A National Evaluation of Community-Based Youth Cessation Programs: End of Program and Twelve-Month Outcomes

Most youth cessation treatment research consists of efficacy studies in which treatments are evaluated under optimal conditions of delivery. Less is known about the effectiveness of youth cessation treatments delivered in real-world, community based settings. A national sample of 41 community-based youth cessation programs participated in a longitudinal evaluation to identify site, program, and participant characteristics associated with successful cessation. Validated quit rates were comparable to those in randomized controlled trials; 7-day abstinence at the end of program averaged 14% and 30-day abstinence at 12 months averaged 12%. Multivariate GEE models explored predictors of smoking cessation at the end of the programs and at 12 months. Results showed correlates of both short- and long-term cessation. Findings point to the importance of both individual and community-level variables, including motivation, opportunities for and encouragement to engage in activities outside of academics, having youth participate in treatment before they become highly dependent smokers, and community norms and ordinances that discourage youth purchase, use and possession of tobacco. Providing evidence-based treatment to youth in community-based settings results in successful cessation.     

Enhancing young people's social competence and health behavior: An important challenge for educators, scientists, policymakers, and funders

Large numbers of America's young people engage in multiple high-risk behaviors that may jeopardize their health and social development. Given the gravity of this situation, many federal agencies and national organizations have called for the implementation of school-based K-12 social competence and health promotion programs. Unfortunately, there is a gap between the comprehensive programs that policymakers are asking educators to implement and the limited scope, duration, and intensity of state-of-the-art health promotion programs that scientists have developed and evaluated. As a result, most schools currently adopt well-marketed programs that lack documented effectiveness. Although current research indicates that brief, well-designed, theory-driven competence promotion and health education programs produce short-term benefits, there have been no controlled, longitudinal field studies to evaluate the long-term effects of K-12 efforts. This paper proposes that policymakers and funding agencies support long-term collaborations among educators and scientists to develop and evaluate K-12 comprehensive social competence and health education programs and identifies critical issues that funded projects should address.     

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.     

Sustained Implementation of Evidence‐based Programs in Disadvantaged Communities: A Conceptual Framework of Supporting Factors

This paper presents a review of the empirical literature for studies evaluating factors that facilitate and create barriers to sustained program implementation in disadvantaged communities. It outlines study methodology and sustainment outcomes and proposes a conceptual model that involves implementation sustainment support for providers delivering evidence‐based health and family services in disadvantaged communities. Sustained program implementation in the community setting is a significant issue as only 43% of studies reported successfully sustained programs. The review identified 18 factors that facilitate success and create barriers to program sustainment. The factors are synthesized into three themes; program characteristics, workplace capacity, and process and interaction factors. The majority of factors map onto commonly cited sustainability influences in implementation science. However, there was an additional focus for studies included in this review on the importance of factors such as program burden, program familiarity and perceived competence in program skills, workplace support for the program, staff mobility and turnover, supervision and peer support, and ongoing technical assistance. The need to use a conceptual framework and develop measures to guide and evaluate capacity building in EBP implementation and sustainment in low‐resource community settings is highlighted.     

Bridging Science to Practice: Achieving Prevention Program Implementation Fidelity in the Community Youth Development Study

This paper describes the development, application, and results of an implementation monitoring component of the Communities That Care (CTC) prevention framework used in the Community Youth Development Study (CYDS) to ensure high-fidelity prevention program implementation. This system was created based on research that community-based implementation of evidence-based prevention programs often includes adaptations in program design, content, or manner of delivery (Gottfredson and Gottfredson, Journal of research in crime and delinquency, 39, 3-35, 2002; Hallfors and Godette, Health Education Research, 17, 461-470, 2002; Wandersman and Florin, American Psychologist, 58, 441-448, 2003). A lack of fidelity to the implementation standards delineated by program designers is one indicator of a gap between prevention science and practice which can lessen the likelihood that communities will realize the positive participant effects demonstrated in research trials. By using the CTC model to select and monitor the quality of prevention activities, the 12 CYDS communities replicated 13 prevention programs with high rates of adherence to the programs' core components and in accordance with dosage requirements regarding the number, length, and frequency of sessions. This success indicates the potential of the CTC program implementation monitoring system to enhance community Prevention Delivery Systems (Wandersman et al. American Journal of Community Psychology, this issue) and improve the likelihood of desired participant changes.     

A Qualitative Systematic Review of Youth Participatory Action Research Implementation in U.S. High Schools

This qualitative systematic review examined the context-specific factors that influence the implementation of youth participatory action research (YPAR) projects in high schools within the United States. Thematic synthesis was conducted to identify and analyze the YPAR implementation factors that were present in 38 peer-reviewed studies. Results indicate the following two analytic themes concerning YPAR implementation in high schools: (a) pedagogical strategies and (b) stakeholder dynamics and needs. The themes provide support for existing ecological frameworks of implementation factors and demonstrate that adult researchers’ project-specific decisions are nested within educational power structures. This paper will discuss the implications of these YPAR implementation themes in executing YPAR projects in high schools.     

The Role of a State‐Level Prevention Support System in Promoting High‐Quality Implementation and Sustainability of Evidence‐Based Programs

Although numerous evidence‐based programs (EBPs) have been proven effective in research trials and are being widely promoted through federal, state, and philanthropic dollars, few have been “scaled up” in a manner likely to have a measurable impact on today's critical social problems. The Interactive Systems Framework for Dissemination and Implementation (ISF) explicates three systems that are critical in addressing the barriers that prevent these programs from having their intended public health impact. In this article we describe the relevance of these systems in a real‐world context with a specific focus on the Prevention Support System (PSS). We expand on the ISF model by presenting funders and policy‐makers as active and engaged stakeholders, and demonstrate how a state‐level PSS has used empirical evidence to inform general and program‐specific capacity‐building and support interactions among researchers, funders, and practitioners in Pennsylvania. By embracing this expanded ISF framework as a conceptual model for the wide‐scale dissemination and support of EBPs, and recognizing the need for a distinct state‐level PSS, Pennsylvania has created an infrastructure to effectively address the primary barriers to moving from lists of EBPs to achieving population‐level public health improvement. 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     

Physical activity to address multimorbidity among survivors of sexual violence: A comprehensive narrative review

BackgroundSexual Violence (SV) is highly prevalent and experienced by women and men throughout the United States and world. Survivors of SV often experience poor mental and physical health, and poor health-related quality of life. Studies have explored the associations between SV survivorship and maladaptive health behaviors, but few have examined SV and health promoting activities such as exercise.PurposeThe aim of this narrative review is to describe available peer-reviewed literature regarding SV and physical activity and provide recommendations for future research. Specifically, this review aimed to identify information relevant for promoting and designing exercise interventions that can integrate into clinical treatments for adult survivors of SV.MethodsA search of electronic databases identified 18 articles on SV and exercise behavior.ResultsFour of these studies were exercise interventions, 10 were observational studies, and 4 were qualitative interviews. Results broadly indicate that levels of physical activity among survivors of SV is unclear. Findings from trials indicate exercise may have a positive impact on mental health in survivors of SV. Qualitative interviews found survivors often enjoyed exercising and identified several health benefits, suggesting exercise interventions may be feasible and acceptable in this population. Interviews also identified valuable information about survivors' experiences with exercise.ConclusionsResearch in this area would benefit from: representative samples of adults among populations at high risk for victimization, more consistent and in-depth reporting of SV history and exercise levels, consistent and trauma-informed outcome measurements, and more diverse study designs and interventions. Increased exploration of exercise in this population is warranted given the well-established evidence base indicating the health promoting qualities of exercise for mental and physical health among trauma affected populations.     

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 Quality Implementation Framework: A Synthesis of Critical Steps in the Implementation Process

Implementation science is growing in importance among funders, researchers, and practitioners as an approach to bridging the gap between science and practice. We addressed three goals to contribute to the understanding of the complex and dynamic nature of implementation. Our first goal was to provide a conceptual overview of the process of implementation by synthesizing information from 25 implementation frameworks. The synthesis extends prior work by focusing on specific actions (i.e., the “how to”) that can be employed to foster high quality implementation. The synthesis identified 14 critical steps that were used to construct the Quality Implementation Framework (QIF). These steps comprise four QIF phases: Initial Considerations Regarding the Host Setting, Creating a Structure for Implementation, Ongoing Structure Once Implementation Begins, and Improving Future Applications. Our second goal was to summarize research support for each of the 14 QIF steps and to offer suggestions to direct future research efforts. Our third goal was to outline practical implications of our findings for improving future implementation efforts in the world of practice. The QIF's critical steps can serve as a useful blueprint for future research and practice. Applying the collective guidance synthesized by the QIF to the Interactive Systems Framework for Dissemination and Implementation (ISF) emphasizes that accountability for quality implementation does not rest with the practitioner Delivery System alone. Instead, all three ISF systems are mutually accountable for quality implementation. 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     

Bridging the Gap Between Prevention Research and Practice: The Interactive Systems Framework for Dissemination and Implementation

If we keep on doing what we have been doing, we are going to keep on getting what we have been getting. Concerns about the gap between science and practice are longstanding. There is a need for new approaches to supplement the existing approaches of research to practice models and the evolving community-centered models for bridging this gap. In this article, we present the Interactive Systems Framework for Dissemination and Implementation (ISF) that uses aspects of research to practice models and of community-centered models. The framework presents three systems: the Prevention Synthesis and Translation System (which distills information about innovations and translates it into user-friendly formats); the Prevention Support System (which provides training, technical assistance or other support to users in the field); and the Prevention Delivery System (which implements innovations in the world of practice). The framework is intended to be used by different types of stakeholders (e.g., funders, practitioners, researchers) who can use it to see prevention not only through the lens of their own needs and perspectives, but also as a way to better understand the needs of other stakeholders and systems. It provides a heuristic for understanding the needs, barriers, and resources of the different systems, as well as a structure for summarizing existing research and for illuminating priority areas for new research and action. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.     

Researchers, Practitioners, and Funders: Using the Framework to Get Us on the Same Page

The worlds of prevention research and practice are largely disconnected. The growing body of scientific knowledge regarding effects of prevention programs is not often disseminated and translated in a manner that leads to wide scale changes in practice. The Centers for Disease Control and Prevention, in collaboration with a team of academic researchers, has developed the Interactive Systems Framework for Dissemination and Implementation to help us understand the roles and interactions of those associated with developing knowledge, those associated with using the knowledge in practice settings, and those acting in the roles of bridge, support, and broker between the research and practice communities. This special issue on the Framework presents a variety of theoretical, practical and empirical issues related to this framework and its subsystems. This compilation of articles discuss the capacity of the Framework’s subsystems, provide examples of the generally under-developed prevention support system, describe the additional challenges involved in disseminating a change in culture, discuss the delicate balance and interaction of fidelity and adaptation, present a meta-analysis of the relationships between program implementation and program outcomes, and include examples of how the Framework has been used to guide action. The present commentary on this special issue provides a critical examination of the contributions, implications, and challenges raised by each of these articles. It also includes a discussion of how the Framework relates to the basic values and practice of community psychology and concludes with some suggested future directions and challenges for the continued development and use of the Framework.     

Kleptomania: A Review of the Research

Research on kleptomania is limited. Earlier views and recent reports of treatment are reviewed in this article. More study is needed to delineate this impulse-control disorder.     

The 1-2-3 Magic Program: Implementation Outcomes of an Australian Pilot Evaluation With School-Aged Children

No abstract available for this article.     

More than Data Collectors: A Systematic Review of the Environmental Outcomes of Youth Inquiry Approaches in the United States

Over the last twenty years, research on the impact of engaging children and adolescents in the generation of new knowledge about their lives, schools, and communities, has grown tremendously. This systematic review summarizes the findings from empirical studies of youth inquiry approaches in the United States, with a focus on their environmental outcomes. Searches of four interdisciplinary databases retrieved a total of 3,724 relevant articles published between 1995 and 2015. Sixty‐three distinct studies met the systematic review inclusion criteria, of which, 36 (57.1%) reported that the youth inquiry approach contributed to positive changes among adults, peers, organizations, and/or institutions. These environmental outcomes were qualitatively recorded, inductively categorized, and then organized into Bronfenbrenner's ecological framework. Youth inquiry approaches led to practitioner growth and changes in peer group norms at the micro‐system level, program development or improvement and research benefits at the meso‐system level, and school, city, and state level policy adoption at the exo‐system level. Qualitative methods, especially case studies, were most commonly used to evaluate the impact of youth inquiry approaches on environmental outcomes. Studies of approaches that utilized advocacy to create change, targeted decision‐makers as the audience for the youth's work and convened for a longer duration were more likely to report improved environmental outcomes. This systematic review suggests that youth inquiry approaches are a promising strategy for ecological systems change.     

Inside the Black Box: Assessing and Improving Quality in Youth Programs

Over the past decade, structured programming for children and youth during the non-school hours has expanded exponentially. A confluence of recent research studies and program evaluations backs the publicly perceived notion that after-school programs can positively influence important developmental and learning outcomes. The rapid expansion of the field and the potential of programs to contribute to child and youth development have made defining what high quality programs look like and learning how to improve program quality key challenges facing the field. This paper describes what is known about the relation between youth program quality and youth developmental outcomes, summarizes different quality assessment tools being used in the field, and discusses how such tools are being used to drive systemic quality improvement efforts.