Commentary on “It’s good to feel like you’re doing something”: a qualitative study examining state health department employees’ views on why ineffective programs continue to be implemented in the USA”

Mar 20,2022 | Christopher M. Shea Commentary

Decisions about which programs to implement, continue, or discontinue have substantial implications for organizations and the communities they serve. Mazzucca et al. contribute to the developing line of research on mis-implementation—“the  inappropriate continuation of programs or policies that are not evidence-based or the inappropriate termination of evidence-based programs and policies.”1  More specifically, the authors examine mis-implementation from the perspectives of practitioners in state health departments to reveal what they think makes programs ineffective and why ineffective programs are continued.  Findings related to what makes programs ineffective reinforce the need for adapting programs to local context and building sufficient capacity within public health agencies for implementation and evaluation.  Most interesting, in my opinion, are two findings about why ineffective programs are continued—partnership maintenance and program champions—because both are typically thought of in a positive light.  Therefore, the study illustrates how even such desirable goals and strategies may lead to some unintended, undesirable consequences.  Of course, I am not suggesting that public health agencies should discontinue all partnerships and the utilization of champions; however, individuals leading programs and implementation efforts would do well to be aware of possible undesirable consequences and monitor for them, even when there is a partnership and/or champion in place.  With respect to utilizing champions, organizational leaders not only need to identify appropriate champions and support them effectively, but they also need to be mindful of cases in which a champion’s commitment to a program and persistence in promoting it may contribute to the inefficient use of organizational resources.

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  1. 1. Brownson RC, Allen P, Jacob RR, Harris JK, Duggan K, Hipp PR, et al. Understanding mis-implementation in public health practice. Am J Prev Med. 2015;48(5):543–51.