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Testing implementation support for evidence-based programs in community settings: a replication cluster-randomized

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Summary

Implementation support interventions like Getting To Outcomes (GTO) improve evidence-based program fidelity in community organizations. GTO enhanced adherence and quality of program delivery over two years.

Keywords:
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Area of Science:

  • Implementation Science
  • Public Health Interventions
  • Community-Based Research

Background:

  • Community organizations face challenges implementing evidence-based prevention programs effectively.
  • There is a need for research on interventions that support high-quality program implementation.

Purpose of the Study:

  • To test the "Getting To Outcomes" (GTO) implementation support intervention within the "Preparing to Run Effective Programs" (PREP) randomized controlled trial.
  • To evaluate GTO's impact on the fidelity and proximal outcomes of the CHOICE alcohol and drug prevention program implemented by Boys and Girls Club sites.

Main Methods:

  • A randomized controlled trial comparing 15 sites implementing CHOICE (control) with 14 sites implementing CHOICE supported by GTO (intervention).
  • GTO intervention included manuals, training, and technical assistance for adoption, planning, delivery, evaluation, and quality improvement.
  • Fidelity (adherence, quality, dosage) was assessed via observer ratings and logs; youth outcomes (attitudes, intentions) via surveys at baseline, 3, and 6 months.

Main Results:

  • After two years, intervention sites showed significantly higher adherence and quality of CHOICE program delivery compared to control sites.
  • Dosage of program delivery remained similar between groups.
  • No significant differences in youth proximal outcomes were observed between intervention and control groups, potentially due to high baseline prosocial responses.

Conclusions:

  • Systematic implementation support through GTO can enhance the fidelity of evidence-based programs in community settings.
  • GTO's effectiveness in improving implementation fidelity is replicated across different evidence-based programs.
  • GTO demonstrates potential as a versatile support intervention for various community-based programs, despite not impacting proximal outcomes in this study.