Guiding Values: A Strategy for Intervention Co-Creation and Implementation

Background and Purpose: Evidence based interventions often identify values that are foundational to the intervention, however, these values are rarely centered as an important part of the intervention development process. For true impact, collaboration and co-creation with young adults is essential, and the creation of guiding values presents an opportunity to dialogue and set a foundation for how to operate in all phases of intervention development and implementation. This presentation describes the process of co-creating guiding values with young adults and community partners, then using these values as a strategy to center young adult partnership, guide implementation, and assess fidelity.

Methods: Utilizing an approach grounded in youth participatory action research, we developed a young adult working group (YAWG) that met twice a month for four months as we built on two existing interventions to develop a team-based support model for young adults in rapid rehousing. We began with the guiding values of the existing interventions as a starting point, then utilized our YAWG to draft new principles to center our work. After multiple rounds of stakeholder feedback including from partners at the housing program, the group finalized a set of guiding values which were a driving force in intervention development and testing. Semi-structured interviews were conducted with intervention staff following a phased open trial (n=60) where team members talked about the intervention in reference to the guiding values and provided specific examples of how they translated them into their roles in the intervention.

Results: The team identified six core guiding values for our intervention, ChargeUp!: power-sharing, grace, authenticity, culture of care, accountability, and systems change. Team members described applying them when delivering the intervention (“I always had to couple grace with accountability. I can’t really give grace alone, Mine always was followed up with, “Okay, I got you, however...you still got to do it”). Values were centered in team meetings (i.e. power sharing: “between the clinician, the coordinator, and the transition support specialist, everybody was pretty much at the same level. It wasn’t like, “I am a clinician, so I know more.” It was more like, “Well, here’s my perspective. What’s your perspective?”) and used for guidance when making decisions about research and intervention procedures. A values-based supervision form was utilized to ensure each role was practicing with fidelity to the values.

Discussion: Guiding values hold promise as a strategy for incorporating young adult partnership in intervention development and implementation. Guiding values also provide a framework to guide fidelity in complex interventions that involve teams making many decisions. Our work in developing and centering guiding values in ChargeUp! provides an example of a tangible strategy for facilitating collaboration to develop rigorous interventions for impact.