Full implementation represents going to scale in the local community and typically takes 2–4 years. This stage is where new learning is integrated into standard practices, policies, and procedures and is about balancing fidelity, contextual flexibility, and feedback loops. Embedded evaluative and continuous improvement approaches provide support for these efforts. Essential components of the full implementation stage include the following:

• Ensuring integration of all intervention components
• Ensuring achievement of desired outcomes
• Routinizing the daily work