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Putting the Pieces Together: An Integrated Model of Program Implementation

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Abstract

Considerable evidence indicates that variability in implementation of prevention programs is related to the outcomes achieved by these programs. However, while implementation has been conceptualized as a multidimensional construct, few studies examine more than a single dimension, and no theoretical framework exists to guide research on the effects of implementation. We seek to address this need by proposing a theoretical model of the relations between the dimensions of implementation and outcomes of prevention programs that can serve to guide future implementation research. In this article, we focus on four dimensions of implementation, which we conceptualize as behaviors of program facilitators (fidelity, quality of delivery, and adaptation) and behaviors of participants (responsiveness) and present the evidence supporting these as predictors of program outcomes. We then propose a theoretical model by which facilitator and participant dimensions of implementation influence participant outcomes. Finally, we provide recommendations and directions for future implementation research.

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Notes

  1. We distinguish between the concepts of attendance and dosage. Although attendance is sometimes described as “dosage” in the implementation literature (e.g., Charlebois et al. 2004a; Spoth and Redmond 2002), this confounds a participant behavior with an element of program design. We suggest that dosage should refer to the number of sessions offered, and is thus under the purview of program designers and administrators, while attendance should be used to describe number of sessions participants attend.

References

  • Backer, T. E. (2002). Finding the balance: Program fidelity and adaptation in substance abuse prevention. Rockville, MD: Center for Substance Abuse Prevention.

    Google Scholar 

  • Baydar, N., Reid, M. J., & Webster-Stratton, C. (2003). The role of mental health factors and program engagement in the effectiveness of a preventive parenting program for Head Start mothers. Child Development, 74, 1433–1453.

    Article  PubMed  Google Scholar 

  • Berkel, C., Hagan, M., Jones, S., Ayers, T. S., Wolchik, S. A., & Sandler, I. N. (2009, November). Longitudinal examination of facilitator implementation: A case study across multiple cohorts of delivery. Paper presented at the annual meeting of the American Evaluation Association, Orlando, FL.

  • Blake, S. M., Simkin, L., Ledsky, R., Perkins, C., & Calabrese, J. M. (2001). Effects of a parent-child communications intervention on young adolescents’ risk for early onset of sexual intercourse. Family Planning Perspectives, 33, 52–61.

    Article  CAS  PubMed  Google Scholar 

  • Blakely, C. H., Mayer, J. P., Gottschalk, R. G., Schmitt, N., Davidson, W. S., Roitman, D. B., et al. (1987). The fidelity-adaptation debate: Implications for the implementation of public sector social programs. American Journal of Community Psychology, 15, 253–268.

    Article  Google Scholar 

  • Boruch, R. F., & Gomez, H. (1977). Sensitivity, bias and theory in impact evaluations. Professional Psychology, 8, 411–434.

    Article  Google Scholar 

  • Botvin, G. J. (2004). Advancing prevention science and practice: Challenges, critical issues, and future directions. Prevention Science, 5, 69–72.

    Article  PubMed  Google Scholar 

  • Botvin, G. J., Dusenbury, L., Baker, E., James-Ortiz, S., & Kerner, J. F. (1989). A skills training approach to smoking prevention among Hispanic youth. Journal of Behavioral Medicine, 12, 279–296.

    Article  CAS  PubMed  Google Scholar 

  • Brach, C., & Fraser, I. (2000). Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research & Review, 57, 181–217.

    Google Scholar 

  • Bush, P. J., Zuckerman, A. E., Taggart, V. S., Theiss, P. K., Peleg, E. O., & Smith, S. A. (1989). Cardiovascular risk factor prevention in Black school children: The “Know Your Body” evaluation project. Health Education Quarterly, 16, 215–227.

    CAS  PubMed  Google Scholar 

  • Castro, F. G., Barrera, M., & Martinez, C. R. (2004). The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit. Prevention Science, 5, 41–45.

    Article  PubMed  Google Scholar 

  • Charlebois, P., Brendgen, M., Vitaro, F., Normandeau, S., & Boudreau, J.-F. (2004). Examining dosage effects on prevention outcomes: Results from a multi-modal longitudinal preventive intervention for young disruptive boys. Journal of School Psychology, 42, 201–220.

    Article  Google Scholar 

  • Charlebois, P., Vitaro, F., Normandeau, S., Brendgen, M., & Rondeau, N. (2004). Trainers’ behavior and participants’ persistence in a longitudinal preventive intervention for disruptive boys. Journal of Primary Prevention, 25, 375–388.

    Article  Google Scholar 

  • Coatsworth, J. D., Duncan, L. G., Pantin, H., & Szapocznik, J. (2006a). Patterns of retention in a preventive intervention with ethnic minority families. Journal of Primary Prevention, 27, 171–193.

    Article  PubMed  Google Scholar 

  • Coatsworth, J. D., Duncan, L. G., Pantin, H., & Szapocznik, J. (2006b). Retaining ethnic minority parents in a preventive intervention: The quality of group process. Journal of Primary Prevention, 27, 367–389.

    Article  PubMed  Google Scholar 

  • Conduct Problems Prevention Research Group. (1999). Initial impact of the Fast Track prevention trial for conduct problems: II. Classroom effects. Journal of Consulting & Clinical Psychology, 67, 648–657.

    Article  Google Scholar 

  • Cross, T. L., Bazron, B. J., Dennis, K. W., & Isaacs, M. R. (1989). Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed: Volume I. Washington, DC: National Technical Assistance Center for Children’s Mental Health, Georgetown University Child Development Center.

  • Cross, W., West, J., Wyman, P. A., & Schmeelk-Cone, K. H. (2009). Disaggregating and measuring implementor adherence and competence. Paper presented at the 2nd Annual NIH Conference on the Science of Dissemination and Implementation, Bethesda, MD.

  • Dane, A. V., & Schneider, B. H. (1998). Program integrity in primary and early secondary prevention: Are implementation effects out of control? Clinical Psychology Review, 18, 23–45.

    Article  CAS  PubMed  Google Scholar 

  • Diamond, G. M., Liddle, H. A., Hogue, A., & Dakof, G. A. (1999). Alliance-building interventions with adolescents in family therapy: A process study. Psychotherapy: Theory, Research, Practice, Training, 36, 355–368.

    Article  Google Scholar 

  • Dillman Carpentier, F., Mauricio, A. M., Gonzales, N. A., Millsap, R. E., Meza, C. M., Dumka, L. E., et al. (2007). Engaging Mexican origin families in a school-based preventive intervention. Journal of Primary Prevention, 28, 521–546.

    Article  PubMed  Google Scholar 

  • Durlak, J. (1998). Why program implementation is important. Journal of Prevention & Intervention in the Community, 17, 5–18.

    Article  Google Scholar 

  • Durlak, J., & DuPre, E. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41, 327–350.

    Article  PubMed  Google Scholar 

  • Dusenbury, L. A., Brannigan, R., Falco, M., & Hansen, W. B. (2003). A review of research on fidelity of implementation: Implications for drug abuse prevention in school settings. Health Education Research, 18, 237–256.

    Article  PubMed  Google Scholar 

  • Dusenbury, L. A., Brannigan, R., Hansen, W. B., Walsh, J., & Falco, M. (2005). Quality of implementation: Developing measures crucial to understanding the diffusion of preventive interventions. Health Education Research, 20, 308–313.

    Article  PubMed  Google Scholar 

  • Eames, C., Daley, D., Hutchings, J., Whitaker, C. J., Jones, K., Hughes, J. C., et al. (2009). Treatment fidelity as a predictor of behaviour change in parents attending group-based parent training. Child Care, Health & Development, 35, 603–612.

    Article  CAS  Google Scholar 

  • Eddy, J. M., Dishion, T. J., & Stoolmiller, M. (1998). The analysis of intervention change in children and families: Methodological and conceptual issues embedded in intervention studies. Journal of Abnormal Child Psychology, 26, 53–69.

    Article  CAS  PubMed  Google Scholar 

  • Elliott, D. S., & Mihalic, S. (2004). Issues in disseminating and replicating effective prevention programs. Prevention Science, 5, 47–52.

    Article  PubMed  Google Scholar 

  • Emshoff, J., Blakely, C., Gray, D., Jakes, S., Brounstein, P., Coulter, J., et al. (2003). An ESID case study at the federal level. American Journal of Community Psychology, 32, 345–357.

    Article  PubMed  Google Scholar 

  • Fagan, A. A., Hanson, K., Hawkins, J. D., & Arthur, M. W. (2008). Bridging science to practice: Achieving prevention program implementation fidelity in the Community Youth Development study. American Journal of Community Psychology, 41, 235–249.

    Article  PubMed  Google Scholar 

  • Forgatch, M. S., Patterson, G. R., & DeGarmo, D. S. (2005). Evaluating fidelity: Predictive validity for a measure of competent adherence to the Oregon model of parent management training. Behavior Therapy, 36, 3–13.

    Article  PubMed  Google Scholar 

  • Garvey, C., Julion, W., Fogg, L., Kratovil, A., & Gross, D. (2006). Measuring participation in a prevention trial with parents of young children. Research in Nursing & Health, 29, 212–222.

    Article  Google Scholar 

  • Giles, S., Jackson-Newsom, J., Pankratz, M., Hansen, W., Ringwalt, C., & Dusenbury, L. (2008). Measuring quality of delivery in a substance use prevention program. Journal of Primary Prevention, 29, 489–501.

    Article  PubMed  Google Scholar 

  • Gingiss, P., Roberts-Gray, C., & Boerm, M. (2006). Bridge-It: A system for predicting implementation fidelity for school-based tobacco prevention programs. Prevention Science, 7, 197–207.

    Article  PubMed  Google Scholar 

  • Gonzales, N. A., Wolchik, S. A., Sandler, I. N., Winslow, E. B., Martinez, C. R., & Cooley, M. (2006, June). Quality management methods to adapt interventions for cultural diversity. Paper presented at the annual meeting of the Society for Prevention Research, San Antonio, TX.

  • Haggerty, K. P., Fleming, C. B., Lonczak, H. S., Oxford, M. L., Harachi, T. W., & Catalano, R. F. (2002). Predictors of participation in parenting workshops. Journal of Primary Prevention, 22, 375–387.

    Article  Google Scholar 

  • Hansen, W. B., Graham, J. W., Wolkenstein, B. H., & Rohrbach, L. A. (1991). Program integrity as a moderator of prevention program effectiveness: Results for fifth-grade students in the Adolescent Alcohol Prevention Trial. Journal of Studies on Alcohol, 52, 568–579.

    CAS  PubMed  Google Scholar 

  • Hubble, M. A., Duncan, B. L., & Miller, S. D. (1999). The heart and soul of change: What works in therapy. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Ialongo, N. S., Werthamer, L., Kellam, S. G., Brown, C. H., Wang, S., & Lin, Y. (1999). Proximal impact of two first-grade preventive interventions on the early risk behaviors for later substance abuse, depression, and antisocial behavior. American Journal of Community Psychology, 27, 599–641.

    Article  CAS  PubMed  Google Scholar 

  • Kam, C.-M., Greenberg, M. T., & Walls, C. T. (2003). Examining the role of implementation quality in school-based prevention using the PATHS curriculum. Prevention Science, 4, 55–63.

    Article  PubMed  Google Scholar 

  • Kerr, D. M., Kent, L., & Lam, T. C. (1985). Measuring program implementation with a classroom observation instrument: The Interactive Teaching Map. Evaluation Review, 9, 461–482.

    Article  Google Scholar 

  • Kosterman, R., Hawkins, J. D., Haggerty, K. P., Spoth, R., & Redmond, C. (2001). Preparing for the Drug Free Years: Session-specific effects of a universal parent-training intervention with rural families. Journal of Drug Education, 31, 47–68.

    Article  CAS  PubMed  Google Scholar 

  • Kumpfer, K. L., Alvarado, R., Smith, P., & Bellamy, N. (2002). Cultural sensitivity and adaptation in family-based prevention interventions. Prevention Science, 3, 241–246.

    Article  PubMed  Google Scholar 

  • Lillehoj, C. J., Griffin, K. W., & Spoth, R. (2004). Program provider and observer ratings of school-based preventive intervention implementation: Agreement and relation to youth outcomes. Health Education & Behavior, 31, 242–257.

    Article  Google Scholar 

  • Lochman, J. E., Boxmeyer, C., Powell, N., Qu, L., Wells, K., & Windle, M. (2009). Dissemination of the Coping Power program: Importance of intensity of counselor training. Journal of Consulting & Clinical Psychology, 77, 397–409.

    Article  Google Scholar 

  • McGraw, S. A., Sellers, D. E., Stone, E. J., Bebchuk, J., Edmundson, E. W., Johnson, C. C., et al. (1996). Using process data to explain outcomes: An illustration from the Child and Adolescent Trial for Cardiovascular Health (CATCH). Evaluation Review, 20, 291–312.

    Article  CAS  PubMed  Google Scholar 

  • NRC/IOM. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: National Research Council and Institute of Medicine.

    Google Scholar 

  • Nye, C. L., Zucker, R. A., & Fitzgerald, H. E. (1995). Early intervention in the path to alcohol problems through conduct problems: Treatment involvement and child behavior change. Journal of Consulting & Clinical Psychology, 63, 831–840.

    Article  CAS  Google Scholar 

  • Palinkas, L. A., Aarons, G. A., Chorpita, B. F., Hoagwood, K., Landsverk, J., & Weisz, J. R. (2009). Cultural exchange and the implementation of evidence-based practices: Two case studies. Research on Social Work Practice, 19, 602–612.

    Article  Google Scholar 

  • Parcel, G. S., Ross, J. G., Lavin, A. T., Portnoy, B., Nelson, G. D., & Winters, F. (1991). Enhancing implementation of the Teenage Health Teaching Modules. Journal of School Health, 61, 35–38.

    Article  CAS  PubMed  Google Scholar 

  • Patterson, G. R., & Forgatch, M. S. (1985). Therapist behavior as a determinant for client noncompliance: A paradox for the behavior modifier. Journal of Consulting & Clinical Psychology, 53, 846–851.

    Article  CAS  Google Scholar 

  • Pentz, M. A., Trebow, E. A., Hansen, W. B., MacKinnon, D. P., Dwyer, J. H., Johnson, C. A., et al. (1990). Effects of program implementation on adolescent drug use behavior: The Midwestern Prevention Project (MPP). Evaluation Review, 14, 264–289.

    Article  Google Scholar 

  • Prado, G., Pantin, H., Schwartz, S. J., Lupei, N. S., & Szapocznik, J. (2006). Predictors of engagement and retention into a parent-centered, ecodevelopmental HIV preventive intervention for Hispanic adolescents and their families. Journal of Pediatric Psychology, 31, 874–890.

    Article  PubMed  Google Scholar 

  • Resnicow, K., Davis, M., Smith, M., Lazarus-Yaroch, A., Baranowski, T., Baranowski, J., et al. (1998). How best to measure implementation of school health curricula: A comparison of three measures. Health Education Research, 13, 239–250.

    Article  CAS  PubMed  Google Scholar 

  • Ringwalt, C. L., Vincus, A., Ennett, S., Johnson, R., & Rohrbach, L. A. (2004). Reasons for teachers’ adaptation of substance use prevention curricula in schools with non-White student populations. Prevention Science, 5, 61–67.

    Article  PubMed  Google Scholar 

  • Ringwalt, C. L., Pankratz, M., Jackson-Newsom, J., Gottfredson, N., Hansen, W. B., Giles, S. et al. (2010). Three-year trajectory of teachers’ fidelity to a drug prevention curriculum. Prevention Science, 11, 67–76.

    Google Scholar 

  • Rogers, E. M. (1995). Diffusion of drug abuse prevention programs: Spontaneous diffusion, agenda setting, and reinvention. Bethesda, MD: NIDA Research Monograph.

    Google Scholar 

  • Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: The Free Press.

    Google Scholar 

  • Rohrbach, L. A., Gunning, M., Sun, P., & Sussman, S. (2010). The Project Towards No Drug Abuse (TND) dissemination trial: Implementation fidelity and immediate outcomes. Prevention Science, 11, 77–88.

    Article  PubMed  Google Scholar 

  • Shelef, K., Diamond, G. M., Diamond, G. S., & Liddle, H. A. (2005). Adolescent and parent alliance and treatment outcome in Multidimensional Family Therapy. Journal of Consulting & Clinical Psychology, 73, 689–698.

    Article  Google Scholar 

  • Slavin, R. E. (1990). Comprehensive cooperative learning models: Embedding cooperative learning in the curriculum and school. In S. Sharan (Ed.), Cooperative learning: Theory and research (pp. 261–283). New York: Praeger.

    Google Scholar 

  • Spoth, R. L., & Redmond, C. (2002). Project Family prevention trials based in community-university partnerships: Toward scaled-up preventive interventions. Prevention Science, 3, 203–221.

    Article  PubMed  Google Scholar 

  • Spoth, R., Guyll, M., Trudeau, L., & Goldberg-Lillehoj, C. (2002). Two studies of proximal outcomes and implementation quality of universal preventive interventions in a community-university collaboration context. Journal of Community Psychology, 30, 499–518.

    Article  Google Scholar 

  • Stanton, B., Harris, C., Cottrell, L., Li, X., Gibson, C., Guo, J., et al. (2006). Trial of an urban adolescent sexual risk-reduction intervention for rural youth: A promising but imperfect fit. Journal of Adolescent Health, 38, 25–36.

    Article  Google Scholar 

  • Tobler, N. S., & Stratton, H. H. (1997). Effectiveness of school-based drug prevention programs: A meta-analysis of the research. Journal of Primary Prevention, 18, 71–128.

    Article  Google Scholar 

  • Tolan, P. H., Hanish, L. D., McKay, M. M., & Dickey, M. H. (2002). Evaluating process in child and family interventions: Aggression prevention as an example. Journal of Family Psychology, 16, 220–236.

    Article  PubMed  Google Scholar 

  • Widaman, K. F., & Kagan, S. (1987). Cooperativeness and achievement: Interaction of student cooperativeness with cooperative versus competitive classroom organization. Journal of School Psychology, 25, 355–365.

    Article  Google Scholar 

  • Wilson, B. D. M., & Miller, R. L. (2003). Examining strategies for culturally grounded HIV prevention: A review. AIDS Education & Prevention, 15, 184–202.

    Article  Google Scholar 

  • Wilson, S. J., & Lipsey, M. W. (2007). School-based interventions for aggressive and disruptive behavior: Update of a meta-analysis. American Journal of Preventive Medicine, 33, S130–S143.

    Article  PubMed  Google Scholar 

  • Wolchik, S. A., Sandler, I. N., Jones, S., Gonzales, N., Doyle, K., Winslow, E., et al. (2009). The New Beginnings Program for divorcing and separating families: Moving from efficacy to effectiveness. Family Court Review, 47, 416–435.

    Article  PubMed  Google Scholar 

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Acknowledgements

Cady Berkel and Erin Schoenfelder’s involvement in the preparation of this manuscript were supported by Training Grant T32MH18387.

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  1. Prevention Research Center, Arizona State University, Phoenix, AZ, USA

    Cady Berkel, Anne M. Mauricio, Erin Schoenfelder & Irwin N. Sandler

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  1. Cady Berkel
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  2. Anne M. Mauricio
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  4. Irwin N. Sandler
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Correspondence to Cady Berkel.

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Berkel and Mauricio contributed equally to the development of this manuscript.

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Berkel, C., Mauricio, A.M., Schoenfelder, E. et al. Putting the Pieces Together: An Integrated Model of Program Implementation. Prev Sci 12, 23–33 (2011). https://doi.org/10.1007/s11121-010-0186-1

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