Community Chapter 10.docx

6 Pages
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Department
Psychology
Course Code
PS282
Professor
Colleen Loomis

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Chapter 10: Prevention and Promotion Implementing Problems Opening Exercise: Prevention in your future  The purpose of this chapter is to provide you with a guide for effectively addressing these situations Introduction: Program Implementation is Challenging  How prevention science is implemented in real-life settings  SAMHSA: US Substance Abuse and Mental Health Services Administration o In 2005 a group of researchers published meta-analysis of results from 46 drug prevention programs funded by SAMHSA. o Focused on the prevention of child and adolescence substance abuse, all targeted at high-risk youth o Evaluations covered a total of 5 years over 46 sites around the US o Results were disappointing the mean effect size over all the sites were 0.2, almost zero. o 21/46 sites the effect sizes were negative. Meaning that the comparison groups demonstrated less substance abuse then the participants after the intervention (Derzon, Salem Springer, Brounstein 2005)  Why did the program fail to show positive results in real-world settings? o Programs that just provided information about the substances were not effective o At many of the sites the control groups, were not really control groups. Many of the children were actually being exposed to some sort of intervention program and not just in the program being evaluated o The programs were implemented in many different ways at different sites It is not just program implementation—It is program innovation Concepts of how to transfer effective educational programs and adapt them to new host settings have evolved through Four Stages (Cookbook, Replication, Adaption, Invention/Innovation)  Cookbooks: 1970’s. Programs had to be thoroughly documented, ideally in “kits” that could be followed precisely, step-by-step  Replications: Staff trained in the methods used by program developers and then bringing these methods back to specific settings to be carried our as similar as possible  Adaptation: Late 1980’s. Having the developer serve as a consultant in making the necessary changes  Invention/ Innovation: creating a program tailored to the unique circumstances at a given time Issues in Implementation Implementation: refers to how a program is actually delivered in a real life setting. The term implementation covers a wide range of practices. Durlak and Dupre (2008) discuss 8 different aspects of implementation (5 of which are based on work by Dane and Schneider, 1998)  Fidelity: how closely is the design of the original program maintained  Dosage/ Intensity: how often/ how frequently is the program presented  Quality: how well are the components presented?  Participant Responsiveness: how engaged are the participants, attendance of participants  Program Differentiation: were there clear theoretical and practical distinctions between this program and other intervention  Monitoring of control/ comparison conditions: were the control participants exposed to any other type of intervention  Program reach: how many of the intended participants were actually enrolled in the program?  Adaptation: what aspects of the program were adapted to fit the specific context of the setting? Implementation Models Scaling up: the process of going from one original development of an innovation to its widespread implementation (Schnorr 1997) Four Stages of program development and implementation can be identified:  Experimental Development: a program demonstrates its effectiveness under small-scale, optimal, highly controlled conditions compared to a control group  Technological Application: a program demonstrates its effectiveness under real world conditions similar to the conditions for which it is eventually intended but still under the guidance of its developers  Diffusion of Innovation: a program is adopted by other organizations or communities and demonstrated effectiveness under real world conditions when not under the direct scrutiny and guidance of its developers  Widespread Implementation: implementation becomes widespread when a program continues to show its effectiveness in a wide variety of settings and is transferred from its developers to new implementers, who in turn conduct further program diffusions Diffusion of Innovations: refer to a broader theory of the processes through which new ideas, technology and products spread through cultures. Everett Rogers published a textbook: Diffusion of Innovations, which standardized some of the ideas in this area. Rogers stated that in order for an organization or individual to adopt a new idea, a 5 step process must occur: Knowledge, Persuation, Decision, implementation and confirmation.  Knowledge: potential adopters of the program need to be aware the program exists  Persuasion: sufficient evidence regarding the program to persuade them to adopt it  Decision: after decision to adopt is made, the program is then implemented.  Implementation: this stage was still in the nature of “trial” of the program and the adopter would need to see evidence that the program produces benefits in that setting before confirming a commitment to program  Commitment: (refer to above) What exactly is happening when we try to diffuse our knowledge of successful prevention and promotion programs into widespread practice? The mode,s generally have been of two types: Research to Practice Models: focus on the desire of researchers and policymakers to “push” communities and organizations to adopt evidence-based programs. Asks the questions “we know that it works, but how do we get it to successfully adopt in real-life settings? Community-centered models: need to be able to answer the questions “how do we find programs that will work for our issues in our community and then how do we successfully adopt them?” (Saul et al., 2008)  The split between the two types of models is a bit of a false dichotomy. The primary goal of both types of models is to help generate information that will support the successful implementation of prevention research  Successful program implementation must be based on a participatory action research approach. Community members must be involved in every step An Integrative Model There has been work done to integrate these two types of models, such as in the Interactive System Framework for Dissemination and Implementation (ISF). (Describes the syste
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