Reliable effectiveness: a theory on sustaining and replicating worthwhile innovations.

While many health and human service innovations are sustained and replicated, it has been a puzzle how to sustain and replicate the performance of the better ones. What knowledge, skills, and conditions are required to reproduce across space and time the effectiveness of those innovations that are the most worthwhile? An extensive body of literature and experience is reviewed to suggest a comprehensive conceptual framework of programmatic, organizational, and environmental factors that may shape the circumstances for sustaining and replicating effectiveness.