|Organizational level||Staff turnover||Emerged due to restructuring in MGH and NYU sites → Turnover in site leaders is particularly disruptive. CHW feel pressure to deliver intervention before training is done.|
Not enough staff to implement intervention.
Turnover leads to challenge in keeping CBO staff engaged.
Balancing out labor demands with other full-time responsibilities in agency → burnout.
|Organizational level||Training||More guidelines regarding intervention adaptation and maintenance.|
Academic partners should provide additional training on adapting intervention for long-term adoption.
Training would need to focus on how to maintain intervention fidelity while limiting data collection to only what is essential.
|Organizational and community level||Funding||Using data for funding applications.|
Set aside time.
Keep in mind different needs of sites.
Research staff may be able to provide some support in future after grant ends.