Sustaining an Evidence-Based Program Over Time: Moderators of Sustainability and the Role of the Getting to Outcomes®...

Area of Science:

• Public Health
• Implementation Science
• Adolescent Psychology

Background:

• Adolescent substance use remains a significant public health issue, necessitating effective evidence-based programs (EBPs).
• Schools and community organizations face challenges in implementing and sustaining these EBPs.
• Limited research exists on improving EBP sustainability through implementation support interventions.

Purpose of the Study:

• To test the effectiveness of the Getting To Outcomes (GTO) implementation support intervention on the sustainability of the CHOICE EBP for adolescent substance use prevention.
• To identify predictors of sustainability for key tasks (GTO performance) and program fidelity (CHOICE fidelity).

Main Methods:

• A randomized controlled trial was conducted across 29 Boys and Girls Club sites.
• The study tracked CHOICE implementation for two years post-intervention across GTO-supported and control sites.
• Path models were used to analyze sustainability predictors, including GTO performance and CHOICE fidelity.

Main Results:

• One year post-GTO support, no significant differences in CHOICE fidelity were found between groups, though GTO sites showed better evaluation practices.
• Improved GTO performance predicted better CHOICE fidelity.
• Two years post-GTO support, GTO sites demonstrated significantly higher rates of sustained CHOICE implementation compared to control sites.

Conclusions:

• The Getting To Outcomes (GTO) intervention can enhance the long-term sustainability of evidence-based programs in low-resource settings.
• Implementation support is crucial for organizations to maintain the effectiveness of adolescent substance use prevention programs.
• Investing in implementation support maximizes the return on investment for evidence-based programs.