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. What would you like to do?
2005 meta analysis reviewed how many drug prevention programs that were funded by US substance abuse and mental health services administration?
Who did these drug prevention programs target?
High risk children and teens by using a wide variety of approaches (in class instruction, refusal skills, recreation oriented)
What was the common outcome goal that all programs within national cross site evaluation shared?
To reduce the rates at which participating youth initiated or increased their substance use
What was the result of the meta analyses from those 46 programs?
21 of 46 had negative effect sizes
Why were initial prevention results not significant? (3)
-differences in programs
When the 3 issues were accounted for statistically, what happened and why?
-effect size rose to .24 bc well implemented and designed prevention work
Why were initial prevention results not significant?) differences in program?
-behavioral, skills based, theory based programs
*theory based programs were more effective
Why were initial prevention results not significant?) methodological problems ?
Control groups were not really control groups
Why were initial prevention results not significant?) implementation variability?
How well was the program integrated into the day to day functioning of the organization ?
Evolution of program dissemination) Cook book approach
- There were kits that were supposed to give step by step replication
- *common in 1970s
Evolution of program dissemination) replication of programs
program experts would train staff in specific settings
Evolution of program dissemination) adaptation of programs
- Understood that programs needed to be adapted to settings
- *ideally by having program director as consultant
program dissemination evolution) intervention/innovation (2)
-evidence based programs seen as sources of ideas and inspiration rather than procedures to replicate.
-create program tailored to a setting but based upon best practices
program dissemination evolution) what is needed for effective prevention is not just program adaptation but...
Need of systematic program innovation and implementation
Issues in implementation) aspects of a program (8)
-quality of program
-monitoring of control conditions
***not all of these are aspects are monitored.
Issues in implementation) aspects of program: fidelity
Closely follows original program
Issues in implementation) aspects of program: dosage/intensity
Often or frequency
Issues in implementation) aspects of program: quality
Quality of program presentation
Issues in implementation) aspects of program: participant responsiveness
-likeability and engagement
Issues in implementation) aspects of program: program differentiation
Theoretical and practical distributions
Issues in implementation) aspects of program: monitoring of control conditions
Issues in implementation) aspects of program: program reach
- Reaching of those intended were actually enrolled
- *were the target group enrolled or not?
Issues in implementation) aspects of program: adaptation
aspects adapted to the context of the setting
Implementation models) 4 stages of program development & implementation
-diffusion of innovation
Implementation models) stages of program development & implementation: diffusion of innovation?
program adoption requires organizational knowledge, persuasion, decision, implementation, & confirmation
Implementation models) research to practice models?
Research and policy makers push communities and organizations to adopt evidence based programs
Implementation models) community centered models?
Communities ask what kinds of programs work for the problems we are facing and how can we adopt them for our community?
Integrative model) interactive systems framework for dissemination and implementation: prevention synthesis and translation system
-providing understandable information about available programs
Integrative model) interactive systems framework for dissemination and implementation: prevention support system? (2)
-providing training and technical support
-addresses issues of capacity
Integrative model) interactive systems framework for dissemination and implementation: prevention delivery system?
Systems that are actually implementing the program
Support for the ISF model) drulak and duper reviewed 5 meta analyses and 59 additional studies, what were results?
Sites that demonstrated better program implementation had effect sizes 2-3 times higher than sites with poor implementation
Participatory action research in program implementation) implementation requires that you...(2)
-Understand the context in which you are working
-requires continually adapting the program to fit the setting
Participatory action research in program implementation) how should adaptations be made?
Must be based upon empirical evidence of the ongoing interaction between the program and the setting
Participatory action research) what is it?
Collaborative cycle in which research (assessment) continually informs action (implementation) and action informs research
Participatory action research) what does it require?
That a structure of working relationships is in place to ensure that the process is particpatory
Participatory action research) key stakeholders ?
- They all need to be involved in some way
- *includes children and adolescents
evaluate for unintended consequences)
What would you like to do?
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