Measure Twice, Cut Once

Choosing an Evidence-Based Program (EBP) to prevent substance use and promote the development of a resilient student body in your school community is an exciting enterprise.  A successful implementation requires organization, planning, and commitment from all stakeholders within the community and the implementation sites.  To guide you in facilitating a seamless implementation and achieving positive pro-social outcomes in your student body, we developed the Too Good Implementation Center in partnership with the University of South Florida's Institute for Translational Research Education in Adolescent Drug Abuse (ITRE). The Too Good Implementation Center is a comprehensive guide to the five phases of effective program implementation.  Each phase in the Implementation Center illustrates the implementation processes, goals, and best practices to achieve to maximize student outcomes in your prevention strategy. To assist you in planning and executing a high-fidelity implementation, we’ve developed a five-part blog series. This week, we’ll dive into the Exploration Phase and provide guidance on where to begin your journey towards establishing an effective prevention strategy in your community.

Successful implementations depend on thorough planning and capacity building.

Exploration Phase

The primary goal of the Exploration Phase of implementation is to identify and articulate a need for change and to select the right Evidence Based Program (EBP) to meet that need.  Successful implementations depend on thorough planning and capacity building. Working through what you want to change, how you wish to change it, and the ability of your organization to effect that change should be done as early in the process as possible to best prepare your efforts for success.

Begin by completing a needs assessment to measure the substance use and school climate factors which need to be addressed in your school community. Define the target population you will serve, identify the settings for program delivery, and document the expected short-and long-term outcomes of implementing a prevention-based approach to meet your needs. Develop a logic model and framework for achieving outcomes, and define strategies for affecting change. Once you have determined the need and desired outcomes, the next step is to evaluate programs based on several criteria: the program’s theoretical framework, logic model, strategies, prescribed outcomes, and compatibility with your target population, capacity, and setting.

Prevention Framework

An effective prevention framework aims to prevent risky and unhealthy behavior by first targeting the development of key skills and the education of youth about the effects and consequences of those behaviors. Education on the negative consequences of violence and substance use alone is not an effective prevention strategy and rarely changes behavior. Other “informative” or “emotional appeal” strategies like didactic lectures, scare tactics, alarming statistics, or infrequent or one-off presentations have proven to be ineffective in reducing or deterring substance use and violence in children and youth.

Effective prevention programs use a strengths-based approach that builds self-efficacy and develops character as part of a strategy to address risk. Protective factors and resiliency increase in this model, equipping students with the ability to face and overcome challenges, rather than turn to negative behaviors. Research also indicates that an effective prevention framework provides lesson content through interactive and collaborative activities to engage diverse learning modalities and support prosocial norms in the school community.

Your prevention strategy should include outlines of how you plan to reach beyond school walls to garner support and involvement from parents

Setting and Target Population Effectiveness

To determine if a program will be effective in your target setting and student population, consider the demographics and targeted risk factors within your school population. Your comprehensive prevention strategy should take into consideration the unique community challenges present in your area. If your community struggles with gaining parental involvement, for instance, your prevention strategy should include outlines of how you plan to reach beyond school walls to garner support and involvement from parents. Include budget in your plans for community speakers and parent education nights to strengthen and amplify your on-campus prevention efforts.

Intended Outcomes

Choosing an EBP that will meet the needs of your community includes comparing your desired outcomes with the research-backed outcomes shown in the programs you are evaluating. An effective prevention strategy should target the following protective factors for increase:

• Social and emotional competency skills
• Personal efficacy
• Exposure to school, community, and cultural norms that reject substance use or antisocial behaviors
• Increased knowledge and perception of harm of the negative effects of problem behaviors
• Positive school connectedness

As well as targeting the following factors for decrease:

• Poor social and emotional skills
• Favorable attitudes toward substance use or antisocial behavior
• Norms favorable toward substance use or antisocial behavior
• Peer rewards for substance use or antisocial behaviors
• Early initiation of substance use
• Physical violence
• Bullying behavior

In this five-part blog series, we will publish additional chapters based on the phases in the Too Good Implementation Center to provide guidance on how to effectively frame and support an outcomes-based EBP and prevention strategy. Tune in as we explore the phases of Program Installation, Initial Implementation, Full Implementation, and Program Sustainability.