Active Approaches to Implementing and Scaling Evidence-Based Prevention Strategies
The ultimate success of prevention science will not be measured by the effectiveness of prevention programs, practices, and policies alone, but also by our ability to bring the full experience of effective wellbeing strategies to children, families, and communities and to achieve intended wellbeing outcomes at scale. However, our usual passive methods of transferring evidence-based strategies into service settings (e.g., diffusion or dissemination of information; training; laws, mandates, and regulation; providing funding incentives), when used alone, typically result in only 5 to 15% of the population experiencing interventions as intended.[1]
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The effective implementation of wellbeing strategies, at scale, involves key partners who collaborate to embed active implementation and scaling capacity, infrastructure, and best practices within community-wide prevention systems.[3] Active implementation involves utilizing responsible management strategies for complex systems environments to ensure that:
practitioners are competent and confident delivering chosen wellbeing strategies within their organizations and larger community-wide prevention system;
core intervention components (i.e., “active ingredients”) are received by children, youth, and families as intended;
organization, system, and community partners work in concert, eliminating silos and increasing access to effective services; and
linked leadership and implementation team structures – across every level of a prevention system – continually improve and sustain wellbeing strategies over time using data.[4]
There is much work to do, but with the right partners success can be achieved. Active implementation approaches are being utilized in several federal and state initiatives at this time, including the Permanency Innovations Initiative (U.S. Administration for Children & Families), the State Implementation and Scaling-up of Evidence-based Practices Center (U.S. Department of Education), the scaling of evidence-based child and family support strategies in North Carolina, and the scaling of evidence-based home visitation in Washington State and Montana.
For more information, contact Will Aldridge (919-966-4713; will.aldridge@unc.edu),
Diana Fishbein (814-865-7377; dfishbein@psu.edu), or John Roman (roman-john@norc.org)
Suggested Citation: Aldridge, W. A. II, & the National Prevention Science Coalition to Improve Lives. (2016, Feb). Ensuring that evidence has impact: Active approaches to implementing and scaling evidence-based prevention strategies. Oakland, CA: National Prevention Science Coalition to Improve Lives.
[1] Nutt, P. (2002). Why Decisions Fail: Avoiding the Blunders and Traps That Lead to Debacles. San Francisco: Berrett-Koehler Publishers Inc. Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, National Implementation Research Network. (FMHI Publication No. 231). Green, L. W. (2008). Making research relevant: if it is an evidence-based practice, where’s the practice-based evidence? Family Practice, 25, 20-24. Wiltsey Stirman, S., Kimberly, J., Cook, N., Calloway, A., Castro, F., & Charns, M. (2012). The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research. Implementation Science, 7, 17-17. doi: 10.1186/1748-5908-7-17. [2] State Implementation and Scaling-up of Evidence-based Practices Center (n.d.). Module 2: Implementation drivers. Retrieved from FPG Child Development Institute, University of North Carolina, Active Implementation Hub website: http://implementation.fpg.unc.edu/module-2. [3] Metz & Albers (2014) What does it take? How federal initiatives can support the implementation of evidence-based programs to improve outcomes for adolescents. Journal of Adolescent Health, 54, 592-596. [4] Aldridge, W. A., II, Boothroyd, R. I., Fleming, W. O., Lofts Jarboe, K., Morrow, J., Ritchie, G. F., & Sebian, J. (2016). Transforming community prevention systems for sustained impact: Embedding active implementation and scaling functions. Translational Behavioral Medicine. Advance online publication. doi:10.1007/s13142-015-0351-y Fixsen, D., Blase, K., Metz, A., & Van Dyke, M. (2013). Statewide implementation of evidence-based programs. Exceptional Children, 79, 213-230. Metz, A., & Bartley, L. (2012). Active Implementation Frameworks for Program Success. Zero to Three, 32, 11-18.