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Overview

OVERVIEW AND EVIDENCE BASE

What do we mean by this process?

Assuring Technical Assistance is a process of connecting groups to expertise and resources that address needs and provide support over phases of a community improvement effort. Participation in this process can enhance competencies (i.e., in planning or evaluation) and specialized knowledge (e.g., child development), and increase a group's potential to affect change. The process of Assuring Technical Assistance secures and provides support to communities over time as they plan, implement, evaluate, and sustain efforts for making a difference. When groups engage in this process, they are strengthening their own capacities to learn, practice, and subsequently implement effective prevention strategies.

Assuring Technical Assistance is a key process to help groups create conditions for being effective in their community improvement effort.

How it works

Community researchers and practitioners have repeatedly expressed the need for timely and accessible technical assistance to support the often complex process of community change and improvement. Technical assistance may be needed and requested for different purposes, including: (a) Using data to set priorities and establish goals and objectives, (b) integrating individual and environmental approaches for change, (c) selecting and implementing effective programs at the local level, and (d) incorporating outcome evaluations into the effort. Timely and appropriate technical assistance can create conditions for communities to address these and other challenges. Groups that build and support core skills and knowledge via technical assistance can strengthen "member capacity" and become more effective at producing desired changes (Foster-Fishman, Berkowitz, Lounsbury, Jacobson, & Allen, 2001).

Although the exact forms of effective technical assistance remains uncertain, Assuring Technical Assistance may helps groups to:

  • Connect external and internal human resources with particular expertise for addressing needs (e.g., Holder et al., 1997; Nezlek & Galano, 1993)
  • Enhance participation by providing needed supports and increasing access to essential member resources (Foster-Fishman, Berkowitz, Lounsbury, Jacobson, & Allen, 2001). This process can build capacity for action by building capacity of members, and also create a shared skills-based or common ground for taking collaborative action (Kreuter, Lezin & Young, 2000; Parker et al., 1998).
  • Enhance core competencies for this work, including community assessment, member recruitment and leadership development, action planning, program development and implementation, evaluation, social marketing, and fundraising (e.g., Roussos & Fawcett, 2000). Technical assistance and support can also provide the "glue" to keep a partnership together by offering and facilitating a process of listening, group process, negotiation, and humility (Israel, Schulz, Parker, & Becker, 1998).
  • Increase the chance of successful implementation and sustainability of prevention efforts by striking a balance between scientific evidence of effective prevention programming and local communities' knowledge of what would work in their specific context (Mitchell, Florin, & Stevenson, 2002)
  • Address context-sensitive issues such as available resources and staff development that can influence project implementation and effectiveness (e.g., Florin, Mitchell, & Stevenson, 1993).
  • Overcome geographical, economic, and other barriers for addressing needs by working with innovative (e.g., Internet-based) support systems (e.g., Fawcett et al., 2000; Fawcett, Schultz, Carson, Renault, & Francisco, 2003)

Empirical and Experiential Evidence

In a study of six community programs implementing the Planned Approach To Community Health (PATCH), technical assistance mostly focused on collecting data for a needs assessment (e.g., Behavioral Risk Factor Survey). Similar levels of technical support were not provided to analyze and interpret data, build consensus to determine priorities, or plan and implement relevant and effective strategies. This type of "front loading" disproportional support for data gathering dampened planning efforts and the abilities of projects to implement substantial interventions (Goodman, Steckler, Hoover, & Schwartz, 1993). Despite this challenge, projects with the greatest implementation successes were those with leaders who had experiences and training in the work of community health promotion. Consequently, in the absence of such skills, efforts to build community capacities (e.g., workshops, mentoring, and other training) and transfer professional expertise to community members are essential for success.

Effective and systematic provision of technical assistance is also critical for implementing proven interventions (see Implementing Effective Interventions). Overall, little research is directed at how to disseminate and increase community adoption of interventions shown to be effective in research settings. Many "technology transfer" efforts fail to change implementation behaviors because they rely on providing information, a relatively weak strategy, as their primary dissemination approach. By contrast, in a randomized trial of 74 organizations, Kelly et al. (2000) reported that dissemination packages that included (a) Implementation manuals, (b) staff training workshops, and (c) follow-up consultation resulted in more frequent adoption and use of research-based HIV prevention interventions. As such, if research findings are to be used by providers, technical assistance and support activities must go beyond developing a compendium of effective interventions. Additional support might also involve community members and organizations in determining unmet needs and strategies to address them.

Internet-based technical assistance and support also makes the work of community change and improvement easier and more rewarding (Fawcett, Schultz, Carson, Renault, & Francisco, 2003). The Community Tool Box is an online resource that includes (a) information and tools to guide the work, (b) a documentation system to understand and improve targeted intervention, (c) forums and other learning communities for co-learning and problem-solving, and other resources for developing core competencies and building capacity. Although no substitute for face-to-face contact, these Internet-based tools are a relevant method for community-based participatory research and action. They also serve a multiplier role by enabling efforts to expand and go to scale.

It is important to note that several barriers such as denied funding can limit access to technical assistance, especially when support is organized by external sources. As such, what we are learning about the effects of Assuring Technical Assistance often comes from support provided to funded communities.

Implications for Research and Practice

At present, much of the information available on Assuring Technical Assistance does not explicitly manipulate or test this process and its effects on community change and improvement. Although this process has been identified as a key ingredient for advancing change, there is a need for more systematic evaluations of its implementation and effects. Such research would provide a better understanding of types of technical assistance and support mechanisms that effectively assist community initiatives as they pursue community change and improvement.

Some key research questions include: (a) What are necessary components of and indicators to measure effective technical assistance? (b) A what level (e.g., individual, organization, community) or to what end (e.g., changes in context, activities, outcomes) should technical assistance support be directed? (c) What are the gaps or unmet needs in current technical assistance efforts? (d) Under what conditions (e.g., frequency, duration, content) is the provision of technical assistance associated with program improvements (e.g., program implementation, changes in more distant outcomes)? (e) How can communities, technical assistance providers, and funders work together to determine effective technical assistance arrangements? And (f) How can "unfunded" communities secure support and technical assistance to address their needs?

Overall Recommendation for Practice

Based on research and experience, we highly recommend Assuring Technical Assistance as a key process to advance community change and improvement.