Going to Scale with Evidence-based Interventions: The Next Frontier for Prevention Science


Dean Richard Barth co-authored new research "Going to scale with evidence-based interventions: The next frontier for prevention science" that was presented earlier this month at the 11th Annual Conference on the Science of Dissemination and Implementation of Health held in Washington, DC. [Download the presentation]

Background:

The prevalence of many behavioral health and related problems have increased over the last decade, even in the face of a growing knowledge and evidence base. Many different programs, policies, and practices have been shown to prevent such problems, but there are very few evidence-based interventions (EBIs) that have been implemented at the scale needed to impact population health. Scaling-up EBIs is a major goal of the Society for Prevention Research (SPR) and therefore, in 2017, they formed the Mapping Advances in Prevention Science (MAPS) IV Task Force, which was charged with identifying the barriers to and facilitators of EBI scale-up. The Task Force focused this work on 5 public systems (education, child welfare, juvenile justice, public health, and behavioral health) because a) they are the interface between EBIs and those that need them, and b) because scale-up efforts will inevitably occur within, not across, systems.

Methods:

The Task Force’s assessment was conducted in two steps. First, they created system-specific work groups comprised of research scientists working with practitioners and policy makers in these systems. Each group used the scientific literature and the members’ tacit knowledge and experiences to document system-specific barriers and facilitators of EBI scale-up, and make recommendations to increase EBI scale-up in that system. Second, the Task Force reviewed each work groups’ conclusions and identified where there were unique and common themes.

Findings:

In all, the Task Force identified seven types of barriers to/facilitators of EBI scale-up in public systems. They include: 1) statutory endorsement and funding, 2) community involvement and capacity, 3) data monitoring and evaluation capacity, 4) workforce development, 5) EBI knowledge, 6) public system leadership support, and 7) EBI developer and funder capacity.

Implications for D&I Research:

The information compiled by the Task Force informed the development of an Ecological Model for EBI Scale-up in Public Systems, which can be used by practitioners to begin breaking down the barriers and creating more opportunities for EBI scale-up at a systems level, and by D&I researchers who aim to systematically study the scale-up process.

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