SEPTEMBER 2014

WILLING, ABLE READY:

BASICS AND POLICY IMPLICATIONS OF 

READINESS AS A KEY COMPONENT FOR 

IMPLEMENTATION OF 

EVIDENCE-BASED INTERVENTIONS

ABOUT THIS ISSUE 

BRIEF

This issue brief was written by 

Allison Dymnicki, Ph.D., of the 

American Institutes for 

Research, Abraham 

Wandersman, Ph.D., of the 

University of South Carolina,

David Osher, Ph.D., of the 

American Institutes for 

Research, Violanda Grigorescu, 

M.D., of the Centers for Disease 

Control and Prevention, and 

Larke Huang, Ph.D.,of the 

Substance Abuse and Mental 

Health Services Administration 

In 2012, ASPE awarded the 

American Institutes for Research 

to manage the Investing in What 

Works (IWW) project, to 

continue ASPE’s efforts to keep 

building the knowledge and 

supports that evidence-based 

programs and initiatives can use 

to improve the quality and 

outcomes of interventions funded 

through federal investments. 

Office of the Assistant Secretary 

for Planning and Evaluation

Office of Human 

Services Policy

U.S. Department of Health 

and Human Services

Washington, DC 20201 

Executive Summary

As more federal agencies recommend that organizations 

implement evidence-based interventions (EBIs), it is critical to 

know whether an organization is ready to implement these 

approaches. “Readiness” refers to the extent to which an 

organization is both willing and able to implement a particular 

practice. An emerging body of scholarly work identifies three 

components of readiness that organizations should address when 

implementing new EBIs: (a) motivation of people within the 

organization to adopt new EBIs, (b) general organizational 

capacities, and (c) intervention-specific capacities. Motivation 

includes beliefs about an intervention and support for the 

program which contribute to the desire to adopt a practice. 

General capacity speaks to different aspects of organizational 

functioning such as culture, climate, staff capacity, and 

leadership. Intervention-specific capacity describes human, 

technical, and fiscal conditions such as knowledge, skills, and 

intervention-related abilities that are important to the successful 

implementation of a particular practice.

Although a scientific body of knowledge about readiness already 

exists, there is a need to develop more concrete 

recommendations for federal agencies and practitioners to use 

when implementing EBIs. This brief establishes the basics of 

readiness using the R=MC2

 (Readiness = Motivation × General 

Capacity and Intervention-Specific Capacity) heuristic, 

examines some of the policy implications of readiness, and 

identifies directions for future research. 
Key Take Away-Messages

 When considering an organization’s readiness for implementing EBIs, it is helpful to

consider the constructs of motivation, general capacity, and intervention-specific

capacity. This relationship is represented in the heuristic R=MC2.

 Policymakers may include targeted questions about readiness in funding opportunity

announcements (FOAs) and develop criteria to evaluate answers to these questions to

incorporate information about readiness when choosing grantees.

 Practitioner organizations (e.g., community-based organizations, schools) should assess

their readiness before implementing an EBI to better understand their technical assistance

needs. They should also assess organizational readiness throughout the life cycle of a

program to foster continuous program improvement.

 Policymakers interested in future research on readiness could consider determining

commonalities and differences in FOAs across federal agencies, and researching the

differential effectiveness of different types of technical assistance provided based on the

readiness of an organization.

 Researchers should explore the weights of various subcomponents of the R=MC2

heuristic (i.e., the relative importance of different aspects of motivation) to establish high

priority areas for training and technical assistance (TTA).

Introduction 

Program administrators and staff are increasingly called to use evidence-based interventions 

(EBIs) and practices1

1 We define “evidence-based interventions” as programs, practices, or policies that have been proven to positively change the problem 

being targeted by a body of scientific knowledge, usually including some form of evaluation (Kratochwill & Shernoff, 2003). 

 to improve outcomes for children and youth across a variety of areas. 

However, an often unmeasured but necessary precondition for undertaking program 

improvement activities is that an organization be “ready” for the change; that is, staff are 

motivated and capable of making the adjustments required. Readiness (or lack thereof) is key to 

whether a change will take hold successfully or fail to catch on. Readiness to implement EBIs 

effectively influences whether the time, energy, and money dedicated to new programs will be 

well spent.

The purpose of this brief is to describe the role of readiness in implementing and scaling up 

EBIs. Issues that are related to implementation readiness and EBI scale up are relevant to 

producing knowledge about what works, and for moving science into practice in socially 

significant ways. Readiness as conceptualized here, involves the extent to which the members of 

an organization as well as the organization as a whole are motivated, individually as well as 

strategically, and have the capacity to implement an intervention with quality. This brief is 

targeted primarily to staff working in federal agencies but it is also relevant to federal and state 

policymakers, practitioners, researchers, evaluators at all levels, and consumers—those who will 

ultimately benefit from the successful implementation of EBIs at scale.

ASPE ISSUE BRIEF | 2 
What Are the Core Components of Readiness?

This brief builds on the readiness literature and in particular a conceptualization of readiness 

proposed by Scaccia and colleagues (2014). Three components of readiness should be considered 

when implementing an EBI that is new to an organization: motivation, general capacity, and 

intervention-specific capacity.2

2 The focus of this brief is on the readiness of an organization and/or the community where it is located. Equally important, but beyond

the scope of this brief, is the readiness of an EBI to be scaled up and the quality of evidence that suggests that a practice is “evidencebased.” 

The three components can be depicted as R=MC 2 (Readiness = 

Motivation × General Capacity × Intervention-Specific Capacity). 

To What Extent Is the Organization Motivated To Implement the 

Intervention?

Scaccia et al. (2014) define motivation as being influenced by the “perceived incentives and 

disincentives that contribute to the desirability” to use an intervention. We see motivation as both 

individual and organizational. Motivation is specific to the intervention being implemented. It 

includes beliefs about and support for the intervention—such as collective expectations, 

attributes of an intervention, anticipated outcomes of an intervention, pressures for change, and 

emotional responses. Table 1 presents a list of the subcomponents of motivation3

. 

3 For each of the three readiness constructs, the key subcomponents identified from a systematic review of the readiness literature are 

presented. This is not an exhaustive list of all subcomponents that could comprise each readiness construct.

 Table 1. Subcomponents of Motivation 

Subcomponents of 

Motivation Definition of Subcomponent

Relative Advantage Degree to which a particular intervention is perceived as being better than what 

it is being compared against; can include perceptions of anticipated outcomes.

Compatibility Degree to which an intervention is perceived as being consistent with existing 

values, cultural norms, experiences, and the needs of potential users.

Doability Degree to which intervention is perceived as relatively difficult to understand 

and use. 

Trialability Degree to which an intervention can be tested in a pilot fashion before going to 

scale.

Observability Degree to which outcomes that result from the intervention are visible to others.

Priority Extent to which the intervention is regarded as more important than other 

interventions. 

Source: Scaccia et al. (2014)

What Is the General Capacity of the Organization That Will Implement 

the Intervention?

General organizational capacities are related to maintaining a functioning organization 

(e.g., sufficient staffing, effective organizational leadership) and connecting with other 

ASPE ISSUE BRIEF | 3 
organizations and the community. This includes the context, culture, current infrastructure, and 

organizational processes of the organization where the EBI will be implemented. General 

capacities are associated with the ability to implement any intervention (Flaspohler, Duffy, 

Wandersman, Stillman, & Maras, 2008) and include human, fiscal, technical, and evaluative 

categories. Table 2 presents a list of general capacities. 

Table 2. Subcomponents of General Capacities 

Subcomponents of 

General Capacities Definition of Subcomponent

Culture Expectations about how things are done in an organization; how it functions.

Climate How employees collectively perceive, appraise, and feel about their current 

working environment. 

Organizational 

Innovativeness

General receptiveness toward change; i.e., an organizational learning 

environment. 

Resource Utilization How discretionary/uncommitted resources are devoted to interventions. 

Leadership Whether power authorities articulate and support organizational activities. 

Structure Processes that influence how well an organization functions on a day-to-day 

basis.

Staff Capacity General skills, education, and expertise that staff possess.

Source: Scaccia et al. (2014)

What Are the Capacities Needed To Put a Particular Intervention in Place?

Intervention-specific capacities are the human, technical, and fiscal conditions important for 

successfully implementing a particular intervention with quality (Flaspohler et al., 2008; Scaccia 

et al., 2014)4

4 In Scaccia et al. (2014), this is referred to as “innovation-specific capacity.” We use the term “intervention-specific capacity” 

synonymously throughout this brief.

. Although table 3 presents global constructs associated with intervention-specific 

capacity, each new program, practice, or policy has its own set of knowledge and skills required 

to implement it with quality. 

Table 3. Subcomponents of Intervention-Specific Capacity

Subcomponents of 

Intervention-Specific 

Capacity Definition of Subcomponent

Intervention-Specific 

Knowledge, Skills, 

and Abilities

Knowledge, skills, and abilities needed for an intervention, such as an 

understanding of the EBI’s theory of change or skills being taught in curricula. 

Program Champion Key stakeholder(s) who support an intervention through connections, 

knowledge, expertise, and social influence. 

Specific 

Implementation 

Climate Supports

Extent to which the intervention is supported; presence of strong, convincing, 

informed, and demonstrable management support. 

ASPE ISSUE BRIEF | 4 

 
Subcomponents of 

Intervention-Specific 

Capacity Definition of Subcomponent

Interorganizational 

Relationships 

Relationships between (a) providers and the training and technical assistance 

(TTA) support system and (b) between different provider organizations that are 

used to facilitate implementation. 

Source: Scaccia et al. (2014)

Understanding Organizational Readiness as R=MC2

Organizational readiness for an intervention is a function of three components: (1) motivation, 

(2) general organizational capacity, and (3) intervention-specific capacities. Each component 

contributes to an organization’s readiness and is abbreviated by R=MC2 (Scaccia 

et al., 2014). One implication is that if any of the components is zero or near zero, the 

relationship is multiplicative and the organization is not ready to implement an EBI and any 

attempt to implement the EBI before the missing element is addressed will likely be 

unsuccessful. 

For organizations to implement EBIs at scale successfully, it is important for funders, 

researchers, and practitioners to understand readiness and how to create it. 

What Does Readiness Look Like During Different Phases of Implementation?

The National Implementation Research Network framework describes four phases of 

implementation: 

1. Exploration (when people explore the possibility of making use of an innovation) 

2. Installation (where the goal is to acquire or repurpose the resources needed to do the work 

ahead) 

3. Initial implementation (when the innovation is being used for the first time) 

4. Full implementation (reached when 50% or more of the intended practitioners, staff, or 

team members are using an effective innovation with fidelity and good outcomes 

(National Implementation Research Network, n.d.) 

Readiness at one phase does not ensure readiness for the next phase. Communities and 

organizations need to be ready to enter each phase of implementation: exploration, installation, 

initial implementation, full implementation. It would be useful for key stakeholders (e.g., 

leadership, implementers, community members, and clients being served) to discuss readiness 

regularly. Because readiness is dynamic (i.e., it evolves during a project period and can increase, 

stay the same, or decrease over time in different phases), these discussions enable project staff to 

consider readiness components as new challenges arise and to modify the existing approach to 

meet these needs. Readiness indicators can be assessed through a range of methods, including 

surveys of providers, clients served, or community members; focus groups eliciting group 

perspectives; and observation of program components. In the next section, we discuss the 

implications of the readiness heuristic for staff working in federal agencies. 

ASPE ISSUE BRIEF | 5 
Implications of Readiness for Staff Working in 

Federal Agencies

The importance of readiness when implementing an EBI raises a variety of questions for 

practitioners, funders, training and technical assistance (TTA) providers, and researchers, 

including: 

 How can funding opportunity announcements (FOAs) measure the readiness of grantees to 

implement EBIs with quality?

 How can TTA resources be used to assess and support implementation readiness? 

 How can funders partner with TTA providers and practitioners to enable more 

organizations to become ready to implement EBIs with quality? Attention to the readiness 

of grantees during the grant making process and through TTA may improve the likelihood 

that grantees will succeed in implementing their proposed interventions with fidelity and 

can achieve the outcomes projected in their applications. 

A framework can be helpful in providing a big picture for integrating research and practice to 

achieve outcomes and to illustrate the roles of practitioners, researchers/evaluators, TTA 

providers, and funders in this process. Wandersman and colleagues (2008) at the Centers for 

Disease Control and Prevention and elsewhere developed the Interactive Systems Framework for 

Dissemination and Implementation (ISF) to help bridge research and practice in innovative ways. 

The ISF describes three interacting systems: the Delivery System is the organization(s) or 

community setting that actually implements interventions (e.g., mental health centers, schools). 

The Delivery System needs sufficient general capacity, motivation, and intervention-specific 

capacity (i.e., readiness) to be ready to implement an intervention with quality to achieve 

outcomes. The Support System (e.g., training and technical assistance centers) uses strategies like 

TTA to strengthen the Delivery System’s ability to be ready to implement interventions with 

quality (Wandersman et al., 2012). The Synthesis and Translation System synthesizes the 

products of research and translates them into user-friendly formats that practitioners in the 

Support and Delivery Systems can easily access and understand. One of the benefits of using a 

framework such as the ISF to understand readiness is its ability to show how different systems in 

an organization and community interact to promote readiness. For example, the Support System 

can provide targeted TTA based on the Delivery System organizations’ readiness needs (e.g., 

TTA can be provided specifically to improve the motivation of frontline staff). See the sidebar 

for more information about the ISF and how it is being used to synthesize and translate research 

to be ready for practitioners’ use and how funders use it to diagnose major gaps in the logic that 

would lead to outcomes. 

ASPE ISSUE BRIEF | 6 
How To Assess Implementation Readiness Through Funding Opportunity 

Announcements

In various venues, federal staff have expressed a strong interest in asking about readiness 

appropriately in FOAs. Table 4 presents sample questions that could be included in FOAs that 

assess the three readiness components along with criteria that federal staff might use when 

reviewing FOA responses. 

Federal staff could use these criteria in several ways to score applicants. Many of these questions 

and criteria already exist in the problem statement, project design/goals and objectives, 

management plans, and management capacity sections of FOAs. Therefore, these questions and 

criteria could be taken from other sections and included in a new form tied to all federal 

organizations; they could become a Government Performance and Results Act indicator for 

organizational functioning. (Readiness would be one part of this.) When scoring, one suggestion 

is to use a tiered scoring approach in which different applicant scores are associated with 

different levels of funding, TTA support, and evaluation requirements. Each agency should 

consider the implications for proposal length and overall scoring when adding this type of 

information to FOAs. 

Interactive Systems Framework for

Dissemination and Implementation (ISF)

The ISF has been applied in many fields of prevention and treatment, including to summarize the 

literature; for example, home visiting programs (Paulsell, Del Grosso & Supplee (in press); child abuse 

prevention (Brodowski et al., 2013), and diagnosing needs for TTA (e.g., a CDC teen pregnancy 

prevention initiative, Lesesne et al., 2008). Below, we provide a quick example of the three systems 

and how they interact, drawing upon Lesesne et al. and other developments in teen pregnancy 

prevention. There are hundreds of articles and multiple evidence-based programs about teen 

pregnancy prevention. Organizations in the delivery system (e.g., schools, Boys and Girls Clubs) are 

not likely to ask staff to review the literature. A synthesis and translation of the literature would be 

helpful. The U.S. Department of Health and Human Services has gathered information on 

31 evidence-based programs for teen pregnancy prevention (see http://www.hhs.gov/ash/oah/oahinitiatives/teen_pregnancy/db/programs.html). However, having access to a website does not mean 

that the organizations in the delivery system are ready to implement any of the 31 evidence-based 

programs. 

Questions remain, such as “Do organizations have the general capacity to be good host organizations 

for an evidence-based program? Do they have the innovation-specific capacity required to deliver a 

specific evidence-based program that meets the requirements for quality implementation, and are they 

motivated to implement the evidence-based program with quality?” The support system serves as an 

intermediary system that can provide TTA to help delivery system organizations become ready for 

implementation. 

ASPE ISSUE BRIEF | 7 
Table 4a. Examples of Readiness Questions Related to the Motivation Construct To Include in Funding Opportunity 

Announcements

Component Proposed Questions Related to Motivation 

Proposed Criteria for Assessment by Federal Agencies and 

Reviewers Related to Motivation

Relative Advantage To what extent does the proposed approach add value 

to existing practices and programs? Describe how 

different the proposed approach is from current 

practices and existing programs and why you think the 

proposed approach will help you better meet the needs 

of the youth and communities you serve. 

Points given to applicants who describe 

• the programs and practices currently in place and needs 

not currently being met, 

• how the proposed approach will meet these needs and 

how it will do a better job than current programs. 

Compatibility Describe how the proposed approach is compatible 

with other programs already in your school, 

organization, or community and the priorities of your 

school, organization, or community. (E.g., explain 

how new and current programs and practices will be 

aligned, including how the new proposed approach 

will replace or strengthen existing practices, and 

describe current priorities as outlined in a Strategic 

Plan or similar document.) 

Points given to applicants who describe 

• the current programs and practices (if not yet done in 

preceding step), 

• how this program will replace another program or how it 

will be aligned with other programs (e.g., describe how 

training and Professional Development (PD) for all 

existing and proposed programs will be coordinated), 

• how the leadership will message, describe, and support 

this new approach so that it is not regarded as only 

another program added to everything else that staff are 

already doing.5

5 For example, if an organization already has an established mentoring structure in place for new staff and is proposing to implement a new substance abuse program that all staff will be 

trained in, an applicant could describe how the proposed approach would build on that mentoring structure. For example, if all new staff are required to attend monthly 1-hour PD sessions, 

one topic of a PD session could be on the new substance abuse program.

Observability Describe the extent to which outcomes of the 

proposed approach are visible (e.g., explain how you 

will observe the key components of the proposed 

approach to see whether they are being implemented). 

These questions are related to a logic model.

Points given to applicants who describe: 

• the different parts of the proposed approach and how it 

will be observed.6 

6

 Depending on what the proposed approach includes, this could be described as (a) weekly staff meetings for groups of people being trained to allow time for problem-solving 

implementation challenges as they arise, or (b) monthly data meetings for organization staff to review program data and make appropriate changes to the program.

ASPE ISSUE BRIEF | 8 

 
Table 4b. Examples of Readiness Questions Related to the General Capacity Construct To Include in Funding Opportunity 

Announcements

Component Proposed Questions Related to General Capacity 

Proposed Criteria for Assessment by Federal Agencies and 

Reviewers Related to General Capacity

Organizational 

Innovativeness

Describe the extent to which your organization is 

adaptive to change (e.g., provide examples of other 

recently implemented changes to programs and 

practices similar to the topic of the grant application; 

describe staff response to these changes; describe 

successes or challenges encountered during these 

changes and how a continuous improvement process 

helps to deal with challenges that arise). 

Points for applicants who describe: 

• the way their organization handled the implementation of 

a recent change to programs or policies (e.g., how the 

organization handled an implementation challenge), 

• staff survey results about the organization’s openness to 

intervention or continuous improvement approaches. 

Resource Allocation Describe the success of your organization at finding 

and obtaining additional resources (e.g., list grants 

awarded over the past 5 years; describe grants that you 

plan to apply for; describe organizational capacity for 

writing grants). 

Points for applicants who:

• list grants previously awarded and diverse sources of 

funding (ideally funding would come from different 

private and public funders, foundations, or community 

organizations), 

• have a dedicated grant writer or contract writer, 

• describe how they find out about new grants. 

Leadership Describe the degree to which leaders in the 

organization support organizational activities and how 

they plan to convey this support to other staff in the 

organization. 

Points for applicants who describe

• how leadership supports organizational activities and 

plans for communicating this support to other staff. For 

example, does leadership send out monthly updates 

about organizational activities? Do data collection, 

monitoring, and annual reviews of organizational 

activities occur?

Structure How do organizational structures support the 

functioning of the organization on a day-to-day basis? 

(E.g., describe staff size, background and experience, 

training provided to new staff, opportunities for staff 

collaboration, time allocated for staff planning and 

problem solving, the amount of collaboration among 

staff, and internal decision making processes.) 

Points for applicants who describe

• the way their organization functions on a day-to-day 

basis (i.e., what training is provided for new staff, how 

much, when, what structures will be put in place for 

people to collaboratively plan or solve common issues) 

• staff survey results about collaboration among staff or 

the effectiveness of decision making processes.

ASPE ISSUE BRIEF | 9 
Table 4c. Examples of Readiness Questions Related to the Intervention-Specific Capacity Construct To Include in Funding 

Opportunity Announcements

Component

Proposed Questions Related to InterventionSpecific CapacityProposed Criteria for Assessment by Federal Agencies and 

Reviewers Related to Intervention-Specific Capacity

Having a Program 

Champion 

Do key people in your organization support the 

proposed approach? Who are these people (e.g., role, 

level)? 

Points for applicants who describe:

• program staff (especially managers and leaders) who 

have requested this program and who will support it 

going forward (e.g., what part of the organization these 

people are in, and how they will continue to be 

champions of this work throughout the planning and 

implementation phases). 

Implementation 

Climate

What resources will be devoted to the proposed 

approach? (E.g., Will an implementation team oversee 

the implementation of the proposed approach? Who 

will be included in this? How often will they meet? 

How will the organization or community leaders be 

involved in this team?) 

Points for applicants who describe:

• the allocation of resources (not only dollars but the 

number of part- and full-time staff that will be included 

in the proposed approach), 

• the implementation team (who will be part of this), and 

• plans to hold regular (e.g., biweekly or monthly) 

meetings with this team.

Interorganizational 

Relationships 

Do you plan to establish any relationships with other 

organizations also interested in the proposed 

approach? If so, please describe who these 

organizations are and how you plan to maintain such 

relationships over time. 

Points for applicants who describe: 

• how they will share best practices and learn from other 

organizations implementing a similar approach over the 

project period (e.g., a description of a plan to collaborate 

through monthly, quarterly, or yearly calls and visits, 

sharing reports and data tools). 

ASPE ISSUE BRIEF | 10
What Is the Role of TTA in Supporting Implementation Readiness?

TTA providers need to use their limited resources and capacities strategically. Analysis of 

readiness (specifically motivation, general organizational capacity, and intervention-specific 

capacity) can help to align the strengths and limitations of a grantee with the types of TTA that 

are deemed appropriate (Wandersman, Chien, & Katz, 2012). Conversely, organizational staff 

can assess the readiness of their organization to offer different types of support strategies (e.g., 

online vs. in-person, capacity to train all staff in an organization at once vs. capacity to train a 

select group of people in multiple cohorts) and develop their implementation plan accordingly. 

For example, TTA providers could ask organizational staff to answer a brief set of questions 

such as, “Will there be an implementation team to oversee the implementation of this proposed 

approach? Who will be part of this team? What kind of training do members of this team need to 

be successful at implementing this approach? Are there opportunities for ongoing staff 

collaboration after the training that can be used to reinforce and apply skills learned?” The TTA 

being provided could then be customized based on responses to these questions (e.g., if the 

assessment indicates that general capacity needs to be built, then tools, training, and technical 

assistance (TA) will be used to enhance that specific need). If a TTA provider is working with a 

site for an extended period of time, readiness assessments could be completed several times 

during a project and two-way conversations between the TTA provider and TTA recipients could 

inform how to improve different aspects of readiness. 
How Do We Partner With and Foster Readiness in Settings With Limited 

Capacity and Willingness?

Some organizations with critical 

needs and who receive federal 

funding may not currently have the 

capacity to implement EBIs with 

quality.7

7 An important first step is to assess the potential of organizations to develop readiness (DiMaggio & Powell, 1983; Levin & Minton, 

1986). Several measures to be used for this purpose are listed in Additional Resources. 

 This problem can be 

addressed by working with these 

organizations to first build their 

capacity through a readiness 

development phase of the initiative. 

For example, the Substance Abuse 

and Mental Health Services 

Administration (SAMHSA) has done 

this with its Circles of Care program, 

which helps tribal communities build 

a capacity to implement systems of 

care and in so doing, to compete for 

grants under the Comprehensive 

Community Mental Health Services 

for Children and Their Families 

Program. The Maternal Infant and 

Early Childhood Home Visiting 

Program is another example. Lessons 

learned from this effort emphasize the 

importance of developing trusting 

relationships in which federal staff 

and TA providers work closely with 

grantees during the project period to 

provide support in three major areas: 

(a) developing a needs assessment 

and plan for responding to identified 

needs, (b) developing and carrying 

out their implementation plans, and 

(c) designing and carrying out a 

locally driven rigorous evaluation. 

Another example includes the 

Permanency Innovations Initiative 

(PII) which is a multi-site federal 

demonstration project designed to improve permanency outcomes among children in foster care 

who face the most serious barriers to permanency (Permanency Innovations Initiative Training 

and Technical Assistance Project & Permanency Innovations Initiative Evaluation Team, 2013). 

Maternal, Infant, and Early Childhood 

Home Visiting Program 

In 2010, the Maternal Infant and Early Childhood Home 

Visiting Program (MIECHV), administered by the Health 

Resources and Services Administration (HRSA) in 

collaboration with the Administration for Children & Families 

(ACF), implemented a provision of the Patient Protection 

and Affordable Care Act (2010), which expanded home 

visiting to states, territories, and tribes (Supplee, et al., 

2013). Through this effort, three percent of funds were set 

aside for tribes, tribal organizations, and urban Indian 

organizations and administered by ACF. To promote the 

capacity of the tribal MIECHV grantees, ACF required 

grantees to develop a needs assessment to assess their 

capacity to implement home visiting programs and use the 

results to create a plan for responding to identified needs. 

Ongoing TA and support continued throughout the 

implementation process by having ACF staff and TA 

providers work closely with the grantees as they developed 

and carried out their implementation plans.

Tribal grantees were also required to conduct a rigorous 

evaluation of their home visiting program, its 

implementation, or both, because of limited evidence in the 

field about the effectiveness of home visiting in tribal 

communities

(http://homvee.acf.hhs.gov/Tribal_Report_2012.pdf). The 

Office of Planning, Research & Evaluation (OPRE) within 

ACF funded the Tribal Home Visiting Evaluation Institute 

(TEI) to provide TA in designing locally driven, rigorous 

evaluations of home visiting. The TEI provides 

individualized, culturally relevant TA that empowers 

grantees to conduct research and evaluation that is 

meaningful for the tribe and meets FOA requirements for 

rigor (i.e., credibility, applicability, consistency, and 

neutrality). The TEI builds on ACF’s past and continuing 

efforts to build evaluation and research capacity within 

American Indian/American Native communities to improve 

their early childhood programming. The approach TEI takes 

to helping grantees develop an evaluation plan that links 

their community needs to the intended impact of the home 

visiting model enables communities to build readiness 

within a prescribed framework.

ASPE ISSUE BRIEF | 12

 
An overarching objective of PII is to develop interventions that are supported by solid evidence 

of effectiveness and are ready for replication, adaptation, and broad-scale rollout. PII grantees 

are guided through four implementation stages: exploration, installation, initial implementation, 

and full implementation. A specific focus of PII is on building readiness during the exploration 

stage where grantees receive technical assistance to coordinate a teaming structure, select and 

promote buy-in for an intervention, and plan for implementation and evaluation of the 

intervention. These activities are intentionally intended to create readiness for change within 

grantee organizational structures, ensure the appropriateness of the selected target population for 

intervention, assess the needs of the target population, and determine the feasibility of the 

interventions meeting those needs. 

Directions for Future Research

Although scholarly work has identified several core components of readiness and this brief 

presented some policy implications, gaps still exist in the field’s understanding of how readiness 

relates to scaling up and implementing EBIs. Future research directions could include (a) how to 

measure the relative importance of motivation, general capacity, and intervention-specific 

capacity in grant applications (and their subcomponents) and (b) how to understand differences 

in readiness based on scale of implementation (e.g., communities vs. states) and different types 

of organizations (e.g., child welfare vs. substance abuse treatment providers, faith-based 

coalitions vs. not-for-profit organizations, small businesses vs. national providers, or urban vs. 

rural settings). One future direction identified by our federal coauthors involves the analysis of 

performance data (e.g., Government Performance and Results Act indicators) collected in crosssite, national, and local evaluations, and how readiness constructs can be investigated using these 

data. This type of program data, which is widely available, should be assessed for its quality. If 

the quality of the data is confirmed, they could be used along with quantitative and qualitative 

data collected during the implementation and evaluation of an EBI to increase our understanding 

of how different aspects of readiness play out in practice. A second future direction involves 

developing some readiness criteria among different programs that could be useful to explore 

differences in readiness and its importance in the successful implementation of EBIs. For 

example, future work could identify criteria for working with communities that have limited 

infrastructure—in other words, criteria that communities should meet before being selected for 

implementing an EBI. Based on information gleaned from several federal staff with expertise in 

this area, these criteria might include (a) strong leadership support from a senior and midlevel 

staff member, (b) alignment of the intervention with their strategic plan, and (c) evidence of 

organizational sustainability (e.g., resources are in place for the organization to function for the 

next 5 years). 

Knowledge Sharing Among Staff at Federal Agencies about Readiness

Several approaches to practice and intentional research could enhance knowledge on these 

topics. Although there has been a focus on linking science with practice across agencies, grant 

programs, and grantees, this effort has been sporadic. An assessment of FOAs across federal 

agencies could help ensure the proper exploration of commonalities and differences in effective 

strategies and performance measurements across varying types of applications (e.g., intervention 

programs vs. surveillance systems). Research could compare the effectiveness of TTA being 

provided based on an organization’s readiness by assessing the relationship of TTA to program 

ASPE ISSUE BRIEF | 13
outcomes for communities with different levels of initial readiness. This could inform best 

practices for infusing readiness based on certain organizational or community characteristics. 

Conclusion

To increase the number of grantees that will succeed at implementing EBIs and achieving 

positive outcomes, it is important to understand what grantees should have in place before and 

during implementation. Scholarly work suggests that in order to be successful grantees should be 

willing (motivated) and able (have the general and intervention-specific capacities). Recognizing 

the importance of readiness has several policy implications for federal funders; these include 

assessing readiness during the grant application process, using readiness data to deploy TTA 

strategically, and building readiness in organizations with limited capacity. More 

communication, collaboration, and systematic evaluation among federal partners about these and 

other policy implications can help deepen the evidence base on readiness and promote the 

successful implementation of EBIs.

Additional Resources

Measures of Organizational Readiness (2005)

This summary document, developed by the National Association of State Mental Health Program 

Directors (NASMHPD) Research Institute, reviews measurement instruments that can be used to 

assess the readiness of organizations to implement EBIs. 

Dimensions of Organizational Readiness (Hoagwood, 2003)

The Dimensions of Organizational Readiness (DOOR) instrument was developed as a state 

planning tool designed to identify stakeholder beliefs and attitudes about organizational 

processes. This instrument incorporates six domains, including invention characteristics, 

practitioner characteristics, client characteristics, service delivery characteristics, service agency 

characteristics, and service system characteristics. 

General Organizational Index (GOI) (Lynne, Finnerty, & Boyle, 2005)

The GOI instrument measures a set of organizational characteristics related to the capacity of 

organizations to implement and sustain EBIs. It incorporates the following domains: program 

philosophy, eligibility/client identification, penetration, assessment, individualized treatment 

plan, individualized treatment, training, and supervision. The GOI score sheet and protocol can 

be found on pages 57–72 of the SAMHSA document, Evaluating Your Program: Assertive 

Community Treatment. 

Organizational Climate Measure (OCM) (Patterson, et al., 2005)

The OCM instrument was developed to assess aspects of organizational climate that affect the 

effectiveness of organizations. The instrument incorporates the following constructs: acceptance 

of new ideas, ability to respond to change, identification of need for change, flexibility in 

ASPE ISSUE BRIEF | 14
responding to changes needed in procedures, support in developing new ideas, and orientation to 

improvement and innovation. 

Organizational Readiness for Implementing Change (ORIC) (Shea et al., 

2014)

The ORIC measure was developed to assess organizational readiness for change in health care 

settings. The measure includes two facets, change commitment (i.e., organizational members’ 

shared resolve to implement and change) and change efficacy (i.e., organizational members’ 

shared belief in their collective capability to implement a change).

References

Brodowski, M. L., Counts, J. M., Gillam, R. J., Baker, L., Spiva Collins, V., Winkle, E., et al. 

(2013). Translating evidence-based policy to practice: A multilevel partnership using the 

Interactive Systems Framework. Families in Society: The Journal of Contemporary 

Social Services, 94(3), 141–149. 

DiMaggio, P. J., & Powell, W. W. (1983). The iron cage revisited: Institutional isomorphism and 

collective rationality in organizational fields. American Sociological review, 48, 147-160. 

Flaspohler, P., Duffy, J. L., Wandersman, A., Stillman, L., & Maras, M. (2008). Unpacking 

prevention capacity: The intersection of research to practice models and communitycentered models. American Journal of Community Psychology, 41, 182–196. 

Hoagwood, K., Schoenwald, S. K., & Chapman, J. E. (2003). Dimensions of Organizational 

Readiness-Revised (DOOR-R). Unpublished instrument. 

Kratochwill, T. R., & Shernoff, E. S. (2003). Evidence-based practice: Promoting 

evidence-based interventions in school psychology. School Psychology Quarterly, 18(4), 

389. 

Lesesne, C. A., Lewis, K. M., White, C. P., Green, D. C., Duffy, J. L., & Wandersman, A. 

(2008). Promoting science-based approaches to teen pregnancy prevention: Proactively 

engaging the three systems of the interactive systems framework. American Journal of 

Community Psychology, 41(3-4), 379-392. 

Lewin, A. Y., & Minton, J. W. (1986). Determining organizational effectiveness: another look, 

and an agenda for research. Management science, 32(5), 514-538. 

Lynne, D., Finnerty, M., & Boyle, P. (2005). Implementing EBPs: Early results and the use of 

the General Organizational Index and other tools in implementing EBPs. Paper presented 

at the Fifteenth Annual NRI Conference on State Mental Health Agency Services 

Research, Program Evaluation, and Policy. Baltimore, MD. 

Measures of Organizational Readiness. (2005). NASMHPD Research Institute. Retrieved from

http://www.nri-inc.org/reports_pubs/2005/EBPMeasuresOrgReadiness2005.pdf 

ASPE ISSUE BRIEF | 15
National Implementation Research Network. Implementation stages. Retrieved from

http://nirn.fpg.unc.edu/learn-implementation/implementation-stages

Nevid, J. S. (2011). Psychology: Concepts and Applications: Concepts and Applications. 

Cengage Learning.

Patterson, M., et al. (2005). Validating the organizational climate measure: links to managerial 

practices, productivity and innovation. Journal of Organizational Behavior, 26, 379-408. 

Retrieved from https://wiki.uio.no/admin/amunder/images/a/a0/OCM-1-.pdf 

Paulsell, D., Del Grosso, P., & Supplee, L. (in press). Supporting replication and scale-up of 

evidence-based home visiting programs: Assessing the implementation knowledge base 

using the Interactive Systems Framework for Dissemination and Implementation. 

American Journal of Public Health. 

Permanency Innovations Initiative Training and Technical Assistance Project & Permanency 

Innovations Initiative Evaluation Team. (2013). The PII approach: Building 

implementation and evaluation capacity in child welfare (Rev. ed). Washington, DC: U.S. 

Department of Health and Human Services, Administration for Children and Families, 

Children’s Bureau, and Office of Planning, Research and Evaluation. 

Scaccia, J., Cook, B., Lamont, A., Wandersman, A., Castellow, J., Katz, J., & Beidas, R. (in 

press). A practical implementation science heuristic for organizational readiness: R = 

MC2. Journal of Community Psychology.

Shea, C. M., Jacobs, S. R., Esserman, D. A., Bruce, K., & Weiner, B. J. (2014). Organizational 

readiness for implementing change: a psychometric assessment of a new measure. 

Implementation Science, 9(1), 7-22. 

Supplee, L. H., Harwood, R. L., Margie, N. G., Meyer, A. L. (2013). New opportunities and 

directions in home visiting research and evaluation. Zero to Three, 33(3), 45-50. 

Wandersman, A., Chien, V. H., & Katz, J. (2012). Toward an evidence-based system for 

innovation support (tools,) for implementing innovations with quality: Tools, training, 

technical assistance, quality assurance/quality improvement. American Journal of 

Community Psychology, 50(3-4), 445–459. 

Wandersman, A., Duffy, J., Flaspohler, P., Noonan, R., Lubell, K., Stillman, S., et al. (2008). 

Bridging the gap between prevention research and practice: The Interactive Systems 

Framework for Dissemination and Implementation. American Journal of Community 

Psychology, 41(3–4), 171–181. 

ASPE ISSUE BRIEF | 16
DEPARTMENT OF HEALTH

& HUMAN SERVICES

Office of the Secretary

Washington, DC

OFFICIAL BUSINESS

Penalty for Private Use $300