Session: From University-Based RCT to Community Implementation: Disseminating an Evidence-Based Program for Young Children Who Have Experienced Adversity (Society for Prevention Research 23rd Annual Meeting)

Early intervention has the potential to enhance social, emotional, and health outcomes among high-risk children. However, moving from the stage of developing and testing effective interventions in randomized clinical trials to effective dissemination remains a significant challenge for the field. Indeed, the power of carefully designed programs is often not realized in the community because of inadequate fidelity to the model and failure to adapt to cultural or local needs, among other factors. This symposium will focus upon steps taken toward dissemination of an evidence-based intervention for high-risk children and their families. 

Attachment and Biobehavioral Catch-up is a 10-session parenting program developed for high-risk young children and their parents. The intervention was originally developed for foster parents of infants, but has since been adapted for high-risk birth parents of infants and toddlers, and parents adopting internationally. The intervention has been tested in several randomized clinical trials and has been shown effective in increasing parental sensitivity, and in enhancing child attachment security, executive functioning, and regulation of emotions and physiology (e.g., Bernard et al., 2012; Bernard et al., 2014).

In moving the intervention to the community, it was critical to develop a fidelity measure that truly captured the most important aspects of the program. Meade and Dozier (2013) developed a quantifiable measure of the clinician’s comments regarding parental behavior that has proven powerful in monitoring fidelity as well as in training and supervising clinicians. The first paper will highlight three studies that illustrate this fidelity assessment instrument. Next, when implementing the intervention in the community, support and buy-in from local agencies are key. The second paper will describe implementation of the program within the context of a learning collaborative, presenting evidence from multiple contexts. Finally, to adapt to different family conditions and needs, it was necessary to adapt the intervention. The third paper will describe adaptations to the program for toddlers and for children adopted internationally, and evidence of the intervention’s efficacy with these new populations.