# Examining the role of implementation strategies in sustaining evidence-based interventions in home visiting

> **NIH NIH R21** · NORTHWESTERN UNIVERSITY · 2024 · $240,000

## Abstract

PROJECT SUMMARY
Sustainment of evidence-based interventions (EBIs) is a priority area for the field of implementation science.
However, there are notable gaps in the field’s understanding of how implementation strategies prepare
practitioners to sustain EBIs. Mothers and Babies (MB) is an EBI focused on prevention of perinatal depression
that is widely implemented across home visiting (HV) programs that serve pregnant and parenting individuals.
Specific implementation strategies have been developed and are being used to support MB sustainment in HV
programs, with state HV networks in New Mexico and Rhode Island transitioning from an initial implementation
(0-24 months) to sustainment (24-36 months) phase during the project period. The proposed R21 project will
leverage the research team’s partnership with these networks and has two specific aims. First, we will
determine how existing implementation strategies prepare HV programs to sustain MB. We will collect
administrative data to assess the extent to which MB is sustained at 24 months, inclusive of provider- and
client-level sustainment outcomes. We will also elicit perspectives from New Mexico and Rhode Island HV
mangers, staff, and clients on the extent to which sustainment predictors are associated with fidelity of
implementation strategies and the perceive usefulness of implementation strategies in promoting MB
sustainment. Analyses will also be conducted examining the relationship between sustainment predictors and
sustainment outcomes. Qualitative data will also be collected to assess how implementation strategies
influence sustainment predictors and sustainment outcomes, as well as multi-level contextual factors that affect
how implementation strategies enhance sustainment predictors and sustainment outcomes. Second, we will
develop and pilot test an implementation strategy “bundle” to support MB sustainment in HV. We will use a
human-centered design approach and work with HV managers and staff to finalize an implementation strategy
bundle that supports MB sustainment in HV, and pilot test the new implementation strategy bundle with two
new state HV networks to examine the feasibility, acceptability, and appropriateness of each strategy. These
activities will prepare us to conduct a R01 hybrid-effectiveness Type 2 trial testing the new implementation
strategy bundle as well as sustained MB implementation and effectiveness among HV programs receiving the
strategy bundle. Public health significance and innovation of this project is substantial. Perinatal depression is
the most common health complication associated with pregnancy, affecting one in five women. HV programs
provide services to pregnant and parenting individuals across all 50 states. By developing a sustainment model
for integrating MB into HV, this R21 will facilitate the sustained delivery of MB, which is consistent with NIMH’s
strategic objective to scale-up evidence-based practices and goal of PAR-22-109 to identify, develo...

## Key facts

- **NIH application ID:** 10886317
- **Project number:** 1R21MH133078-01A1
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Shiv Darius Tandon
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $240,000
- **Award type:** 1
- **Project period:** 2024-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10886317

## Citation

> US National Institutes of Health, RePORTER application 10886317, Examining the role of implementation strategies in sustaining evidence-based interventions in home visiting (1R21MH133078-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10886317. Licensed CC0.

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