Conceptualizing and measuring sustainability of prevention programs, policies, and practices

Lawrence A. Palinkas*, Suzanne E. Spear, Sapna J. Mendon, Juan Villamar, Charles Reynolds, Costella D. Green, Charlotte Olson, Audrey Adade, C. Hendricks Brown

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


A large knowledge gap exists regarding the measurement of sustainability of evidence-based prevention programs for mental and behavioral health. We interviewed 45 representatives of 10 grantees and 9 program officers within 4 Substance Abuse and Mental Health Services Administration prevention grant initiatives to identify experiences with implementation and sustainability barriers and facilitators; what "sustainability" means and what it will take to sustain their programs; and which Consolidated Framework for Implementation Research (CFIR) elements are important for sustainability. Lists of sustainability determinants and outcomes were then compiled from each data set and compared with one another. Analysis of themes from interviews and free lists revealed considerable overlap between sustainability determinants and outcomes. Four sustainability elements were identified by all three data sets (ongoing coalitions, collaborations, and networks and partnerships; infrastructure and capacity to support sustainability; community need for program; and ongoing evaluation of performance and outcomes), and 11 elements were identified by two of three data sets (availability of funding; consistency with organizational culture; evidence of positive outcomes; development of a plan for implementation and sustainment; presence of a champion; institutionalization and integration of program; institutional support and commitment; community buy-in and support; program continuity; supportive leadership; and opportunities for staff training). All but one of the CFIR domain elements (pressure from other states, tribes, or communities) were endorsed as important to sustainability by 50% or more of participants. It may be more important to implement a standardized process of eliciting determinants and outcomes of sustainability than to implement a single standardized instrument.

Original languageEnglish (US)
Pages (from-to)136-145
Number of pages10
JournalTranslational behavioral medicine
Issue number1
StatePublished - Dec 10 2018


  • Behavioral health
  • Measurement
  • Methodology
  • Prevention
  • Qualitative
  • Sustainability

ASJC Scopus subject areas

  • Behavioral Neuroscience
  • Applied Psychology


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