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barrier for CBO practitioners to use EBIs is a lack of access to opportunities to build the knowledge and skills needed to successfully implement EBIs 7. While many CBO staff members have rich knowledge of communities' strengths and needs, they often lack sufficient training in public health theory or evidence-based practice 4.Current efforts to build CBO capacity (or skills, motivations, knowledge, and resources 8 for EBI use are often insufficient. Our recent work highlights three important disconnects. First, there is a lack of consensus on targets for capacity-building efforts 7. Second, there are important gaps between current capacity-building offerings and CBO practitioners' needs, which include content that emphasizes health equity, centers' practice-based, and engagement of local experts 9. Third, there is a misalignment between priority skills (one of the targets of capacity-building) between academics developing interventions and practitioners receiving them 10.To address these disconnects, we need fresh insights. We turn to the rich education literature where similar tensions have been identified and professionals are mission-driven, work on the frontline, and often operate in resource-constrained environments. Our goal is to connect advances in capacitybuilding from public health (e.g., the work of Leeman and colleagues 8) and insights from the field of teacher professional development (PD) (Figure 1). As an outcome of ongoing high-quality PD, practitioners' capacity for implementing EBIs is expected to increase, ultimately resulting in increased impact on the health and wellbeing of their communities. Although there have been successes in capacitybuilding for EBI use in CBOs, such as the Getting to Outcomes program 11 new perspectives are needed to better bridge research-and practice-based expertise 7.We used Hill's and Papay's synthesis of recent reviews and meta-analyses that examined the methods and content used for effective PD (which they refer to as Professional Learning) , highlighting a series of actions with a strong evidence base (teacher-to-teacher collaboration, one-to-one coaching, follow-up meetings) and those with a growing evidence base (subject-specific instructional practices, concrete instructional materials, relationships with students) 13. We recognize that there are multiple models of PD in the field of education including Desimone's (2009) outline of the essential features of PD 13, but selected this one for its grounding in the evidence base and emphasis on instructional improvement, an important analogue to efforts to deliver EBIs. Below, we describe each of the core design features of PD as described in the synthesis and provide exemplar applications to capacity-building in CBOs for each factor.1. Teacher-to-Teacher Collaboration PD emphasizes the value of clear, defined teacher-to-teacher collaborations. This may involve practice-based learning opportunities, peer observation and feedback, and efforts to improve student and family engagement 12. As an example, learning communities have been highlighted as an effective strategy to build individual and group capacity 12,[141516. Regardless of the structure, the core function served by these collaborations is that teachers are able to build relationships grounded in shared interests and goals, thereby creating a culture of empowerment that reduces isolation and emphasizes both teacher and student success. 12. This in direct contrast to short windows of opportunities where teachers may leverage their community for day-to-day support and assistance.Considerations for CBO capacity-building: Parallels to teacher-to-teacher collaborations can be found in CBO capacity-building efforts in the forms of community collaboratives and communities practice.For CBO practitioners, this unique approach to capacity-building can provide continuous opportunities to engage in problem solving, with additional benefits of relationship building, information sharing and an increase in self-efficacy 17, though the evidence is mixed on the impact of these collaborations 18 . A more foundational consideration comes from grounding PD in collaboration between implementers (here, CBO staff, centering their expertise, and creating lasting structures for sharing challenges, success, and co-developed solutions. This connects with the broader participatory implementation science literature in emphasizing assets held by a range of actors and supporting structures that improve systems over the long-term to advance impact and equity 19.As a tool, coaching can foster a PD environment that prioritizes teacher and student growth 20.Coaching is effective when it is an ongoing, individualized process that supports teachers to build on and demonstrate theoretical knowledge 21. Additionally, coaches can support teachers in acquiring this knowledge by providing detailed and targeted advanced lesson planning 12. While research recommends that coaching be continuous, this is a non-trivial investment. Further, one of the challenges faced in developing a coaching program is the disconnect that can occur between coaches and teachers with experienced teachers being more resistant than others 22. Immediate, iterative, practice-based follow-up sessions after trainings with opportunities for inquiry and feedback have been identified as an important PD strategy 12. This training material readily accessible, fosters collaboration among instructors, and can increase a sense of accountability for creating practice change 12,24. In addition, follow-up also allows trainers to evaluate and modify the program based on participant feedback.Offering support after initial trainings, is a common strategy in public health and has been shown to effectively support PD goals 8,11. Systematically, this ensures that CBOs are trained and supported in implementing interventions to maximize impact and sustainability. Challenges to the use of this strategy may be the ability to engage CBO practitioners repeatedly and over time as these individuals are often over-burdened and unable to attend sessions at the expense of delivering services 25. Virtual and asynchronous interactions may offer an opportunity to overcome these barriers.4. Subject-specific instructional practice (or knowing how to teach a concept) Subject-specific instructional practice emphasizes the importance of pedagogical content knowledge,or understanding what makes it easy or hard to learn certain topics, as well as the conceptions and preconceptions that learners bring into the learning environment 26. This type of knowledge refers to unique teaching approaches in a specific discipline, such as effective ways to teach motion in a physics class (versus content knowledge, which focuses more on the laws of motions in physics) 12345. The general assumption is that new and experienced teachers are well versed in pedagogical content knowledge, which is not always true 15. Two approaches to supporting pedagogical content knowledge come from curriculum development (e.g., helping teachers create flexible lesson plans) and peer observations 27,28. While valuable, these strategies place a fair amount of burden on teachers and administrators to allow time and support to create clear guidelines and expectations 29,30.Considerations for CBO capacity-building: Given that many CBO staff have not had formal training in public health or delivery of EBIs, capacity-building efforts have a large impact by centering CBO practice, e.g., focusing on what it takes to adapt and implement a specific intervention. Integrating participatory approaches to implementation science and the content of the EBI identifies important opportunities for capacity-building efforts to draw from and spread practitioners' expertise in these areas19.The notion of practice-supportive materials is to emphasize the needs of teachers in achieving concrete teaching goals 12. In contrast to an emphasis on focusing on fundamental concepts and ideas, these materials provide teachers with relevant and accessible materials for instruction 31. Such materials may include additional lesson plans, or training in a specific model. Further, it also reduces the pressure on teachers to modify curricula, instead, providing a stronger focus on classroom instruction and student outcomes 12.Considerations for CBO capacity-building: For CBO practitioners, this emphasizes the need to offer materials that prioritize practice activities, e.g., tools to support EBI adaptation, over materials that emphasize underlying content. As one example, our team offered capacity-building workshops for CBO practitioners that included case examples for which participants were provided with web-based resources, worksheets, and tools to go through the process of finding, selecting, adapting, and planning to implement an EBI 32 Similarly, the Cancer Prevention and Control Research Network offers capacity-building for EBI use that offers a rich range of practice-focused tools and materials to support CBOs in achieving practical goals 33.Researchers have suggested that one often overlooked aspect of professional development are teacher-student relationships 34,35. In their analysis, Hill and Papay note that student academic outcomes are dependent on the interactions between teachers and students. Strengthening relationships among teachers and students can also reduce disciplinary actions and classroom interruptions 12.The parallel for CBOs is connections to communities and for many CBO practitioners, a sense of mission drives their work. The literature is already clear that investing in these deep connections yields benefits via increased receptiveness to EBIs and access to available, local supports among the communities served 7. By centering the ways in which practitioners develop deep relationships with community members, PD efforts can demonstrate alignment with practitioner goals. Drawing on CBOs' strong community relationships can improve communication channels and increase uptake of evidence-based solutions 36 .By experimenting with these strategies from the field of education, public health actors can move beyond merely 'disseminating' information to CBOs to building a sustainable infrastructure of professional learning that respects practitioner expertise, improves EBI implementation, and ultimately advances health equity in underserved communities. In this way, capacity-building efforts in CBOs will stay true to the goal of addressing not equipping organizations to address not only current community needs, but those that will arise in the future 37. We recognize that future work must move beyond identifying core features of conceptual models and further contribute to the evidence base of strategies for PD 30. The features highlighted in this commentary offer a range of design considerations for CBO capacity-building and suggest the potential power of strategic attention to each of the features in a given capacity-building effort.
Kirk et al. (Fri,) studied this question.