If you are looking to adapt your program over time, do it carefully, with intention and thoughtful consideration.

Sustainability Over Time

Fidelity (the degree to which an intervention is delivered as intended) to the program model, over time, can undermine the possibility of program sustainability (Fixsen et al., 2005).

As you learn more about your program’s strengths and limitations, you may identify possible changes or adjustments.

Adaptation and Fidelity

Adaptations to the program model that remove or shift core components can undermine the continued effectiveness of care delivery. Finding the “sweet spot”—where you can adapt to continue your program while not undermining effectiveness—is always going to require careful thinking, the use of your evaluation data, fidelity measures, and involvement from stakeholders.

Often, using technical assistance support can help you understand how best to make these decisions. In general, changes to your program over time can maximize potential benefits when they are done carefully and deliberately as a method for optimizing program fit for your community and organization.

Dynamic Sustainability Framework

Developed by university-based and federal agency researchers, the Dynamic Sustainability Framework depicts the reality that change is constant (Chambers et al., 2013). The differences between static and dynamic sustainability are summarized in Table 1 below.

Table: Static vs. Dynamic Sustainability View

  Static View Dynamic Sustainability View


Inevitable; encouraged,
monitored and guided by
Context Assessment Initial or during
Outcomes Assessment During study by 
Incorporated as part of
Review of Evidence Initial - from
efficacy studies
Ongoing; from convergent
sources including replications
Staffing issues (e.g., 
turnover) and variations
Ignored/feared Planned for; investigated
Generates new knowledge No Yes, feedback to other areas of
science and to earlier stages


Strategies for Sustainability

Sustainability of programs will require adaptation and flexibility. In the following video, practitioners, researchers, and state agency directors share their strategies for program sustainability in the midst of constant change.



If you are taking a dynamic sustainability approach, adaptation will be inherent to your approach.

Doing so requires good data and a precise understanding of the outcomes for your clients and the forces shaping program sustainability.

Last Updated: 09/14/2017