A conversation with Julia Moore

by Jon Scaccia September 9, 2024

In this insightful interview, we sit down with Dr. Julia E. Moore, the Executive Director of The Center for Implementation. Dr. Moore, a renowned implementation scientist with a PhD from Penn State in Human Development, has worked on over 100 implementation projects. She is internationally recognized for her ability to translate complex implementation science concepts into clear, actionable strategies. Dr. Moore’s online mini-course, Inspiring Change: Creating Impact with Evidence-Based Implementation, has empowered over 9,000 professionals worldwide. Her expertise extends to developing knowledge translation and implementation plans for provincial, national, and international organizations, making her a sought-after keynote speaker at major conferences. As Vice-Chair of the Board of Directors for the Kids Brain Health Network, Dr. Moore is deeply passionate about equipping professionals with the tools they need to effectively apply implementation science in their work. In this conversation, she shares her insights on the evolving role of implementation support practitioners and the critical skills required for success in this field.

Can you talk about the background behind developing the updated core competencies for implementation support practitioners? What gaps did you identify that needed addressing?

Back in 2018, we developed core competencies for implementation. At that time, the term ‘support practitioner’ didn’t exist, but the role essentially did. Later, Alison Metz and her group developed another set of competencies. We used a combination of both because they addressed slightly different aspects.

However, it became clear that neither fully covered everything. Our competencies were very technical, while hers were more relational. They both touched on important elements, but there wasn’t a comprehensive view of what an implementation support practitioner does and how they function within the system.

Since then, there’s been a noticeable emergence of individuals working at a more foundational level in this field. We recognized that there are people with different levels of expertise, from those just getting their feet wet to those with advanced skills. We wanted to highlight the distinction between these levels, acknowledging the growth and depth of expertise in the field.

Could you elaborate on the significance of the five functions—connect, understand, inspire, enable, and transform—outlined in the white paper? How do they enhance the role of implementation support practitioners?

Implementation science has often focused on technical aspects like theories and frameworks, which many people, including ourselves, find valuable. But there’s also a crucial set of interpersonal or relationship skills that people need to effectively support implementation. You simply can’t implement anything without strong relationships—it’s impossible.

We wanted to capture these essential but non-technical skills that describe how people create change within a system. This led us to identify the five functions: connect, understand, inspire, enable, and transform. None of these are surprising, but they aren’t always clearly defined for people.

For example, connecting with people—building effective relationships and trust—is fundamental. You need to work well with others to make any progress. Understanding is another key function. It’s not just about jumping in and taking action; it’s about understanding the context, the problem, and how people interact. We need to spend significant time in this understanding phase to do the work effectively.

Inspiring is particularly interesting because most people I talk to have little authority yet need to create change. It’s about how we can inspire and influence without authority, which is central to many roles. The function of enabling is about removing barriers, whether at an individual or system level, to make it easier for people to do what we want them to do.

Lastly, my favorite function is transforming, which involves reflecting on how we show up in the work, understanding our own gaps, and doing the deep reflective work necessary to improve.

Here’s an unfair question for you. How do implementation support practitioners balance the need for adaptation to local contexts with maintaining the integrity and effectiveness of the initiatives they support?

I think the key to balancing adaptation with maintaining integrity lies in not presupposing that we know the answer from the start. This is central to those functions we talked about—we don’t know the answer until we fully understand the context and the gaps that exist.

We need to maintain fidelity to the process and the questions we ask ourselves along the way. How do we know if there’s a need? How do we identify the gaps? Who is being asked to change? What are the barriers and facilitators? What strategies can we use? Are the sites ready, and if not, how do we support them?

It’s not about going in with the mindset of making a change right away but rather about asking a series of important questions. In some cases, the answers come quickly because a lot of groundwork has already been done. In other cases, it takes more time and effort to understand the need and the gap we’re addressing.

Ultimately, we need fidelity to the process of supporting implementation, not just to the specific activities we’re undertaking. If that makes sense.

Inspiring is particularly interesting because most people I talk to have little authority yet need to create change. It’s about how we can inspire and influence without authority, which is central to many roles.

Sustainability is crucial for the long-term success of public health initiatives. What role do implementation support practitioners play in planning for sustainability and ensuring initiatives are sustained?

Implementation support practitioners play a crucial role in planning for sustainability in many different ways. Research shows that the key to sustainability is thinking about it early, upfront, and often. It’s the role of implementation support practitioners to raise questions like, ‘How are we going to sustain this?’ and ‘What does sustainability actually look like?’ If they understand its importance and consistently bring it up early and often, that can make a big difference.

In our experience, implementation support practitioners are often tasked with supporting sustainability long-term. We know that someone needs to be assigned this responsibility; we can’t assume an initiative will continue on its own indefinitely. These practitioners are usually the ones who step into that role.

In public health, what’s fascinating is that while the term ‘implementation support practitioner’ is used in academic literature, it’s rarely used in practice. Yet, many public health practitioners are essentially playing this role every day. Any public health practitioner who supports the implementation of a program, practice, or innovation is engaging in implementation support. Once they realize this, it often resonates with them because it aligns with the challenges they face daily in navigating the system.

With the increasing demand for implementation support practitioners, how can organizations ensure they are hiring individuals with the right competencies and skills?

The demand for implementation support practitioners has grown significantly, especially since the pandemic. I’m amazed at how many jobs there are now.

When hiring, it’s crucial to find people who have both training and experience. The ideal candidate is someone with formal training in the science of implementation and practical experience in actually implementing things. If someone tells you it will be easy, they likely don’t have real experience.

The reality is that very few people have both training and experience. If I had to choose, I would pick someone with experience who is open to learning, and then provide them with the necessary training. Understanding how challenging it is to implement things is a huge first step. There’s often a misconception that implementation will be easier than it actually is, and if people haven’t faced the difficulty of changing behavior before, their first experience can be disappointing.

Fortunately, many people have tried to implement changes over the past few years and have gained valuable experience with the ups and downs of that process.

If someone wanted to get that implementation science training, where could they go?

There are plenty of options for getting training in implementation science. Our most popular program right now is our certificate program, which many people are using to help them secure jobs. You can check it out at The Center for Implementation. (Jon’s note: you should!)

It’s also exciting to see more organizations supporting this training. We’ve noticed that many organizations are sponsoring one or more people to get trained, which is especially common in public health. For example, we currently have a group in infection prevention and control (IPAC) collectively going through training together. It’s a really cool way to revamp how they’re approaching IPAC work and to start thinking differently about it.

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