High Quality Implementation: Meeting the Challenge

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High Quality ImplementationMeeting the Challenge

• Linda Dusenbury, Ph.D.
• Tanglewood Research

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Key Elements ofEffective Programs

• Theoretically valid program content
• Comprehensive approaches
• Developmentally appropriate material
• Sensitivity to the culture and community
• Sufficient dosage and follow-up
• Use of interactive teaching techniques
• Well-trained implementers
• Continuing evaluation

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Content of Effective Programs

• Norm Setting
• Social Resistance Skill Training
• Competence Enhancement

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Norm Setting

• Establishing positive norms
• Correcting misperceptions about behavior
• Correcting misperceptions about attitudes

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Social Resistance Skills Training

• Recognizing influences
• Developing cognitive techniques
• Developing peer resistance skills

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Competence Enhancement

• Personal Skills
• Decision Making
• Stress Management
• Goal Setting
• Social Skills
• Communication Skills
• General Social Skills
• Assertiveness Skills

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Prevention Programs Also Promote Academic
Achievement

• Academic achievement benefits from
• Social and personal skills
• Positive norms
• The reduction of multiple behaviors
• Increased school bonding
• Positive school climate
• Involved families

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Ineffective Prevention Strategies

• Scare tactics and moralistic appeals
• Exclusive focus on Information
• Exclusive focus on self-esteem
• Testimonials by addicts
• Congregation of high-risk youth

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Effects of Fidelity on Smoking
Source Botvin,G.J., Baker,E., Dusenbury,L.,
Botvin,E.M., Diaz,T. (1995). JAMA, 273, 1106-1112.
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Effects of Fidelity on Alcohol
Source Botvin,G.J., Baker,E., Dusenbury,L.,
Botvin,E.M., Diaz,T. (1995). JAMA, 273, 1106-1112.
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Effects of Fidelity on Marijuana
Source Botvin,G.J., Baker,E., Dusenbury,L.,
Botvin,E.M., Diaz,T. (1995). JAMA, 273, 1106-1112.
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Professional Groups Interviewed

• Researchers
• Program Developers
• School Administrators
• Teachers
• Safe and Drug-Free Schools Coordinators

Dusenbury, Brannigan, Falco, Lake. (in press)
An exploration of Fidelity of Implementation in
Drug Abuse Prevention Among Five Professional
Groups. Journal of Alcohol and Drug Education.
Source Dusenbury, Brannigan, Falco, Hansen
(2003) A review of research on fidelity of
implementation implications for drug abuse
prevention in school settings Health Education
Research. 18 237-256.
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Factors Influencing Quality of Implementation

• Program characteristics
• Organizational characteristics
• Characteristics of the provider
• Match between program and participants

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Researchers Perceptions of Barriers to
Effective Implementation

• Lack of Training
• Lack of Support
• Lack of Control
• Competing Demands
• Poor Match Between Program and Participants

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Researchers Strategies for Improving
Implementation

• Identifying essential content
• Detailed instruction manuals
• Methodology for assessing fidelity
• Communication
• Staff development and training
• Support

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Program Developers Perceptions of Barriers to
Effective Implementation

• Providers need to adapt programs
• Limited time and competing demands
• Program maintenance
• Hostile culture and lack of support
• Resistance by providers
• Lack of resources

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Program Developers Strategies for Improving
Implementation

• Detailed instruction manuals
• Strong message Dont change the material!
• Staff development and training
• Ongoing support and consultation

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Other Considerations for Improving Implementation

• A program champion
• Choosing the right providers
• Flexibility

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Administrators Strategies for Improving
Implementation

• Staff development and training
• Technical support
• Measures to assess fidelity

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Teachers Perceptions of Barriers to Effective
Implementation

• Certain teaching strategies or activities
• Student resistance
• Limited time
• Miscellaneous difficulties
• Day-to-day crises

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Teachers Strategies for Improving Implementation

• Creative adaptations
• Specific adjustments
• Infusing the program
• Staff development and training

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Safe and Drug-Free Schools Coordinators
Strategies for Improving Implementation

• Networking
• State coordination
• Program assessments and guides
• Staff development and training
• Experience
• Administrative leadership and support

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Strategies to Increase Effectiveness

• High Quality Implementation
• Follow the program as outlined
• Make modifications that fit the theory
• Staff development
• Ongoing technical support
• Institutionalization
• Continuity across grades
• Continuity of staff
• Program champions