Seminar Presentation from the Evidence Based Parenting Programmes and Social Inclusion conference held at Middlesex University, 20th September 2012

1. Scale, sustainability and evidence-based programmes
Louise Morpeth
Social Research Unit at Dartington

2. We struggle to scale things
that work and sometimes
scale things that harm

3. No EBP has achieved scale
but FNP is heading in the
right direction

4. SUSTAINABILITY

5. I’m not evidence-
I’m evidence- NO! I am based, I’m
ignore her! look evidence-informed
based
at me!

6. 1. Intervention specificity - what is
it?
2. Evaluation quality - is the method
robust enough for us to believe
the findings?
3. Intervention impact - which
aspects of child health and
development are affected and to
what extent?
4. System readiness - is the
intervention replicable?
Standards of Evidence

9. *Approximately 5,000 6th and 7th grade students @ baseline and follow-up
Data from Pentz, Trebow, Hansen, MacKinnon, Dwyer, Johnson, Flay, Daniels, &
CormackEffects of Program Implementation on Adolescent Drug Use Behavior: The
Midwestern Eval Rev.1990; 14: 264-289

10. FFT Results
63
Control Group (N=313)
18-Month Unadjusted Major Recidivism Percentage
55
Individual Therapists (N=387)
Group Mean (Average)
47 47
43 42
34 33 33
31
28
26 26
23 23 22
20
18 17 18
17 1717
14 14 14
12 11
8
0
C 1 2 3 4 5 6 7 M 8 9 10111213M 1415161718M 19202122232425M
Low Fidelity High Fidelity
From: Outcome Evaluation of Washington State's Evidence-Based Programs for Juvenile Offenders, January
2004. Washington State Institute for Public Policy, Report #04-01-1201

12. SCALE UP

13. Innovation vs invention
Small, simple, effective
When attending a home birth in rural Nepal, a birth attendant brings a
delivery kit the size of a deck of cards: a small bar of soap for washing
hands, a plastic sheet to serve as the delivery surface, clean string for
tying the umbilical cord, and a new razor blade for cutting the cord. It’s
cheap and basic, but it helps mothers and babies avoid infection.
Photo: Bill & Melinda Gates Foundation / Toni Greaves

14. Start with scale in mind
Community members participate in discussions after watching video
documentaries screened by the Self Employed Women’s Association
in an urban slum. (Ahmedabad, India, 2010)
Photo: Bill & Melinda Gates Foundation/PrashantPanjiar

15. What is core and what is
adaptable?
Mother’s new car is a cargo bike
The residents of Christiania, a communal neighborhood in Copenhagen,
have long had an affinity for customized bikes – easily personalized but
practical to the core.
Photo: Mikael Colville-Andersen

16. Scale can be local

17. The potential of social
networks
Charting contagion
Harvard medical sociologist Nicholas Christakis is one of the foremost
researchers and communicators on social networks. He and his
collaborators have found that many surprising phenomena are contagious,
such as loneliness, altruism, and obesity.
Network image: Nicholas Christakis

18. Diffusion vs dissemination
The S-curve of diffusion
In 1962, sociologist Everett Rogers set out the ideas of
“dissemination” and “diffusion.” The S-curve predicts how an
innovation proceeds from a trickle of early adopters, to a flood of
mainstream users, until only a few laggards remain.
Image: Everett M. Rogers. 2003[1962]. Diffusion of Innovations,
5th Ed. New York: Free Press.

19. Pull beats push
The demand for vaccination
In many parts of the world, the demand for vaccination shows how
“pull” beats “push.” In Pantasma, Nicaragua, mothers are willing to
wait in line for hours so that their children can receive the rotavirus
vaccine – with the result that 80 percent of children in Nicaragua
have been vaccinated against this life-threatening disease.
Photo: Bill & Melinda Gates Foundation / Brent Stirton

20. We need to understand
demand as well as need

21. There are no blueprints
for scale up
Any blueprints for our work?
A World War II poster from the US prescribes a “Blueprint
for Victory.”
Image: US National Archives and Records Administration

22. Data is essential but we
need stories too
It was 1970 when designer Jeremy Sinclair, at the
advertising agency Cramer Saatchi, created the
“pregnant man” poster for the UK’s Health Education
Council. It aimed to tell a story that men would
recognize.
Advertisement: Jeremy Sinclair

23. Great impact might come
from a simple innovation
widely adopted
A new use for an old wheel
The pulley – a simple re-configuring of wheels and rope – is one of the all-
time great radical ideas. Here, a pulley helps to raise water from a
traditional indoor well in a house in Chettinad. (Tamil Nadu, India, 2008)
Photo: Ramaswamy N.

24. www.dartington.org.uk
lmorpeth@dartington.org.uk
01803 762400
www.preventionaction.org