A Strategy for Improving Child and Family Well-Being
Evidence-based programs and practices are a cornerstone of The Duke Endowment’s work. The Endowment focuses on data and evidence in order to be strategic with our investments, expecting that these efforts will lead to better outcomes for individuals and communities across the Carolinas. This approach also drives our Child and Family Well-Being team in their efforts to support organizations that are working to bring lasting positive change to children within or at risk of entering the child welfare system. However, adding a new approach into an organization’s work isn’t as easy as “plug-and-play.” It takes intentional work and time for an organization to prepare its leadership and staff to implement a new program with fidelity – in ways that uphold the critical elements of the program while adapting to the realities of the organization and the people it serves.
That’s where implementation science comes in.
What is Implementation Science?
Implementation science studies how best to support the successful adoption of proven or promising programs. It addresses the gaps between what research shows can be successful and how that knowledge is applied in real-world settings. Simply put, if a particular program is “what” an organization would like to use, then implementation science helps the organization determine “how” the program can be launched and run successfully over the long term.
It seems like this should be a simple process: explain the benefits, provide some training and then allow the program to operate on its own. But in reality, there are many steps and aspects to helping organizations truly embrace and successfully deploy a new program. And even more work is required over a longer period to get others in the field to adopt and scale them.
Implementation science helps organizations answer questions such as: How can this program be most relevant to communities? What kind of skills, knowledge or lived experience should program staff have, and what kind of ongoing training and coaching will they need? What type of data collection and evaluation will help assess success and support quality improvement?
If explored and addressed accurately, these and other questions shape how an organization can create and support a competent, confident team that deploys a model in community-centered ways that continue to deliver expected (or better than expected) results for communities.
Implementation Science: A Long-Term Commitment and Catalyst
As you might imagine, it can take years to answer these and other questions, and even longer to see an uptake by other entities who recognize the value of an evidence-based model. This is why The Duke Endowment is committed to deep, long-term investments with organizations focused on children and families in North Carolina and South Carolina to help them adopt effective programs with fidelity to achieve positive outcomes that improve lives.
In 2007, the Endowment began its foray into implementation science when we partnered with Catawba County Department of Social Services (DSS) in North Carolina to stop the revolving door of children leaving and returning to the foster care system and focus on efforts that would ensure permanency with each adoption, reunification, guardianship or custody arrangement. Since then, the Endowment has invested $12.5 million to help Catawba County DSS leadership and staff use implementation science principles to research, develop, deploy and test all the elements needed to successfully implement the Success Coach program – and replicate it in five neighboring counties.
A Model for the State
In 2025, the North Carolina Department of Health and Human Services (NCDHHS) took the program statewide, in partnership with Catawba County DSS, Boys and Girls Homes of N.C. and Children’s Home Society of North Carolina.
Implementation science principles most certainly played a role in accelerating the uptake of Success Coach from a county program to a regional and now state level. NCDHHS is investing more than $16.5 million in state and federal funding over the next three years to expand Success Coach to all of North Carolina’s 100 counties. Ultimately, they – and the Endowment – anticipate that Success Coach will serve as a national model and standard for providing effective permanency services for states across the country.
We hope you’ll join us for a more in-depth look at the Success Coach initiative in a future article.
