How Has the Economic Downturn Affected Communities and Implementation of Science‐Based Prevention in the Randomized Trial of Communities That Care?

This study examined implications of the economic downturn that began in December 2007 for the Community Youth Development Study (CYDS), a longitudinal randomized controlled trial of the Communities That Care (CTC) prevention system. The downturn had the potential to affect the internal validity of the CYDS research design and implementation of science-based prevention in study communities. We used archival economic indicators and community key leader reports of economic conditions to assess the extent of the economic downturn in CYDS communities and potential internal validity threats. We also examined whether stronger economic downturn effects were associated with a decline in science-based prevention implementation. Economic indicators suggested the downturn affected CYDS communities to different degrees. We found no evidence of systematic differences in downturn effects in CTC compared to control communities that would threaten internal validity of the randomized trial. The Community Economic Problems scale was a reliable measure of community economic conditions, and it showed criterion validity in relation to several objective economic indicators. CTC coalitions continued to implement science-based prevention to a significantly greater degree than control coalitions 2 years after the downturn began. However, CTC implementation levels declined to some extent as unemployment, the percentage of students qualifying for free lunch, and community economic problems worsened. Control coalition implementation levels were not related to economic conditions before or after the downturn, but mean implementation levels of science-based prevention were also relatively low in both periods.     

Challenges in Supporting Community Implementation of Science-based Programs: A Critical Review of Local Partnerships for Success Plans

This paper provides the opportunity to consider local challenges to implementing science-based programs. Wandersman et al. (American Journal of Community Psychology 2008) define three systems necessary to effectively implement science-based programming. These systems include the Prevention Support System, which is responsible for assisting communities in implementing effective practices; the Prevention Research System, which is responsible for developing and packaging prevention programming; and the Prevention Delivery System, which is responsible for delivering services. The authors conduct a content analysis related to six county level efforts to implement science-based programs in Ohio. These counties are part of a larger Ohio initiative referred to as Partnerships for Success. The authors suggest that local officials are quite skilled at accessing the Prevention Research System and providers at the local level represent an effective service delivery system. The authors contend that the Prevention Support System in these counties is capable of enhancing several functions related to local infrastructure but is deficient in other important elements.     

The Diffusion of Youth-Led Participatory Research in Urban Schools: The Role of the Prevention Support System in Implementation and Sustainability

This article discusses the dissemination of a process of youth-led participatory research in urban secondary schools within the Interactive Systems Framework for Dissemination and Implementation (ISF) developed in collaboration with the CDC and its university partners (Wandersman et al. American Journal of Community Psychology, 41(3-4) 2008). The focus here is on the development of the Prevention Support System with respect to general and innovation-specific capacity building. The specific process under study involves youth-led needs assessment and research to inform the planning of prevention programs and policies to address students' health and developmental needs. The article first briefly describes the youth-led research process, its potential benefits, and a case example in two urban secondary schools. It then describes challenges and responses in providing support for the diffusion of this model in 6 secondary schools. The settings are urban public schools with a majority of students of color from diverse ethnic groups: Asian-American, Latino, and African-American. This project constitutes a collaborative partnership with a university school of public health and community-based organizations (CBOs) to build capacity for long-term, sustainable implementation of this innovative process within the local school system. The perspectives of the university-based researcher and the CBO partners on the development and effectiveness of the Prevention Support System are presented.     

Sustaining the Utilization and High Quality Implementation of Tested and Effective Prevention Programs Using the Communities That Care Prevention System

This paper describes the extent to which communities implementing the Communities That Care (CTC) prevention system adopt, replicate with fidelity, and sustain programs shown to be effective in reducing adolescent drug use, delinquency, and other problem behaviors. Data were collected from directors of community‐based agencies and coalitions, school principals, service providers, and teachers, all of whom participated in a randomized, controlled evaluation of CTC in 24 communities. The results indicated significantly increased use and sustainability of tested, effective prevention programs in the 12 CTC intervention communities compared to the 12 control communities, during the active phase of the research project when training, technical assistance, and funding were provided to intervention sites, and 2 years following provision of such resources. At both time points, intervention communities also delivered prevention services to a significantly greater number of children and parents. The quality of implementation was high in both conditions, with only one significant difference: CTC sites were significantly more likely than control sites to monitor the quality of implementation during the sustainability phase of the project.     

How Culture Impacts the Dissemination and Implementation of Innovation: A Case Study of the Families and Schools Together Program (FAST) for Preventing Violence with Immigrant Latino Youth

We consider how culture impacts the translation of research into practice, focusing on the culture of the client and the culture of the agency implementing selected programs. We build on lessons learned from a pilot study of an evidence-based family-school partnership, Families and Schools Together (FAST), to prevent youth violence with low-income, immigrant Latino families in Southern California. We examine the impact of cultural characteristics on the translation of this innovation into practice at the community level, relying on an interactive systems framework developed recently by Wandersman and colleagues (2008, American Journal of Community Psychology, 41(3–4), in press) discussed in this issue. As we point out, the culture of the client and the culture of the agency can facilitate or impede connections within and across these interactive systems.     

Community-Based Prevention Support: Using the Interactive Systems Framework to Facilitate Grassroots Evidenced-Based Substance Abuse Prevention

The community plays an important role in the success of substance abuse prevention efforts. However, current funding structures and a focus on limited approaches to prevention delivery have created a large gap between what substance abuse prevention professionals practice and what the community at large knows about prevention. The concept of “community” has not always been well‐defined in the field of prevention, and there are few mechanisms to engage grassroots community members in evidence‐based substance abuse prevention. This article explains how Wandersman et al.'s (Am J Community Psychol 41:171–181, 2008) Interactive Systems Framework can be applied to grassroots prevention efforts. The authors describe a Community Prevention Support System that collaborates with the Professional Prevention Support System to promote the adoption of evidence‐based substance abuse prevention practices at the grassroots, community level. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Implementation Quality and Positive Experiences in After-School Programs

Data collected during an evaluation of a multi-site trial of an enhanced after-school program were used to relate quality of program implementation to student experiences after school. The enhanced after-school program incorporated a drug use and violence prevention component that was shown to be effective in previous research. Building on Durlak and Dupre’s (Am J Community Psychol 41:327–350, 2008) dimensions of implementation, we assessed the level of dosage, quality of management and climate, participant responsiveness, and staffing quality achieved at the five program sites. We evaluated how these characteristics co-varied with self-reported positive experiences after-school. The study illustrates how multiple dimensions of program implementation can be measured, and shows that some but not all dimensions of implementation are related to the quality of student after-school experiences. Measures of quality of management and climate, participant responsiveness, and staffing stability were most clearly associated with youth experiences. The importance of measuring multiple dimensions of program implementation in intervention research is discussed.     

An Integrative Suicide Prevention Program for Visitor Charcoal Burning Suicide and Suicide Pact

An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42 months post‐implementation period. The number of visitor suicide pacts decreased from 7 pacts (15 individuals) to 1 pact (2 individuals). No statistically significant differences in the numbers of visitor suicide attempts and resident suicides were observed in the two time periods. No statistically significant changes in visitor suicides during the study period were observed on the comparison islands. The consistency and timing of reduction in visitor suicides correlated with the development and delivery of the integrative program on the intervention island, suggesting a causal association between program delivery and reduction of visitor suicides. The possibility of displacement seems small because there was no increase in visitor suicides on the comparison islands during the study period. This integrative approach in preventing target‐specific suicides may serve as an example for other communities to develop suicide prevention programs that make use of the existing local resources.     

Mobilizing Communities to Implement Evidence-Based Practices in Youth Violence Prevention: The State of the Art

Community mobilization can increase the effective implementation of evidence-based practices (EBPs) in youth violence prevention. These strategies bring together people and organizations in a community to try to solve or reduce a problem. They help communities address the challenges of identifying EBPs, disseminating them to local decision-makers, and then implementing and sustaining them if they are successful. Science-based systems for implementing EBPs such as PROSPER and Communities That Care can help to integrate this complex work in communities. Further insight about implementing EBPs in youth violence prevention is being developed through the CDC-funded Academic Centers for Excellence in Youth Violence Prevention. Community mobilization approaches for seven of these programs are discussed, highlighting successful approaches and challenges encountered.     

Implementing a Comprehensive Program for the Prevention of Conduct Problems in Rural Communities: The Fast Track Experience

Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program.     

Establishing and Evaluating the Key Functions of an Interactive Systems Framework Using an Assets-Getting to Outcomes Intervention

Community practitioners can face difficulty in achieving outcomes demonstrated by prevention science. Building a community practitioner's prevention capacity—the knowledge and skills needed to conduct critical prevention practices—could improve the quality of prevention and its outcomes. The purpose of this article is to: (1) describe how an intervention called Assets‐Getting To Outcomes (AGTO) was used to establish the key functions of the ISF and present early lessons learned from that intervention's first 6 months and (2) examine whether there is an empirical relationship between practitioner capacity at the individual level and the performance of prevention at the program level—a relationship predicted by the ISF but untested. The article describes an operationalization of the ISF in the context of a five‐year randomized controlled efficacy trial that combines two complementary models designed to build capacity: Getting To Outcomes (GTO) and Developmental Assets. The trial compares programs and individual practitioners from six community‐based coalitions using AGTO with programs and practitioners from six similar coalitions that are not. In this article, we primarily focus on what the ISF calls innovation specific capacity and discuss how the combined AGTO innovation structures and uses feedback about its capacity‐building activities, which can serve as a model for implementing the ISF. Focus group discussions used to gather lessons learned from the first 6 months of the AGTO intervention suggest that while the ISF may have been conceptualized as three distinct systems, in practice they are less distinct. Findings from the baseline wave of data collection of individual capacity and program performance suggest that practitioner capacity predicts, in part, performance of prevention programs. Empirically linking practitioner capacity and performance of prevention provides empirical support for both the ISF and AGTO. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

The Interactive Systems Framework Applied to the Strategic Prevention Framework: The Rhode Island Experience

The Interactive Systems Framework for Dissemination and Implementation (ISF) was introduced as a heuristic systems level model to help bridge the gap between research and practice (Wandersman et al., in Am J Commun Psychol 41:171–181, 2008). This model describes three interacting systems with distinct functions that (1) distill knowledge to develop innovations; (2) provide supportive training and technical assistance for dissemination to; (3) a prevention delivery system responsible for implementation in the field. The Strategic Prevention Framework (SPF) is a major prevention innovation launched by the Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA). The SPF offers a structured, sequential, data‐driven approach that explicitly targets environmental conditions in the community and aims for change in substance use and problems at the population level. This paper describes how the ISF was applied to the challenges of implementing the SPF in 14 Rhode Island communities, with a focus on the development of a new Training and Technical Assistance Resources Center to support SPF efforts. More specifically, we (1) describe each of the three ISF interacting systems as they evolved in Rhode Island; (2) articulate the lines of communication between the three systems; and (3) examine selected evaluation data to understand relationships between training and technical assistance and SPF implementation and outcomes. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Aboriginal perceptions of social and emotional wellbeing programs: A systematic review of literature assessing social and emotional wellbeing programs for Aboriginal and Torres Strait Islander Australians perspectives

Australian Aboriginal and Torres Strait Islander communities have been targets of social and emotional wellbeing programs for many years. However, the few health-care programs and services that are evaluated rarely provide insight into the participants' perspectives of program success or failure. This systematic review assessed 33 social and emotional wellbeing programs across Australia to better understand what Aboriginal community members think about the programs and how they could be improved. Results highlighted the interesting and valuable insights provided by Aboriginal participants, including what kinds of program activities and approaches are most suitable, what program characteristics are successful or desired, and their experiences of wellbeing change before and after program participation. They likewise voiced opinions about poorly received programs, culturally inappropriate services and negative experiences. This review highlighted how health and wellbeing programs must better engage Aboriginal and Torres Strait Islander clients to ensure that services are culturally safe, holistic, integrate appropriate staffing, include culturally relevant activities and value patient/participant experiences. These findings have significant implications for the health and wellbeing sector; specifically, research, policy, program design and implementation, evaluation methods, and self-determination.     

Implementation Matters: A Review of Research on the Influence of Implementation on Program Outcomes and the Factors Affecting Implementation

The first purpose of this review was to assess the impact of implementation on program outcomes, and the second purpose was to identify factors affecting the implementation process. Results from over quantitative 500 studies offered strong empirical support to the conclusion that the level of implementation affects the outcomes obtained in promotion and prevention programs. Findings from 81 additional reports indicate there are at least 23 contextual factors that influence implementation. The implementation process is affected by variables related to communities, providers and innovations, and aspects of the prevention delivery system (i.e., organizational functioning) and the prevention support system (i.e., training and technical assistance). The collection of implementation data is an essential feature of program evaluations, and more information is needed on which and how various factors influence implementation in different community settings.     

Fresh Start: A Multilevel Community Mobilization Plan to Promote Youth Development and Prevent Violence

While much has been written about community mobilization for health, few detailed expositions of the formation of community mobilization, especially focused on youth violence prevention exist. The Columbia Center for Youth Violence Prevention, in collaboration with the UNIDOS Inwood Coalition, developed a Community mobilization plan to guide youth violence prevention in Inwood. The plan was developed within the context of an evidence-based organizing framework-Communities that Care (CTC) and takes a multi-level approach to service coordination that includes activities at the Individual, Family, Block, Organizational and Built Environment levels. This article describes how the Community mobilization plan was created, illustrates the use of evidence-based practices to lead to the development of the plan, outlines the plan's community/organizational activities, and summarizes the principles and processes that can be replicated in other communities seeking to start their own community mobilization efforts to reduce youth violence.     

The Implementation of the Fast Track Program: An Example of a Large-Scale Prevention Science Efficacy Trial

In 1990, the Fast Track Project was initiated to evaluate the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders in four demographically diverse American communities (Conduct Problems Prevention Research Group [CPPRG], 1992). Representing a prevention science approach toward community-based preventive intervention, the Fast Track intervention design was based upon the available data base elucidating the epidemiology of risk for conduct disorder and suggesting key causal developmental influences (R. P. Weissberg & M. T. Greenberg, 1998). Critical questions about this approach to prevention center around the extent to which such a science-based program can be effective at (1) engaging community members and stakeholders, (2) maintaining intervention fidelity while responding appropriately to the local norms and needs of communities that vary widely in their demographic and cultural/ethnic composition, and (3) maintaining community engagement in the long-term to support effective and sustainable intervention dissemination. This paper discusses these issues, providing examples from the Fast Track project to illustrate the process of program implementation and the evidence available regarding the success of this science-based program at engaging communities in sustainable and effective ways as partners in prevention programming.     

When Research “Unravels”: One Community Psychologist's Tale of Becoming a Nepantlera

This is an autoethnography of one community psychologist's reflections on the abrupt conclusion of a project that resulted in the dismantlement of a Latinx Student Union at a public middle school in the Pacific Northwest. Gloria Anzaldúa's (Borderlands/La Frontera: The new mestiza, Aunt Lute Books, San Francisco, 2002) notion of nepantla is used to situate how an individual's personal identities often intersects with their professional identities in ways that collide within the research environment. Drawing on the “heart work” core competencies within the field of community psychology (The Community Psychologist, 45, 2012, 8; American Journal of Community Psychology, 55, 2015, 266) and extending the dialogue of feminist community psychologists engaged in narrative work (American Journal of Community Psychology, 37, 2006, 157; American Journal of Community Psychology, 37, 2006, 267; Feminist research practice: A primer, Sage, Los Angeles, 2014; American Journal of Community Psychology, 28, 2000, 883), the author addresses why it is important for researchers of Color engaged in community collaborations to reflect on projects that have unraveled to understand how their positionality shifts within social contexts.     

The Development and Evaluation of a Statewide Training Center for Home Visitors and Supervisors

This paper informs practice in community‐based home visiting workforce development by describing the development and evaluation of a university‐based training certificate program for home visitors and supervisors. The Interactive Systems Framework for Dissemination and Implementation (ISF; Wandersman et al., 2008) guides our conceptualization and paper organization. The ISF describes the components involved in translating research findings into effective implementation of prevention programs. We describe implementation and lessons learned from seven development activities: (a) review of the literature, (b) survey of other training initiatives across the country, (c) focus groups with home visitors and supervisors, (d) consultation with individual home visitors, (e) creation of a state advisory board of home visiting providers and stakeholders, (f) evaluation of two pilot trainings, and (g) video development. We then present evaluation data from 49 home visitors and 23 supervisors who completed the training certificate program after the pilot trainings. Both home visitors and supervisors rated training satisfaction highly, reported significant increases in self‐efficacy related to the training topics, and reported extensive use of motivational communication techniques, which are the foundational skills of the training content. These and other favorable results reflect the benefits of building on advances in theory and science‐based practice and of involving providers and stakeholders repeatedly throughout the development process.