Key Points

· The Tower Foundation supported a five-year initiative to support the implementation of evidencebased practices (EBP). The average award was a three-year award of $84,050.

· The underlying grantmaking theory of change was that behavioral health providers could bring empirically tested protocols to their communities and sustain them over time if supported by long-term funding to support the real costs of implementation (e.g., training, technical assistance, adherence to program protocols, and cultural change).

· Grantees cited the high cost of training, certification, and recertification – especially in the face of high staff turnover – as a primary challenge to implementing EBPs. Several of the initially funded programs experienced higher than expected staff turnover, losing as many as half of the newly trained EBP practitioners quite early in the implementation process.

· The seven programs scoring in the exemplary range for implementation fidelity had no single success driver in common, but three indicated that building internal training capacity was key.

· Foundations can help to make communities more EBP ready and EBPs more generally viable and affordable. Efforts could include local training collaboratives for clinicians or advocacy to educate payer systems and referral networks. The philanthropic community can also support efforts to define the need for EBPs at a grassroots level.

Open Access