence. In 2021 the Active Implementation Specialist® I Certification course was completed. In 2022 the system change work was expanded and tested in a large federal system. Articles describing the science of implementation, the development of usable innovations, fidelity, and so on provide a sound foundation for the pursuit of evidence-based implementation processes that are planned, effective, and replicable.
The Active Implementation Frameworks have far exceeded what we discussed while driving around in 2001. Little did we know how the journey would continue after we parked the motorhome!