Any foundation embarking on a complex venture like the TPPI faces a similar challenge. How do you incentivize and sustain innovation and change at the community level—when the instruments of change (i.e., grantees) are likely to be chronically under- resourced organizations who are typically forced to chase project dollars to meet their payroll? Moreover, even though the focus of your initiative may be consonant with the grantees’ mission, it is most likely not the only thing they do. Add to that a lack of capacity for dealing with data—and a steep, winding hill has been added into your roadmap for change.

Significant resources for the capacity building challenge were built into the TPPI’s structure from the beginning. Cornerstone Consulting Group, an organization with extensive experience with other foundation initiatives related to teen pregnancy prevention and child welfare, received a grant to provide technical support to the Community Action Programs. As noted previously, the evaluation team also provided technical assistance to the sites on data collection, analysis and reporting. Funding was provided for an 18-month planning period to help the sites lay the groundwork for community engagement, partnership development and capacity building around best practices for teen pregnancy prevention.

It’s fair to say that there was conflict between Cornerstone and some of the sites during those early stages of the Initiative. Cornerstone understood its job as helping prepare the sites to meet the Foundation’s criteria for full implementation funding. In essence, it was functioning as an intermediary, yet it was not really given the license to act on the Foundation’s behalf. Meanwhile, some grantees felt that the technical support was heavy-handed and interfered with their autonomy. They also felt inundated on occasion, trying to balance visits and requests from the technical support team, the evaluators, the public education grantee and the Foundation.

As time passed and the sites matured, Cornerstone’s approach to capacity building evolved to help link sites to individualized resources to help them implement their action plans. Cornerstone also supported peer exchanges via a learning-circle approach that allowed Community Action Program staff to build their own skills as they were teaching one another across sites. The site coordinators were encouraged to form their own work groups to meet separately to discuss their common issues and build on their experiences, and an effective learning community emerged.

Cornerstone developed a productive, nuanced working partnership with the Community Action Program sites. As with the most effective technical assistance (or any adult learning), the sites needed space to learn to implement the principles in their own way, being free to make mistakes without being penalized. That kind of learning is not necessarily sequential or linear, despite our well-planned logic models or theories of change. One can’t underestimate the importance of allowing time for thorough planning and alliance building and for trial-and-error implementation.

Something else that took more time than anticipated was the research projects. The original plan was to commission research to fill information gaps that would be directly useful for the community sites. While a significant amount of research was generated and published that made a valuable contribution to the field, many research projects were not completed according to the timeline desired for maximum utility for other TPPI grantees.

There were distinct payoffs from the Foundation’s substantial investment in capacity building. Despite significant staff turnover, the participating institutions built new skills and practices that have had a long-term impact on the way they do business. For example, the experiential training that the California Family Health Council developed for clinic and youth workers has been credited by many for transforming the way they work with teens.

Another example is the continued spread of the Peer Provider model of staffing clinics by teens for teens.(5) The California Family Health Council took the model that originated at the Valley Community Clinic and codified its key elements as part of its three years of funding from the TPPI to build agency capacity and implement it in five communities. They not only managed to cut the implementation time to six months in some cases, but clinics across the state have fundamentally changed the way they work with teens. The California Family Health Council has since spread the model to 28 sites and four learning labs—with the help of Family PACT and Title X funding along with a Hot Spot program that has engaged an additional 14 agencies in comprehensive sex education.