Implementing a direct support staff intervention in services for people with intellectual disabilities and challenging behaviour using the ItFits framework: From needs to action.

Background

Effective interventions often fail to achieve lasting impact due to implementation barriers. This study examined how Support Staff in the Spotlight - an intervention that enhances emotional intelligence and interactional awareness among support staff working with service users with intellectual disabilities and challenging behaviour - can be embedded in daily routines within intellectual disability care.

Method

Using a hybrid effectiveness-implementation-design guided by the ItFits-framework, two Dutch care organisations completed a two-part-process: a needs assessment to identify barriers and facilitators, followed by communities of practice where key stakeholders co-created and refined tailored strategies. Data from focus-groups, structured logs, and interviews were analysed thematically.

Results

The process helped to translate identified needs into concrete actions, such as adapting video-feedback procedures and embedding reflection in team routines. Organisational capacity, managerial continuity, and psychological safety were decisive for sustainability.

Conclusion

Leadership engagement and routinised reflection moments were crucial for sustaining staff-focused interventions in practice.