Plain language summary: "More needs to be known about how external support providers work with organizational, system, and community partners to improve their efforts to implement innovative programs and practices. Although a handful of models of external support have emerged in the literature, support strategies or activities are not often tracked systematically or prospectively. In the current study, we report on the adoption, operationalization, and use of a recently proposed model of external support across 13 regions in North Carolina and South Carolina scaling an evidence-based system of parenting and family interventions. Teams of external support providers tracked their activities using the model across more than 5 years. Results provide a description of what external support might look like across long-term support engagements, noting key patterns about dose of support and use of activities that might be responsible for influencing intended support outcomes. The study offers several findings that might refine our understanding and use of external support strategies. In addition, the study lays groundwork for examining additional research questions, such as the feasibility of support processes and whether and how support activities influence support outcomes."