Improving the Implementation of
Evidence-based Programs That
Respond to Community and
Research Needs
C Hendricks Brown, U Miami
Patti Chamberlain, Ctr for Res to
Practice
Jeanne Poduska, Am Inst Res
Peter Wyman, U Rochester
Implementation Questions
Sustaining
Systemwide
Going to Scale
Going-to-Scale
Sustainability
Effectiveness
Efficacy
Connecting the Dots: Hopkins
Common Implementation Research
Questions
How to test whether intervention effects are
sustained as supports are lifted?
How to increase the adoption of a program, by
communities as well as individuals?
Does adaptation change outcomes?
What support structures lead to successful
implementation, high fidelity, and sustainability?
Connecting the Dots: Hopkins
What things are Unique about
Implementation Trials
1. The Role of Partnership between
Community, Institution, and Researchers
Communities and Researchers
Institutions
“Everyone must get this
program” Rigorous design to
Human Subjects produce relevant
Protection causal inferences
IRB, Institutional
Safety, DSMB
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It is possible to design/conduct Rigorous Trials
addressing Implementation Questions
CAL-40 Trial (Chamberlain) -- NIMH
Test strategy to Improve the county-wide adoption rate of an
evidence-based program
-- randomize 40 counties
Whole Day Trial: (Poduska) -- NIDA
Test effectiveness, sustainability, and scalability of an integrated
whole day intervention in first grade
-- randomize classrooms/teachers
Georgia Gatekeeper Trial (Wyman and Brown) -- NIMH
Test effectiveness of QPR as it is “rolled out” in a community.
-- randomize middle and high schools
Sources of Strength Trial (Wyman and Brown) – SAMHSA, NIMH
Test mediators, effectiveness, and sustainability of Sources of
Strength for suicide prevention.
-- randomize schools
Connecting the Dots: Hopkins