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Population-based dissemination of evidence-based prevention programs (EBP) successfully reached more low socioeconomic-status families than randomized controlled trials (RCT). However, implementation barriers currently limit the effectiveness of this approach.

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Area of Science:

  • Public Health
  • Child Development
  • Implementation Science

Background:

  • Family-based prevention programs aim to improve children's health but struggle to reach families, especially those facing socioeconomic challenges.
  • Evidence-based prevention programs (EBP) are often underutilized by populations that could benefit most, including those not participating in randomized controlled trials (RCT).
  • Population-level implementation of EBP is proposed as a strategy to overcome reach limitations and enhance equity in program access.

Purpose of the Study:

  • To evaluate the effectiveness of a population-level rollout of three EBP in reaching a diverse range of families.
  • To compare the socioeconomic status of families participating in the population rollout with those in typical RCTs.
  • To assess the impact of EBP on parental strategies, child behavior, and quality of life within a real-world community setting.

Main Methods:

  • Three EBP were implemented in a city-wide, uncontrolled trial.
  • Data were collected on participating families and the general population of the city.
  • Participant characteristics, including socioeconomic status, were analyzed. Within-subject effects on parental strategies, child behavior problems, and quality of life were assessed for a subsample.

Main Results:

  • Over 3480 families (30% of the city's population) participated.
  • A higher proportion of low socioeconomic-status families participated compared to a general population sample.
  • Within-subject effect sizes for parental strategies, child behavior, and quality of life were comparable to other uncontrolled EBP studies.

Conclusions:

  • Population-based dissemination of EBP is a promising strategy for reaching at-risk families, particularly those with lower socioeconomic status.
  • This approach contributes to type 2 translation research, bridging the gap between research and practice.
  • Significant implementation barriers were identified, which currently impede the full effectiveness of community-wide EBP rollouts.