Supervisor Turnover: How does it impact evidence-based programs?

Background. Supervision has been identified as a central component of successful implementation of evidence-based interventions (EBIs). Staff inevitably fluctuate over time, potentially influencing program implementation. The current study qualitatively explored the impact of supervisor changes on implementation of RESPECT, an HIV prevention EBI. 

Method.  Data were collected as part of a longitudinal mixed-methods investigation, the Translation into Practice study, a national survey of community-based organizations and public health departments delivering RESPECT (N=30).  Semi-structured interviews were conducted with executive directors and supervisors at two time points (n=53, wave I; n=37, wave II). Interview questions related to staff changes were identified. Responses were coded to identify different categories of supervisor changes and thematically coded to describe the impact of those changes on RESPECT implementation. 

Results. Supervisor changes (e.g., losses, turnover) impacted programmatic skill and knowledge levels within the agency, workload levels for remaining employees, and created gaps in replacement and training for new employees. Losses and turnover among supervisory staff made implementing fidelity monitoring and protocols particularly difficult.

Conclusions. Retaining qualified supervisory staff may play a pivotal role in maintaining program fidelity, and, subsequently, program efficacy.  Supervisors not only monitor program implementation but also provide a significant long-term resource for initial training for new hires and ongoing training with existing staff. They are the long-term memory of the program.