Session: Cross-Country Transportability of Evidence-Based Preventive Programs for High-Risk Children and Youth: How Effective and Why? (Society for Prevention Research 21st Annual Meeting)

There is substantial evidence to show that high quality preventive programs, typically targeted at families or schools, can improve child and youth problem behavior and socio-emotional outcomes. This evidence, combined with rising global concern about youth problem behavior, has led many governments and NGOs around the world to consider implementing evidence-based programs in order to address these problems, and to improve youth outcomes. Doing this immediately raises vital questions: to what extent are effective interventions, and their evidence-base, transportable from one country to another? Is it appropriate, effective and cost-efficient to transport interventions found to be effective in their country of origin, to other countries where cultural context, resource levels, and service organisation may be very different? How much adaptation is needed, and to what extent does this depend on program and context? If transportation is poorly thought-out, is there the potential to waste resources or, at worst, cause harm?

This symposium addresses international transportability of evidence-based preventive programs from multiple perspectives and methods, including: Paper i) the novel use of systematic review and meta-analysis methods to explore key questions about transportability. Using the case of parenting programs for preventing conduct disorder, this study asks how effective are these interventions when transported from country to country, and explores country-level contextual factors, including cultural values and service context factors that may influence their effectiveness for improving youth outcomes. Paper ii) examines issues involved in adaptation of the Incredible Years Teacher program for young children in high-violence, impoverished communities, in a middle-income country. It reports new data from a cluster randomized trial, showing striking effects on teacher (as well as child) behavior, following a low intensity, potentially scalable teacher intervention. Paper iii) reviews the enormous variability in socio-emotional learning (SEL)-type policies and interventions across the globe, and analyzes the challenges such diversity creates in transporting school-based SEL intervention across countries.  These challenges are illustrated using the example of a large cluster randomized trial of school-based SEL policy and programming in three war-affected provinces of the Democratic Republic of Congo. This trial draw on prior work in other countries, and also carries implications for (bidirectional) ‘transportation’ of research and intervention knowledge between countries, considering how prevention trials in low income countries may benefit prevention research and policy in the US, as well as vice versa.