Table 8 Summary of recommendations to advance the evaluation and effectiveness of TA

1. Need for a Standard Definition of TA

Use a consensus method (e.g., Delphi Technique) which includes a panel of expert TA practitioners, researchers, and recipients to develop a standard definition of TA. Consider the following defining features of TA when establishing a standard definition:

 ○ Aim is to increase capacity

 ○ Services target the systems-level (organization, community)

 ○ Supports are targeted and tailored

 ○ Supports are provided by a subject matter expert or specialist

2. Need for More Robust and Rigorous Evaluation Research Designs

• Use more robust evaluation research designs (e.g., experimental designs) to identify causal links between TA implementation and outcomes.

• Increase use of longitudinal study designs to understand the sustainability of TA. Include control and matching techniques to compare outcomes over time.

• Consider approaches rooted in design research (formative experiments occurring in real-world settings) to examine downstream effects of TA.

3. Need for More Reliable Measures and Objective Measures of TA Processes and Outcomes

• Use self-report measures to assess TA recipient attitudes and beliefs, particularly regarding TA satisfaction, self-efficacy, and commitment to change.

• Prioritize the use of objective data to measure outcomes about  knowledge, skills, behavior change, and system-level changes.

• When feasible, use a mixed-methods approach to capture subjective and objective data to enable data triangulation.

• Develop and use psychometrically sound instruments to assess TA.

4. Need for Reporting Standards

• Use a TA logic model to guide the systematic documentation of TA inputs, processes, outputs, and outcomes.

• Develop reporting standards for TA evaluation research studies. Consider the following items for a reporting checklist:

 ○ Provide an explicit conceptual and operational definition for TA. Upon availability, utilize a standard TA definition.

 ○ State the specific aim(s) and targeted direct and indirect outcomes for utilizing TA (e.g., to implement an evidence-based practice/intervention, coalition building, workforce development).

 ○ Provide detailed descriptions of TA activities (e.g., coaching, training, tools, combination), including data relating to core mechanics of TA (e.g., modality, reach, duration of engagement, directionality, frequency of contact). Additionally, describe the methods of measuring TA activities (e.g., measurement tools, procedures).

 ○ Where possible, report: i) the effect of specific TA activities to disaggregate attributions, in addition to the total effect, ii) both direct and indirect outcomes of TA and iii) longitudinal outcomes.