Background
Methods
Overview of the 10 evidence-based programs
Prevention program name/Principal Investigator (references) | Program goals/significant impact | Stage of life | Implementation research and practice | Implementation agent(s) | Setting |
---|---|---|---|---|---|
Quit Using Drugs Intervention Trial (QUIT) Screening, brief intervention and referral for treatment (SBIRT)/Gelberg [57] | Prevent escalation of drug use to abuse/dependence for adults/drug use. The program has demonstrated effectiveness for reducing alcohol abuse and it is currently being tested on substance abuse [57] | Adulthood | Research: type 1 hybrida
Practice: exploration phaseb
| Physician and health educator | Primary care clinics |
Communities that Care: programs vary depending on community selection/Hawkins, Catalano [33] | Prevent youth externalizing behaviors and promote healthy development/violence, alcohol, drug, tobacco use | Childhood | Research: randomized implementation triala
Practice: distributed widely through SAMHSA, sustainmentb
| Community coalition leaders | Rural, small towns and cities, and portions of metropolitan areas, including Latin America |
Familias Unidas/Pantin, Prado [58] | Use parent training to increase parent-child communication/drug use, sex risk, depressive symptoms. Program reduced monthly substance use in Hispanics by 30 % and achieved higher frequency of condom use among adolescents sexually active 30 months after the intervention [26]. | Middle school | Research: pilot type 3 hybrida
Practice: exploration phaseb
| Caregivers, supported by trained facilitator | Small parent groups and home visits with family |
Family check-up/Dishion, Stormshak [59] | Family management practices designed to reduce problem behaviors, enhance parenting skills, reduce family conflict, and reduce substance use. | Elementary, middle, and high school | Research: randomized implementation triala
Practice: active implementationb
| Caregivers, supported by trained counselors | School settings and mental health community agencies |
Good Behavior Game (GBG)/Poduska, Kellam [28] | Use group-based contingencies to reduce child aggressive disruptive behavior/drug and alcohol abuse or dependence disorder, conduct disorder, antisocial personality disorder, suicide ideation and attempts, criminal arrests, sex risk behavior. Results across 3 randomized control trials indicated a 50 % reduction in drug abuse/dependence disorders among males through age 21 [10, 64‐69], a significant reduction in alcohol abuse/dependence disorders for males and females [10], and also demonstrated a reduction in unprotected and risky sexual behavior through young adulthood among the highest risk group [11]. | First and second grade | Research: randomized implementation triala
Practice: wide scale implementation through SAMHSA (http://www.samhsa.gov/grants/2010/sm-10-017.aspx); active implementationb
| School teachers | First- and second-grade classrooms |
Keeping Foster and Kin Parents Trained and Supported (KEEP)/Chamberlain [70] | Program promotes child well-being and prevents foster placement breakdowns through support and skill enhancement of foster and kinship parents. | Middle school | Research: randomized implementation triala
Practice: full scale implementation in New York city through child welfare system; active implementationb
| Foster/kin parents supported by trained health workers | Foster/kin parents groups |
Life Skills Training (LST)/Botvin, Griffin [76] | Prevention of substance abuse (alcohol, tobacco, drug use) and violence. | Elementary, middle, and high school | Research: randomized implementation triala
Practice: implementation in schools through the National Health Promotion Associates (http://www.lifeskillstraining.com/index.php); sustainmentb
| Trained school personnel | School classrooms |
Nurse-Family Partnership/Olds [29] | Increase pre-natal and early stage parenting skills. The program resulted in significant reductions in youth alcohol use, fewer sexual partners, and fewer problems with alcohol or drugs in a 15-year follow-up [80]. | First 2 years of life | Research: natural experiment, type 1 hybrid designa
Practice: implementation in communities through the NFP National Service Office; sustainmentb
| Trained nurses | Home visits |
Sisters Informing Sisters about Topics on AIDS (SiSTA)/Wingood, DiClemente [81] | Demonstrated high increases in condom use and when combined with a biological intervention of HPV vaccination, demonstrated significant reductions in incident high-risk HPV infection [82] | Young adulthood and adulthood | Research: type 1 hybrid designa
Practice: wide scale implementation through CDC’s Dissemination of Evidence-Based Intervention (DEBI) program (http://www.effectiveinterventions.org/en/HighImpactPrevention/Interventions/SISTA.aspx); active implementationb
| Peer/near peer facilitator and health educators | Community-based setting |
Improve parent-child relationships. | Middle school, high school | Research: type 2 hybrid designa
Practice: exploration phaseb
| Caregivers supported by trained facilitators | Community-based settings, community churches |
Systems engineering applied to implementation research
Data collection protocol
The implementation survey
The interview
Results
Characteristics of the 10 programs
Duration (weeks) | Number of sessions | Contact time (minutes/session) | ||
---|---|---|---|---|
N
| Valid | 14 | 14 | 14 |
Missing | 1 | 1 | 1 | |
Mean | 22 | 25.07 | 56.58 | |
Median | 11 | 9 | 60 | |
Standard deviation | 33.911 | 16.276 | 32.870 | |
Range | 128.0 | 63 | 119 | |
Percentiles | 25 | 5.500 | 4.000 | 45 |
50 | 12.000 | 9.000 | 60 | |
75 | 33.911 | 15.750 | 82.500 |
N
| Percent | |
---|---|---|
Program delivery characteristics | ||
Mode of intervention delivery | ||
Face-to-face contact | 11 | 100 % |
Telephone contact | 4 | 36 % |
Computer/Internet contact | 3 | 27 % |
Video/CD | 4 | 36 % |
Print media | 5 | 46 % |
Lectures | 2 | 18 % |
Technology (computer or telephone) | 4 | 36 % |
Type of intervention strategy | ||
Provision of social support | 5 | 46 % |
Tracking and monitoring | 7 | 64 % |
Provision of information | 10 | 91 % |
Provision of behavioral incentives | 6 | 55 % |
Didactic instruction | 6 | 55 % |
Skill building techniques | 11 | 100 % |
Problem solving techniques | 10 | 91 % |
Stress management techniques | 6 | 55 % |
Other techniques | 5 | 46 % |
Intervention delivery location | ||
Participant home | 5 | 46 % |
Classroom | 4 | 36 % |
Physician’s office | . | . |
Hospital/clinic | 2 | 18 % |
Work site | . | . |
Community center | 5 | 46 % |
Nursing home | . | . |
Group residential facility | . | . |
Clinical research space | 3 | 27 % |
Types of materials used | ||
Information sheets/checklists/pamphlets | 7 | 64 % |
Manuals/workbooks | 11 | 100 % |
Internet | 4 | 36 % |
Video | 8 | 73 % |
Audio | 3 | 27 % |
Live demonstrations | 7 | 64 % |
CDs/DVDs | 5 | 46 % |
Other Materials | 1 | 9 % |
Program adaptability features | ||
Intervention strategies are adapted for cultural sensitivity | 11 | 100 % |
The program is scripted | 11 | 100 % |
Degree of scripting | ||
Minimal guidelines | 1 | 9 % |
Goals of each session are specified but no further scripting | 3 | 27 % |
Goals and exercises/tasks of each session are specified | 6 | 55 % |
Specific language is provided, with room for elaboration | 8 | 73 % |
Exact scripts are provided for humans to speak | 2 | 18 % |
Intervention is delivered by machine | . | . |
Other | 2 | 18 % |
Aspect of intervention amenable to adaptation | ||
Number of sessions | 4 | 40 % |
Schedule of sessions | 6 | 60 % |
Duration of sessions | 4 | 40 % |
Location of intervention delivery | 4 | 40 % |
Focus of sessions | 3 | 30 % |
Intervention scripts | 1 | 10 % |
Determination of modifications | ||
Clinical judgment | 4 | 36 % |
Formal checklist/interventionist | 3 | 27 % |
Intervention MOP | 3 | 27 % |
Participant choice | 3 | 27 % |
Computerized algorithm | . | . |
Other determination | 5 | 46 % |
Time of modifications | ||
At intake/initial assessment | 2 | 18 % |
At scheduled increments | 2 | 18 % |
At any session/contact | 4 | 36 % |
At other point | 4 | 36 % |