Session: Scaling up Systems for Community-Based Prevention: Factors, Findings and Lessons On Adoption and Sustainable Implementation (Society for Prevention Research 21st Annual Meeting)

This symposium will address two longstanding programs of research directed toward designing, developing, implementing, and testing scalable delivery systems for evidence-based interventions (EBIs). Initially, focus will be on a sustainable community-university partnership model called PROSPER, one that creates linkages between two existing delivery systems that reach every community in the country–the Land Grant University Cooperative Extension System and public school systems. This will set the stage for considering a complementary type of delivery system that creates its own unique infrastructure, called Communities That Care (CTC), referencing findings about key community implementation operations from scale-up implementations in PA.

For introductory purposes, a description of the theoretical underpinnings and organizational structure of the PROSPER Partnership-based Model will be provided. This will be followed by a summary of findings concerning both PROSPER’s long-term positive outcomes and illustrative evidence of its readiness for going to scale, including results on sustained EBI implementation quality and sustainable community-based implementation teams. This introduction will conclude with a brief overview of three interrelated papers, all of which will summarize empirical findings and then discuss issues and challenges in going to scale.

The first paper will address how the PROSPER projects have taught us lessons about both promoting the adoption of the Model and capacity building for Model implementation in other state Extension systems. Findings from web-based surveys and interviews with participating state representatives will be summarized; challenges concerning the diversity of targeted populations, settings and systems, along with shrinking budgets, will be addressed. A second paper will begin with a synopsis of several sets of findings on sustained implementation quality of the EBIs on the PROSPER menu. It will summarize lessons learned and how those lessons guided adaptive actions concerning issues like supporting efforts to engage prospective participants and the need for optimizing continuous quality improvement through ongoing training and adaptation of TA processes. The third paper will provide a comparison of the PROSPER community-based delivery operations and those of CTC; it will summarize findings from longitudinal data on both systems in the same state setting, focusing on factors associated with a sustained quality of community team functioning. It will address lessons learned about team leadership, membership turnover, TA factors, and community relations in adapting to changing circumstances, in order to sustain community teams’ efforts.