After randomised trials: issues related to dissemination of evidence‐based interventions
| Pages | 55-64 |
| Published date | 12 April 2008 |
| Date | 12 April 2008 |
| DOI | https://doi.org/10.1108/17466660200800012 |
| Author | Brian Bumbarger,Daniel Perkins |
| Subject Matter | Education,Health & social care,Sociology |
55
Journal of Children’s Services
Volume 3 Issue 2 September 2008
© Pavilion Journals (Brighton) Ltd
Abstract
Demonstrating the efficacy and effectiveness of prevention programmes in rigorous randomised trials is
only the beginning of a process that may lead to better public health outcomes. Although a growing
number of programmes have been shown to be effective at reducing drug use and delinquency among
young people under carefully controlled conditions, we are now faced with a new set of obstacles. First,
these evidence-based programmes are still under-utilised compared to prevention strategies with no
empirical support. Second, when effective programmes areused the evidence suggests they are not being
implemented with quality and fidelity. Third, effective programmes are often initiated with short-term grant
funding, creating a challenge for sustainability beyond seed funding. We discuss each of these challenges,
and present lessons learned from a large-scale dissemination effort involving over 140 evidence-based
programme replications in one state in the US.
Key words
prevention dissemination; diffusion; innovation; implementation; fidelity; sustainability
1The Pennsylvania
State University,
Prevention Research
Center
2The Pennsylvania
State University,
Department of
Agricultural and
Extension Education
Introduction
The other authors in this special edition have been
tasked with examining various aspects of randomised
controlled trials (RCTs), presenting case examples
and discussing the challenges of RCTs with the goal
of promoting greater recognition among practitioners
of the value of these highly-controlled studies.
The purpose of this article is related but different.
With the growing number of prevention programmes
that have demonstrated efficacy in RCTs, we turn our
attention to the challenges of parlaying that effort into
greater improvements in public health. As a case study,
we will present the experience of a state-funded
initiative, conducted in Pennsylvania over the last ten
years, aimed at disseminating a broad menu of
evidence-based interventions (EBIs) with the goal of
preventing and reducing juvenile delinquency and youth
drug use. The EBIs promoted in this initiative represent
the first generation of prevention programmes
demonstrated effective through randomised trials.
We discuss three particular challenges that surfaced in
this initiative; challenges that we believe are relevant
to the broader effort to move from RCTs to improved
public health. Although the primary audience of our
article is practitioners (those involved in implementing
EBIs), we believe that researchers, programme
developers, funders and policy makers may also
benefit from the lessons learned in this effort.
Our goal here is not to provide complete solutions
to each of these barriers, but rather to introduce the
important issues and provide some suggestions based
on the experiences of one state, so that practitioners,
programme developers and policy makers are more
cognisant of the challenges of implementing EBIs.
Beyond randomised trials
Prevention science has given considerable attention
to the task of developing interventions based on
After randomised trials: issues
related to dissemination of
evidence-based interventions
Brian K Bumbarger1and Daniel F Perkins2
To continue reading
Request your trial