Can evidence-based prevention programs be sustained in community practice settings? The Early Risers' advanced-stage effectiveness trial
Can evidence-based prevention programs be sustained in community practice settings? The Early Risers' advanced-stage effectiveness trial
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DOI：
10.1007/s11121-005-0024-z
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发表时间：
2006-06-01
影响因子：
3.5
通讯作者：
Hektner, Joel M.
中科院分区：
文献类型：
--
作者：
August, Gerald J.;Bloomquist, Michael L.;Hektner, Joel M.
本研究旨在评估早期崛起者“成功技能”行为问题预防计划的制度可持续性。在之前的早期有效性试验中，早起者已经由一个非营利社区机构在项目开发人员提供的指导、监督、技术援助和财政支持/监督下成功实施。目前的高级有效性试验采用随机对照组设计，以确定该社区机构是否可以用新的参与者队列复制早期的积极发现，但程序开发人员的直接参与较少。一个意图干预策略被用来比较儿童随机分配到早起或无干预比较组。与早期有效性试验中获得的结果相比，项目出勤率要低得多，并且只复制了一个积极的结果。未能复制计划的影响，并不归因于不良的计划实施，因为收集的数据有关的曝光，坚持和交付质量是可以接受的，参与分析表明，家庭谁参加了较高的水平确实受益。社区机构在使家庭按照建议的水平参与方案组成部分方面遇到的困难主要是导致结果的原因。阻碍可持续性的可能组织障碍包括不可靠的运输、机构与当地公立学校系统之间的合作不良、工作人员更替率高、机构缩编以及信托责任和问责制。得出的结论是，方案开发者和方案提供者都需要积极主动地规划可持续性。
This study evaluated institutional sustainability of the Early Risers "Skills for Success" conduct problems prevention program. In a previous early-stage effectiveness trial Early Risers had been successfully implemented by a nonprofit community agency with guidance, supervision, technical assistance and fiscal support/oversight provided by program developers. The current advanced-stage effectiveness trial applied a randomized, control group design to determine whether this community agency could replicate earlier positive findings with a new cohort of participants, but with less direct involvement of program developers. An intent-to-intervene strategy was used to compare children randomly assigned to Early Risers or a no-intervention comparison group. Compared to results obtained in an early-stage effectiveness trial, program attendance rates were much lower and only one positive outcome was replicated. Failure to replicate program effects was not attributed to poor program implementation, because data collected pertaining to exposure, adherence and quality of delivery were acceptable, and a participation analysis showed that families who attended at higher levels did benefit. It was difficulties that the community agency experienced in engaging families in program components at recommended levels that primarily accounted for the results. Possible organizational barriers that impeded sustainability included unreliable transportation, poor collaboration between the agency and the local public school system, high staff turnover, agency downsizing, and fiduciary responsibility and accountability. It was concluded that both program developers and program providers need to be proactive in planning for sustainability.