Organizational and Systems Factors Impacting the Adaptation of a Child Welfare Practice Model from the UK to Finland

Figures & data

Figure 1. The revised EPIS framework by Moullin et al. (2019).

Figure 2. Illustration of stakeholders interviewed for the study at the team, organization, and system levels. Note: CSW = a consultant social worker.

Table 1. Example of generating the theme “innovation factors” through thematic analysis.

Main theme derived from the EPIS framework	Most frequently associated codes linked to the main theme	Identified topics and patterns	Final sub-theme (i.e., the EPIS construct)
Innovation factors	Creating the adaptation	Transferring and adapting the model	Innovation developers
	Excitement
	Model utility	Model utility	Innovation characteristics
	Model clarity	Model clarity
	Difference to service as usual
	Understanding of the model
	Little knowledge of the model
	Model’s fit to child protection	Model’s fit to child protection	Innovation fit
	Differences and similarities between the RSW and the SPM	Model’s fit to the Finnish context
	Model’s foreign origin

Table 2. EPIS constructs identified from the data.

	EPIS construct	Definition (Moullin et al., 2019, pp. 12–13)	Key barriers and facilitators
Outer context	Service environment/policies	“State and federal sociopolitical and economic contexts that influence the process of implementation and delivery/use of the innovation”	Contrary to expectations, the interviewees identified few differences between the two service systems, which aided the adaptation of the RSW model to Finland. In turn, the governmental term of office created a short timetable for the initiative. Along with grant-based financing and parallel reforms, these factors challenged the implementation process.
	Funding/contracting	“Fiscal support provided by the system in which implementation occurs. Fiscal support can target multiple levels (e.g., staff training, fidelity monitoring, provision of the innovation/EBP) involved in implementation and delivery/use of the innovation”	Highly limited resources at both national and local levels impeded the implementation planning and preparations. Contracting with private stakeholders enabled the delivery of the national ToT.
	Leadership	“Characteristics and behaviors of key decision-makers pertinent at all levels who are necessary but not sufficient to facilitate or promote the implementation process and delivery/use of the innovation”	The key decision-makers expressed commitment to the initiative but an “ad hoc” implementation strategy created a vicious cycle that created new implementation barriers.
	Inter-organizational environment and networks	“Relationships of professional organizations through which knowledge of the innovation/EBP is shared and/or goals related to the innovation/EBP implementation are developed/established”	Clear roles within central government aided the process but a lack of collaboration with the original developers when modifying the model to the Finnish context left the adaptation imprecise.
Innovation factors	Innovation/EBP developers	“Characteristics of the individuals or team(s) responsible for the creation of the EBP/innovation that may be the subject of implementation efforts”	Enthusiasm and persistent advocacy aided the transportation of the model from the UK to Finland. In turn, the decision to allow full flexibility in the model’s implementation prevented its consistent delivery throughout the country.
	Innovation/EBP Characteristics	“Features or qualities of innovations to be implemented”	Positive perceptions of the SPM facilitated the implementation but a lack of clarity of its essential elements was a hindering factor.
	Innovation/EBP fit	“The extent to which the innovation/EBP fits the needs of the population served or context in which it is implemented”	For the most part, the model (especially related therapeutic approach) was seen to fit into Finnish child protection social work.
Bridging factors	Purveyors/intermediaries	“Organizations or individuals providing support or consultation for implementation and/or training in the innovation”	The national ToT facilitated the dissemination of the model in the country. However, the majority of agency trainers expressed their disappoinment at the failure of the ToT to provide them with the necessary knowledge and skills to train teams to engage in systemic social work practice.
Inner context	Organizational characteristics	“Structures or processes that take place and/or exist in organizations that may influence the process of implementation”	Many managers reported challenges in preparing the organization for the implementation. Several trainers received mixed feedback on the local training sessions.
	Leadership	“Characteristics and behaviors of individuals involved in oversight and/or decision-making related to EBP implementation within an organization”	Although most managers perceived the model’s implementation positively, their engagement with the initiative varied.
	Quality and fidelity monitoring/support	“Processes or procedures undertaken to ensure adherence to active delivery of the innovation/EBP and/ or an implementation strategy”	In general, a lack of fixed training package and material frustrated the local trainers and led to a high degree of variance in training across the country.
	Organizational staffing processes	“The processes or procedures in place at an organization related to the hiring, review, and retention of staff involved in the active delivery of the innovation/EBP and/or its implementation”	Successful recruitments and staff retention in the implementation teams aided the effort, whereas staff turnover created challenges.
	Individual characteristics	“Shared or unique characteristics of individuals (e.g., provider, supervisor, director) that influence the process of implementation”	Many managers and CSWs were thankful for the practitioners’ motivation to implement the new model and expressed commitment to the implementation process. Some trainers were concerned about consultant social workers’ partial participation and social workers’ resentment during the training sessions.

Moullin, J., Dickson, K. S., Stadnick, N. A., Rabin, B., & Aarons, G. A. (2019). Systematic review of the exploration, preparation, implementation, sustainment (EPIS) framework. Implementation Science : IS, 14(1), 1–1. https://doi.org/10.1186/s13012-018-0842-6

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