Less Is More? Rethinking Training Dosage In Resource Constrained Environments

The current socio-political context has forced researchers to re-evaluate how resources are spent. For example, intervention researchers have long established that there is a dose-response relationship between training duration and outcomes, such that longer, more intensive training is associated with more favorable behavior change outcomes (Feinberg et al., 2008). However, despite social service workforce's desire for values-aligned training, extended training is often resource intensive and time-consuming, placing undue burden on participants already grappling with competing priorities and time pressures (Wandersman & Scheier, 2024). Notably, there is limited evidence that compares training dosage vs. outcomes in real-world implementation settings. Using The SUSTAIN Center as an exemplar, this roundtable aims to 1) provide an overview of SUSTAIN’s capacity-building training model, 2) examine how training dosage differentially influences changes in knowledge, skills, and attitudes (KSA), and 3) discuss under what conditions might brief training models be equally or more effective than extended training models.

The SUSTAIN Center is a capacity-building center that provides justice-centered training, coaching, and grant funding to HIV Service Organizations in the Southern U.S. We implemented two training models across diverse training topics: 1) an extended learning collaborative model, and 2) a brief training model. The extended learning collaborative model consisted of (bi)monthly cohort-based learning sessions and monthly individualized implementation coaching sessions that were up to 9 months in duration. The brief training model consisted of a virtual or in-person topical training sessions lasting between 6 to 10 hours in duration. Both modalities were group-based and interactive training only (no coaching). We implemented both models across 3 topic areas salient to HIV service provision: harm reduction, language justice, and trauma-informed leadership and supervision. We evaluated changes in self-reported KSA using a pre/post evaluation design for both training models. KSA items were collaboratively and iteratively developed by the training and evaluation team according to training content. Each subscale had between 4 to 10 items and were rated on a 10-point Likert scale. All participants worked with people living with HIV at HIV service organizations in the US South. Analyses revealed that across all 3 focus areas, the brief training demonstrated notably greater improvements across KSA domains. In other words, the extended learning collaboratives did not “outperform” the brief trainings despite higher dosage, potentially suggesting diminishing returns with greater training dosage levels.

This roundtable is comprised of applied social work researchers affiliated with the SUSTAIN Center. Panelists will discuss learnings of a comparative analysis, which will be followed by an interactive discussion with participants focused on training dosage considerations, including 1) how ‘enough’ training is defined and measured, 2) when extended training is actually necessary, 3) potential mechanisms by which brief trainings outperform extended trainings, and 4) outcomes that might still require extended training. By providing real-world comparative evidence on training dosage, this roundtable introduces a critical lens on the efficiency versus effectiveness debate as it relates to workforce development in resource-constrained environments.