Federal spending on evidence-based practices (EBPs) in health and social services can offset billions of dollars in societal impacts each year, but there is limited guidance on how to optimize federal grants to support large-scale EBP implementation. In focus groups with state and federal officials, the authors identified seven policy recommendations for federal officials to consider when designing, awarding, and executing EBP implementation grants.

Optimizing Federal Grants to Scale Up Evidence-Based Practices in Health and Social Services

Recommendations from Federal and State Agency Officials

Alex R. Dopp, Blanche Wright, Jin Kim, Grace Hindmarch, Sarah B. Hunter

ResearchPublished Feb 6, 2025

Federal spending on evidence-based practices (EBPs) provides significant returns by offsetting billions of dollars in societal impacts each year. Practices are deemed evidence-based because they have demonstrated their effectiveness in addressing various social and health-related challenges. Federal agencies often invest in EBP delivery through discretionary grants, but there is limited guidance on how to optimize these grants to support large-scale EBP implementation. 

To address this gap, the authors held focus groups with federal and state agency officials (using the findings from ongoing RAND research to frame their discussions) to gather and synthesize their recommendations on how to optimize federal grantmaking for EBP implementation. With the focus group participants, the authors identified seven policy recommendations for federal officials to consider when designing, awarding, and executing grants for EBP implementation, including capacity-building in service delivery organizations to sustain EBPs after grant funding ends. The authors also present real-world case examples to illustrate how funding agencies have put each recommendation into practice.

Recommendations

  • Federal agency officials should practice flexibility when considering the evidence and selecting EBPs for grant funding. Overly rigid standards for "sufficient" evidence have constrained EBP selection to date, resulting in bias against practices for marginalized groups or stigmatized health problems.
  • Federal agency officials should promote equity in grant funding for EBP implementation by supporting low-resourced service delivery organizations to build their capacity for obtaining grant funding and carrying out expected grant activities.
  • Federal agency officials should support communication and cohesion among federal agencies, government entities eligible for federal grants (such as states, territories, and tribal governments), and service delivery organizations throughout grant-related activities to help achieve the grant goals.
  • Federal agency officials should balance the flexibility to tailor EBPs to local contexts with standards for high EBP fidelity throughout grant implementation and evaluation activities.
  • Federal agency officials should address the workforce capacity issues at service delivery organizations and government agencies that limit EBP implementation. If grants that fund EBP implementation do not attend to workforce capacity, they are unlikely to produce sustainable changes.
  • Federal agency officials should lengthen grant award periods to support implementation and sustainment success, such as by allocating funds for planning periods prior to active implementation, time to complete and submit evaluation findings, and continued support after grant funding ends. Long-term funding is critical to maintain continuity in EBP implementation.
  • Federal agency officials should support the integration of indirect EBP activities and direct service delivery into funding systems to promote EBP implementation and sustainment beyond federal grants.

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RAND Style Manual

Dopp, Alex R., Blanche Wright, Jin Kim, Grace Hindmarch, and Sarah B. Hunter, Optimizing Federal Grants to Scale Up Evidence-Based Practices in Health and Social Services: Recommendations from Federal and State Agency Officials, RAND Corporation, RR-A3627-1, 2025. As of April 30, 2025: https://www.rand.org/pubs/research_reports/RRA3627-1.html

Chicago Manual of Style

Dopp, Alex R., Blanche Wright, Jin Kim, Grace Hindmarch, and Sarah B. Hunter, Optimizing Federal Grants to Scale Up Evidence-Based Practices in Health and Social Services: Recommendations from Federal and State Agency Officials. Santa Monica, CA: RAND Corporation, 2025. https://www.rand.org/pubs/research_reports/RRA3627-1.html.
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This research was sponsored by the U.S. National Institute on Drug Abuse and carried out within the Quality Measurement and Improvement Program in RAND Health Care.

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