In his Indenture of Trust, which created The Duke Endowment more than a century ago, industrialist and philanthropist James B. Duke stated, “…in my opinion nothing can take the place of the home and its influences.” Today, in service of Mr. Duke’s vision, the work of the Endowment’s Child and Family Well-Being (CFWB) team focuses on keeping families together and avoiding or minimizing interactions with the child welfare system.
A key part of our strategy is to help scale and expand the use of programs and practices that are proven to achieve this goal. Evidence-based or evidence-informed programs are key to this effort because they have been rigorously tested and evaluated to demonstrate their effectiveness. Evaluation of these programs reveals that our partners’ work and our investments in them are delivering the outcomes our communities need and want.
Of course, evidence-based approaches are not “one-size-fits-all.” We look for programs proven to deliver positive outcomes across diverse populations, such as race, ethnicity, rural or urban settings, and more. When the evidence is limited but the ideas seem promising, we support exploring alternative approaches to better meet the needs of these populations.
What Role do Intermediaries Play?
Adopting and implementing an evidence-based program isn’t as simple as “plug and play.” Providers often need support and expertise as they learn about new models and plan strategies to implement them with ongoing quality and fidelity. To meet this need, the Endowment relies on knowledgeable intermediary partners like Children’s Trust of South Carolina to help other organizations build the capacity to deploy evidence-based programs.
Children’s Trust has served as a statewide intermediary for the expansion of several evidence-based approaches, including the Strengthening Families Program. Strengthening Families is a 14-week family skills training program that provides weekly classes for parents and youth separately, followed by a joint family practice session and family homework assignments. The Duke Endowment was attracted to Strengthening Families because of its focus on increasing protective factors and decreasing risk factors to family stability, as well as the strong body of evidence Strengthening Families has gathered from trials in multiple countries and cultures.
The implementation of evidence-based programs is an intentional, multi-year process. Our intermediaries often begin their work with one or two organizations or locations and gradually expand their reach to new populations or locations, helping agencies build capacity to implement programs with fidelity and assess if they are achieving intended outcomes. Children’s Trust and other intermediaries have expertise in implementation science and help partners mitigate implementation challenges, sustain efforts over time and achieve intended outcomes.
What Makes Strengthening Families Scalable?
Because it is a proven, evidence-based program, Strengthening Families was primed to grow in scale. Children’s Trust’s deep experience with family preservation and expertise in implementation science offered the opportunity to expand Strengthening Families statewide.
In 2015, the Endowment supported Children’s Trust and the South Carolina Department of Social Services (SCDSS) with a five-year investment to expand Strengthening Families in 23 counties across the state. While SCDSS provided direct support to service providers to deliver the program, Children’s Trust offered readiness assessments and implementation planning, ongoing coaching, fidelity monitoring and assistance using data to continually improve practices and develop local and/or state sustainability for the evidence-based work.
Children’s Trust was already a well-known and trusted organization among providers, having worked with them to implement other evidence-based parenting programs such as Triple P. This made it easier to recruit providers to engage in the Strengthening Families program.
In 2025, Strengthening Families served 853 families in 26 counties throughout South Carolina. As a funding partner for this work, the Endowment’s CFWB team conducts regular check-ins with Children’s Trust to continually learn alongside this intermediary, serve as a thought partner and promote successes.
How has Strengthening Families Supported Families?
While expansion is great, what’s most important are the positive results that providers have consistently delivered over the past 10 years. Even during 2020, when COVID-19 forced a switch to virtual delivery, Strengthening Families in South Carolina exceeded the 75 percent national benchmark for program completion, with 89 percent of virtual participants and 81 percent of in-person participants completing the program. In terms of outcomes, evaluations have consistently shown improvements for families, parents and children. The program measured 13 specific outcomes in 2025, and all 13 showed improvement. The Endowment believes that fidelity and outcomes are made possible by the intermediary support that Children’s Trust provides.
Participating families share positive reflections on the experience. As one father said, “Our family is much better at communicating with each other, and we work together as a unit when everyone is helping.” And a 9‑year-old shared, “I am better at talking to my mom without having an attitude because we set up a family meeting to solve our problems.”
Applying Lessons for the Future
The Endowment and its intermediary partners have had great success in expanding several evidence-based programs to the point of endorsement or adoption by state governments. This is true for Triple P in South Carolina and the Success Coach program in North Carolina. However, not every expansion effort has worked. There are myriad factors at play when a program is unable to scale. Rather than considering these incidents “failures,” we use them as learning opportunities to consider and apply in the future.
As for Strengthening Families and other evidence-based programs that show promise, we are continuing to build the capacity of intermediary partners in both states to support implementation. In doing so, we continue Mr. Duke’s legacy of supporting family preservation.
