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Navigating Challenges in Starting New Evidence-Based Programs

8 min read

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Receiving a federal grant is a major milestone for any organization, but it often comes with challenges that demand thoughtful planning, adaptability, and resilience. These unforeseen challenges can throw off even the most thoughtfully developed work plan and significantly hinder your progress. During your grant application or in the early stages of your grant period, be mindful of these key hurdles.

Coordinating logistics for in-person training

Long travel distances, conflicting schedules, transportation, lodging, and venue rental costs all make coordinating in-person workshop leader training across a large geographic area extremely challenging. These barriers can delay training timelines and limit the pool of available facilitators.

As a 2024 ACL Falls Prevention Grantee, the New York State YMCA Foundation is no stranger to the challenges that come with coordinating efforts across such a large state. When most people think of New York, they picture New York City. But the state itself is vast and diverse, with many different regions. The NY YMCA Foundation team had to carefully plan how to deliver in-person facilitator trainings across the entire state, considering not just logistics, but also unpredictable weather, the considerable distance between the western and eastern parts of New York, and how to reach the more rural areas.

While in-person leader training is more effective, the team supplemented it with virtual trainings and organized regional events after ensuring adequate enrollment. They also continue to maintain regular communication with Y implementation sites to stay informed about the number of trained leaders and overall staff capacity.

Additional strategies when coordinating leader training, particularly across a large geographic area include:

Work smarter, not harder

  • Cluster trainings around events: Coordinate trainings to coincide with other large, related events or conferences in the area to maximize attendance and reduce incremental travel.
  • Create "Training Weeks" or mini-conferences: Organize a week of rotating workshops across multiple locations, where facilitators can attend sessions in the region that best fit their schedule.
  • Offer back-to-back trainings: Schedule multiple trainings on consecutive days in neighboring areas to make travel more worthwhile for regional staff or partners who support multiple sites.
  • Provide travel support: Offer stipends or reimbursements for transportation and lodging to lower financial barriers for facilitators from remote areas.

Cumbersome administrative tasks

Administrative tasks (e.g. hiring staff, finalizing MOUs with community partners, organizing training sessions, setting up data platforms) are critical to launching an effective, evidence-based program, but they often demand considerable time and effort. These steps often require collaboration across different teams, navigating approval processes, and addressing both legal and technical requirements.

Although necessary, these early-stage grant activities can lead to bottlenecks that delay program implementation. Hiring setbacks can delay program delivery, while prolonged MOU negotiations or scheduling challenges can slow down partner engagement and training efforts. If not carefully planned for, these cumbersome administrative tasks can push back timelines and limit a grantee’s ability to make an early impact.

Some strategies for planning include:

Start with a detailed, time-phased work plan

  • Break down early activities: Divide the first 60–90 days into weekly tasks with milestones for hiring, MOUs, scheduling, and partner onboarding.
  • Prioritize critical path items: Identify dependencies (e.g., training can’t occur without hiring) and prioritize tasks that unlock others.

Develop fast-track or pre-approved templates

Build Contingency Plans

  • Plan for delays in hiring: Identify interim support options (e.g., consultants, reassigned staff) in case of hiring lags.
  • Backup partner sites: If key partners are delayed, have alternative sites or organizations on standby to keep momentum.

Common startup hurdle #3: Capacity woes

Many organizations have small teams with heavy workloads, which makes it challenging to find the time and capacity to plan and deliver leader training. Additionally, finding qualified trainers and coordinating training logistics often takes more time and resources than expected. Even once training occurs, staff typically need additional time to practice new skills and build their confidence before facilitating their first workshop. When training must be completed before participant recruitment or program activities can begin, any delays can significantly extend overall implementation timelines.

In 2024, ACL Falls Prevention grantee Metropolitan Community Health Services encountered capacity challenges while coordinating Tai Chi leader training across several implementation sites. To remain aligned with their work plan, the team pivoted to keep things moving forward. Initially, they planned to implement the Healthy Steps for Older Adults program. However, after realizing the associated costs, they pivoted to Tai Chi for Arthritis as a more feasible option. During the leader training process, their master trainer had to cancel their second and final training session, which caused a delay. Despite this setback, the team has back-to-back workshops scheduled to begin once training is completed in June.

Some strategies to address resource and staffing challenges include:

Communicate early and often with ACL and NCOA TA teams

  • Avoid missed opportunities: Reaching out to your NCOA technical assistance liaison early allows time to shift resources before small issues become bigger ones.
  • Tailored support: There's not a one-size-fits-all strategy to address capacity woes. Your ACL Program Officer (PO) and TA liaison can recommend specific tools, templates, or even connect you to peers who have experienced similar issues.
  • Take advantage of available resources: Be sure to explore the wide range of materials available on the NCOA website and NCOA Connect. These platforms feature valuable resources from fellow grantees who share their challenges, solutions, and practical strategies to strengthen internal capacity and enhance program delivery.

Build internal workforce capacity

  • Internships and volunteer corps: Support the recruitment of public health, occupational/physical therapy, nursing, or social work students to serve as program interns or data entry volunteers.
  • Recruitment campaign support: Provide templated job postings or a toolkit for recruiting lay leaders and volunteers.

Cross-training staff for greater flexibility and resilience

  • Boosts organizational resilience: Provides backup support to keep programs on track during staff absences, transitions, or busy times.
  • Encourages collaboration: Helps staff understand the full program workflow, fostering more cohesive teamwork.
  • Start small: Identify 1–2 critical roles where backup is most needed and provide targeted training to select team members to fill those gaps.

Common startup hurdle #4: Reestablishing relationships and partnerships

Many grantees have faced significant challenges in reestablishing relationships and partnerships in the aftermath of COVID-19. The Kansas Department of Health and Environment, a 2024 ACL Chronic Disease Self-Management and Falls Prevention grantee, shared that they lost significant momentum on key initiatives when COVID-19 hit. Upon receiving this ACL grant, they faced the challenge of reestablishing relationships and partnerships that had become inactive or shifted during the pandemic.

Like other grantees, they found that rebuilding connections required intentional effort, such as in-person site visits, frequent one-on-one check-ins, and trust-building. At times, this also meant adjusting to a new reality post-pandemic where many former partners had shifted their focus and efforts.

Some strategies for re-establishing or building partnerships include:

 Strengthen communication channels

  • Set up regular check-ins, newsletters, or shared dashboards to maintain momentum and ongoing engagement.
  • Share stories of impact, data on program outcomes, and opportunities for shared success to build enthusiasm and encourage reengagement.
  • Acknowledge your partners’ roles in success stories, grant reporting, social media, and events. Shared credit builds shared trust.

Show consistency and follow through

  • Demonstrate reliability by keeping commitments, meeting deadlines, and providing timely updates. When unexpected situations come up, such as a meeting needing to be rescheduled, communicate clearly and promptly to keep everyone informed.
  • Make yourself visible, accessible, and responsive. Sometimes just “showing up” (virtually or in-person) can rebuild connections.

Be transparent

  • Share both challenges and successes openly. Acknowledge setbacks and communicate your plan to address them.
  • Clearly outline roles, responsibilities, and expectations from the beginning to avoid confusion and foster trust.

Common startup hurdle #5: Communication breakdown

Several 2024 ACL grantees experienced delays and setbacks due to persistent communication challenges with both internal and external partners. Many reported difficulty reaching contacts across different organizations, often requiring multiple follow-ups.

In some instances, partners who had initially expressed support became unresponsive once implementation began, forcing grantees to adjust their plans and quickly secure alternative implementation sites. These issues disrupted coordination and complicated planning efforts. Scheduling workshops and training sessions around major holidays became especially difficult with key staff unavailable for extended periods.

Here are some targeted strategies to reduce disruption during the holidays:

Planning around holidays

  • Develop a holiday-aware project calendar: At the beginning of the year or project cycle, map out all known holiday periods and staff availability across key partners.
  • Frontload critical activities: Schedule time-sensitive tasks like workshops, training sessions, or major deliverables before a holiday. Clarify expectations around response times, how decisions will be made, and who to contact for specific needs.

Adjust timelines proactively

  • Build in buffer periods: Add 1–2 week buffers before and after major holidays to absorb scheduling delays without derailing the larger timeline.
  • Review and revise timeline quarterly: Reassess the implementation calendar periodically to adapt to new constraints or emerging issues.

The bottom line

Proactive planning is key for long-term success, but obstacles are inevitable and may not always be foreseeable. Embrace these hurdles as part of the learning process, stay flexible, and seek support when needed. Keep a record of challenges, solutions, and successes to inform future decisions and share key lessons with grantees, old and new.

As a friendly reminder, NCOA TA Liaisons are always there to support you throughout your grant. During your monthly calls, be sure to bring up any challenges to discuss and we will be sure to brainstorm some strategies with you and/or connect you with other grantees who have experienced and overcame similar startup hurdles.

We also recommend that you check out resources on NCOA Connect such as grand rounds, capacity building, and sustainability workgroups. On NCOA Connect, you will be able to find recorded materials. Additionally, the NCOA website, is filled with tipsheets, guides, and articles, so make sure to check that out as well.

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