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5 Toward Efficient and Sustainable Delivery of Interventions
Pages 51-62

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From page 51...
... summarized the burgeoning knowledge base for prevention science. It noted that 40 years of prevention science research advances have produced a strong understanding of the epidemiology and etiology of problem behaviors, a wealth of efficacy trials that have tested preventive interventions, and research findings on how to build an effective infrastructure to use prevention science to achieve community impact.
From page 52...
... A major difficulty in overcoming this challenge is that communities are different from one another, and communities need to decide locally what policies and programs they use. Overcoming this difficulty requires building the capacity of local coalitions to reduce common risk factors for multiple negative outcomes, according to Catalano, which in turn requires several actions: • Assessing and prioritizing epidemiological levels of risk, protection, and problems • Choosing proven programs that match local priorities • Implementing chosen programs with fidelity to those targeted Catalano used the Communities That Care (CTC)
From page 53...
... a ­ ssess the key components of CTC's strategy, including goals, steps, ­ ctions, a and conditions needed for CTC implementation to build prevention infrastructure. The milestones and benchmarks are listed in CTC training manuals and discussed in training workshops, incorporated into the community coordinator's job performance objectives, and reviewed by technical assistance providers and coordinators during weekly phone calls.
From page 54...
... to achieve effective prevention infrastructure. • Build capacity and provide tools to assess and prioritize local risk, protection and youth outcomes, match priorities to evidence-based programs, and repeat assessment periodically.
From page 55...
... THE STAGES OF IMPLEMENTATION COMPLETION A growing body of measures target key aspects of implementation, including organizational culture and climate, organizational readiness, leader­ ship, attitudes toward evidence-based practices, and the use of research evidence. However, there remains a gap in the measure of the implementation process itself, said Lisa Saldana, senior research scientist at Oregon S ­ ocial Learning Center.
From page 56...
... It also has demonstrated face validity while identifying three clusters of sites based on their pre-implementation behavior: those that complete activities relatively quickly, those that are relatively slow, and noncompleters. Finally, it has demonstrated predictive validity in that sites that both took longer to complete each stage and completed fewer activities had a significantly lower hazard of successful program start-up during the study period (Saldana et al., 2011)
From page 57...
... Marion Forgatch, ­ senior scientist emerita at the Oregon Social Learning Center and executive director of Implementation Sciences International Inc., illustrated this process by discussing implementations of the Parent Management Training Oregon (PMTO) model, which provides interventions to parents to help protect children and enhance their development (Forgatch and Patterson, ­ 2010)
From page 58...
... As part of a broader infrastructure, a governing authority is tasked with sustaining model fidelity and effective treatment outcomes. This process starts with a visionary leader or group committed to affecting lasting change, said Forgatch.
From page 59...
... . MEASURING IMPLEMENTATION FIDELITY USING COMPUTATIONAL METHODS In the past, measuring the fidelity of implementation has generally involved direct observation or the observation of recordings, which requires highly trained individuals and can be time consuming and costly.
From page 60...
... But the cost of a human rater is approximately $800 per session, which, said Gallo, "becomes prohibitively expensive as local agencies want to pick up on these interventions and carry on the same work carefully." The second example he described is based on nonlinguistic cues. The Good Behavior Game is a universal classroom behavior management strategy for first grade teachers that has been shown to influence adolescent and young adult drug abuse, sexual risk behavior, delinquency, and suicidal behavior (Kellam et al., 2008)
From page 61...
... The program is 98 percent accurate in distinguishing a neutral from an angry tone, and 87 percent successful in distinguishing a neutral from an emotional tone. "This is something that we can do in a split second throughout an hour session," Gallo noted.
From page 62...
... 2014. Blending qualitative and computational linguistics methods for fidelity assess­ ent: Experience with the Familias Unidas preventive intervention.


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