Implementation
What you must know
Implementation is delivery with quality control. Core concepts: fidelity (delivering the intervention as designed) versus adaptation (modifying it for context); dose delivered versus dose received; reach; and pilot testing before full rollout. Know the distinction between adapting surface structure (language, images, food examples, setting, delivery channel) and altering deep structure (the theory-based core components that make the program work). Be prepared to discuss staff recruitment, training, and technical assistance; participant recruitment and retention (incentives, reminders, trusted messengers); materials development using plain language and readability standards; logistics tools like the Gantt chart; partnership coordination; marketing of the program; and sustainability planning, including institutionalization and diversified funding. Quality assurance and continuous monitoring allow mid-course correction rather than waiting for the final report.
Traps questions set
- Treating any change to a program as an acceptable adaptation - the test is whether core components survive.
- Confusing dose delivered (what staff provided) with dose received (what participants experienced).
- Skipping pilot testing and moving directly to scale-up.
- Assuming a program proven elsewhere will perform identically in a new population without adaptation.
- Building a marketing plan that ignores the audience segment most in need.
Rule of thumb
Adapt surface structure freely; protect deep structure absolutely. If you remove a core component, you are testing a new intervention and need a new evaluation.
Worked example: A curriculum validated with college students is delivered in Spanish to a community center. Changing language, images, and meeting times is fine; dropping the self-efficacy skill-building sessions is not - that is the active ingredient.