Connecting technical and relational competencies in implementation support.

Blog post by Rouzana Komesidou & Tiemen Visée

Rouzana Komesidou is a researcher, consultant, and the founder of Mosinian Research & Consultancy, located in Limassol, Cyprus. Her research and consulting work focus on creating the necessary conditions within systems to implement and sustain quality programs for youth, families, and communities.

Tiemen Visée is an implementation support practitioner at the Trimbos-Institute, the Dutch knowledge institute for mental health, the use of alcohol, tobacco and drugs.

In November 2022, the EIC offered an exciting scholarship opportunity for its members to attend the Certificate Program in Implementation Practice by the Collaborative for Implementation Practice at UNC School of Social Work. The certificate program helps implementation support practitioners to strengthen their technical (e.g., assess needs and assets, use implementation science frameworks, conduct improvement cycles) and relational (e.g., build trusting relationships, co-design, address power differentials) competencies to support program implementation. 

Over the course of six weeks, we had the privilege of hearing from experts in the field of implementation science, learning about implementation competencies, and pushing ourselves to question our assumptions. We are thankful for the opportunity to reflect on and share our experiences in this blog. 

Rouzana’s experience

As a researcher, I use implementation science to improve educational and clinical services for children with communication disorders (i.e., disorders in speech, language, and/or hearing). My journey in implementation science started with a focus on technical competencies to promote uptake of evidence-based practice in schools. These included knowing how to define the problem or gap in service delivery, using frameworks and approaches to adapt and implement interventions, and building capacity for continuous improvement and sustainment. 

Technical competencies serve as a crucial foundation for ensuring quality implementation of evidence-based programs and are vital for achieving desired outcomes. However, technical competencies represent just one side of the coin. Relational competencies, such as effective communication, co-learning, and building trusting relationships with partners, are equally important for achieving sustainable and meaningful implementation outcomes. Both technical and relational competencies must work in tandem for comprehensive and effective implementation.

Prior to this course, I did not have any opportunities to concentrate on my relational competencies. While there is an expectation for us to possess strong relational skills in order to advance our research agendas, unfortunately, we often do not allocate enough time to fully understand and develop these skills. As an outsider, it can be challenging to enter schools and establish trusting relationships with administrators, educators, and families. Building rapport and gaining trust is difficult due to numerous factors, including differences in priorities and perspectives, power dynamics, and a history of mistrust in research. 

The certificate program allowed me to reflect on my past experiences and shortcomings, and to dedicate time to understanding and practicing relational skills. I am excited to continue developing both my technical and relational competencies in implementation support and use them to create systems that children with communication disorders, their families, and the professionals who work with them deserve. 

Tiemen’s experience 

I started work at a local welfare and healthcare organization, mainly implementing national programs into a local context. This often requires a local professional who focuses on building relationships, trust, co-creation, and brokering to successfully launch a program in a community. This is where my journey in implementation science began.

Whether it was getting seniors to participate in fall prevention training, parents to adopt a different parenting style, or motivating troubled youth for addiction treatment, it was essential to first establish a relationship before implementing an evidenced-based program (EBP). Without this relationship, I was just another professional trying to get something from the community. Making sure I got their support often led to reduced program effectiveness because the community’s needs and desires were not in line with the EBP. For instance the evidence-based fall prevention training would be 2 times a week for 10 weeks with boring exercises as described by the elderly. So in order to get elderly to participate I made it 1 time a week for 12 weeks and for them to stay I replaced exercises with games. Now, I work on the other end of the spectrum. I work for an EBP and implement it in the local community without losing the effective elements. Once again, building relationships and trust is critical for a successful implementation.

During this course, I learned how to combine technical aspects of implementation science with the relational aspects of the work. Instead of adapting the program to the community’s wishes, I now can use implementation science to employ tactics that ensure communities embrace the program. This includes identifying obstacles and developing strategies to overcome them, as well as identifying community strengths and leveraging these strengths to strengthen the program.

All in all, I knew that building relationships and earning trust is essential for a successful program implementation in a local context. But combining it with the technical aspects of implementation science, I can help communities effectively embrace programs and benefit from their advantages.

We are happy to share our experiences so feel free to connect with us if you want to hear more!

Rouzana Komesidou, Email: [email protected]

Tiemen Visée, Email: [email protected]