The Process of Scaling-up a Prevention System to Ensure High Quality Program Implementation At the Community-Level

Significant advances have shown that prevention programs can significantly improve social, emotional, and behavioral outcomes of their recipients.  High quality implementation of these programs is a critical factor in this process.  Yet, consistently achieving high quality implementation continues to be challenging in real-world conditions.  This presentation addresses this challenge of scaling-up prevention systems.  First, this presentation will summarize the implementation quality findings within PROSPER, including the lessons learned about supporting high quality implementation of evidence-based programs (EBP).  Secondly, this presentation will describe how these lessons have been considered in scaling-up PROSPER.

Ten years of data have been collected from a variety of sources at multiple time points to better understand factors related to quality implementation of EBPs in “real-world” settings.  Technical assistance providers (PCs) rated the quality of team processes, recorded team requests for technical assistance (TA), and rated the quality of the team-PC relationship.  Team Members also rated their teams’ functioning annually.  Direct observations of implementation quality for all family-focused and school-based EBPs were conducted.  Additionally, the recruitment, attendance, and graduation of families attending the Strengthening Families Program: For Parents and Youth 10-14, were recorded.

 Observer ratings of implementation quality demonstrated sustained high quality implementation across several years.  Specifically, on average, almost 90% of core curriculum material was consistently delivered.   Additionally, ratings of facilitator quality were consistently high (M = 3.77 on a 4-pt scale).  Rates of recruitment, attendance, and graduation in SFP: 10-14 were also strong and sustained across multiple years.  Ratings of participant engagement in both the family-focused and school-based programs were strong (M = 3.51 on a 4-pt scale).  There were few team and TA factors that consistently predicted these strong outcomes over time.

 It seems that the PROSPER model, which contains large group and small group professional development experiences, as well as a dedicated and consistent TA provider assigned to each community team, was the key in supporting high quality implementation.  Several steps have been taken to support continued high quality implementation in PROSPER expansion states.  For example, model trainings continue to emphasize the importance of implementation quality.  Each state is assigned a State Coach and Network Evaluator, who have regular contacts with state leads.  Close coordination with program developers has been imperative.  The presentation will conclude with discussion of these and additional factors.