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

Abstract

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.