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Implementing Evidence-Based Programs with Fidelity and Adaptation
- 1. Michelle Carvalho, MPH, CHES; Cam Escoffery, PhD, MPH, CHES; Louise Wrensford, PhD; Michelle Kegler, DrPH, MPH Georgia Public Health Association Annual Meeting April 12, 2011
- 12. Interactive Systems Framework Wandersman, A., Duffy, J., Flaspohler, P., Noonan, R., Lubell, K., Stillman, L., et al. (2008). Bridging the Gap Between Prevention Research and Practice: The Interactive Systems Framework for Dissemination and Implementation. American Journal of Community Psychology, 41(3), 171-181.
- 17. 16 Mini-grants sites funded 2007-2012 5 Tifton Thomasville Bainbridge Albany Blakely Pelham Sylvester Nashville Adel Valdosta Cordele
- 18. 2007-2009 12 Awarded Sites & 5 Programs Funded Organizations Evidence-Based Program 4 Churches Body and Soul 4 Worksites Treatwell 5-A-Day 2 Community Coalitions Parents as Teachers (PAT) High 5 Low Fat Program Senior Center Little By Little Nutrition Program Hospital Diabetes Management Center Patient-Centered Assessment & Counseling for Exercise (PACE)
- 33. EBP Training Topics (pre-award) Session Title What Do We Mean By Evidence-Based? Needs Assessment and Program Planning Finding an Evidence-Based Program Selecting a Program That Fits Your Community Adapting the Evidence-Based Program with Fidelity Implementing an Evidence-Based Program Evaluating Your Program
- 34. TEACH model: Translating Evidence into Action through Collaboratives for Health TA Contact Structured TA Topics (examples) Stage in Map of Adaptation Process Pre-award Training See prior training slide Assess, Select, Prepare Kick-Off Training for awarded sites EBIs, Needs assessment, Organizational readiness, Core elements Assess, Select, Prepare Site Visit Fit, Adaptation, Evaluation planning Assess, Select, Prepare, Pilot Conference Call Implementation Work Plan, Partnerships Assess, Select, Prepare, Pilot Ongoing Contact Overcoming barriers, implementation fidelity, maintenance Assess, Pilot, Implement, Maintenance
- 36. Tools Adapted from: Lesesne, C. A., Lewis, K. M., Moore, C., Fisher, D., Green, D., & Wandersman, A. (2007). Promoting Science-based Approaches to Teen Pregnancy Prevention using Getting To Outcomes: Draft June 2007. Unpublished manual.
- 41. Preliminary Results: Skills Related to EBPs Tasks (1= very hard; 5= very easy) Mean SD Tasks with higher reported ability Define goals and objectives for your program. 3.95 .83 Discuss the benefits of using evidence-based programs. 3.90 .72 Develop an implementation work plan. 3.80 .70 Tasks with lower reported ability Plan for maintenance of program. (e.g. leverage of resources) 2.75 .97 Develop solutions to identified implementation barriers. 3.00 1.03 Describe the steps of the program adaptation process. 3.20 .77 Prepare for the implementation of your program. (e.g. training of staff, hiring of staff, piloting, partnerships) 3.20 1.15
- 42. Attitudes about EBPs All scores of negative statements were reversed. The higher the mean score, the more positive their attitude about EBPs. *Reverse Coded
- 45. QUESTIONS? www.sph.emory.edu/eprc Michelle Carvalho [email_address]
Hinweis der Redaktion
- Our mini-grants, training and TA efforts fall into this area of the K2A Framework: Translation Supporting Structures and process evaluation of a dissemination strategy for EBIs into community practice.
- It is a logical next step to expand opportunities for training, technical assistance and financial support to promote the translation of research into practice (Kerner, et al., 2005a). A push-pull-infrastructure model proposed by Orleans, Gruman and Anderson (2002) contends that while pushing scientific knowledge into practice, there must also be a simultaneous increased demand for evidence-based approaches and an increased infrastructure capacity to deliver those interventions (Orleans, et al., 2002). In this model, the number of providers delivering the evidence-based interventions and the number of people in the population receiving them should increase, which in theory should result in improved outcomes. A mini-grant funding model accompanied by technical assistance is an example of using this push-pull-infrastructure model. It creates demand in the community to implement such programs while building capacity through technical assistance. Orleans, C., Gruman, J., & Anderson, N. (2002). Designing for Dissemination: The Larger Challenge of Translation: An Extraordinary Opportunity for Cancer Control. Paper presented at the Designing for Dissemination Collaborative Meeting, Washington, D.C.
- Organizational functioning includes organization function, staffing, leadership, problem-solving, communication and decision-making, role clarity, shared vision, formalization, risk-taking, centralization, external relationships, and human capacity (Levinger and Bloom, 2000 ; Weiss et al., 2002; Preskill and Tores, 1998; Caplan, 1971; Kenny and Sofaer, 2000; Schminke et al, 2002)
- Nine participants (45%) held supervisory or managerial roles and six (30%) considered themselves “front line staff.” Fifteen (75%) had a bachelors or graduate level degree. The average time employed at their current organization was about 9 years. Six (33.3%) reported prior experience implementing EBPs. Almost all (18) reported that someone from their organization advocated for the use of an EBP for the currently funded mini-grant.