The authors reviewed scores of primary prevention programs to identify preventive interventions that had undergone quasi-experimental or randomized trials and been found to reduce symptoms of psychopathology (aggression, depression, or anxiety) or factors commonly associated with an increased risk for later mental disorders. In this review, the authors identify and describe 34 universal and targeted interventions that have demonstrated positive outcomes under rigorous evaluation. The authors go on to examine common characteristics of successful prevention programs and make recommendations based on these characteristics for policy and practice in school-and communitybased prevention of childhood psychopathology.We are grateful to Anne Mathews-Younes and Gail Ritchie at CMHS for their support of empirically based prevention science and their specific support and feedback in this project. We are also thankful to the program developers and research scientists whose programs are reviewed in this report. They have provided timely feedback on our reviews of their work and we are hopeful that we have accurately represented their findings.

When evidence-based programs (EBPs) are scaled up in natural, or non-research, settings, adaptations are commonly made. Given the fidelity-versus-adaptation debate, theoretical rationales have been provided for the pros and cons of adaptations. Yet the basis of this debate is theoretical; thus, empirical evidence is needed to understand the types of adaptations made in natural settings. In the present study, we introduce a taxonomy for understanding adaptations. This taxonomy addresses several aspects of adaptations made to programs including the fit (philosophical or logistical), timing (proactive or reactive), and valence, or the degree to which the adaptations align with the program's goals and theory, (positive, negative, or neutral). Self-reported qualitative data from communities delivering one of ten state-funded EBPs were coded based on the taxonomy constructs; additionally, quantitative data were used to examine the types and reasons for making adaptations under natural conditions. Forty-four percent of respondents reported making adaptations. Adaptations to the procedures, dosage, and content were cited most often. Lack of time, limited resources, and difficulty retaining participants were listed as the most common reasons for making adaptations. Most adaptations were made reactively, as a result of issues of logistical fit, and were not aligned with, or deviated from, the program's goals and theory.

Over the past four decades, significant strides have been made in the science of preventing youth problem behaviors. Subsequently, policymakers and funders have begun to insist on the use of evidence-based programs (EBPs) as a requirement for funding. However, unless practitioners are able to sustain these programs beyond initial seed funding, they are unlikely to achieve their ultimate goal of broad public health impact. Despite its obvious importance, sustainability has received relatively little attention in prevention science until recently. Moreover, there have been few opportunities to study the correlates of sustainability in large-scale, multi-year initiatives involving multiple programs. The present study examined rates of sustainment of a wide range of proven-effective prevention and intervention programs; identified factors related to organizational support and readiness, program and implementer characteristics, and sustainability planning that distinguished sustained programs; and examined variability in these associations across classroom-based, community/mentoring, family-focused prevention, and family treatment program types within the context of a state-wide EBP dissemination initiative in Pennsylvania over 4 years. The majority of EBPs sustained functioning 2 years or more beyond their initial funding. In general, sustained programs reported greater community coalition functioning, communication to key stakeholders, knowledge of the program's logical model, communication with the trainer or program developer, and sustainability planning. In addition to these universal correlates, important program-specific correlates emerged as well. Implications for the technical assistance and support necessary to promote the sustainability of EBPs in nonresearch contexts are also discussed.

Access to this document was granted through an Emerald subscription provided by emerald-srm:368933 [] For AuthorsIf you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractDemonstrating the efficacy and effectiveness of prevention programmes in rigorous randomised trials is only the beginning of a process that may lead to better public health outcomes. Although a growing number of programmes have been shown to be effective at reducing drug use and delinquency among young people under carefully controlled conditions, we are now faced with a new set of obstacles. First, these evidence-based programmes are still under-utilised compared to prevention strategies with no empirical support. Second, when effective programmes are used the evidence suggests they are not being implemented with quality and fidelity. Third, effective programmes are often initiated with short-term grant funding, creating a challenge for sustainability beyond seed funding. We discuss each of these challenges, and present lessons learned from a large-scale dissemination effort involving over 140 evidence-based programme replications in one state in the US.

A number of programs, policies, and practices have been tested using rigorous scientific methods and shown to prevent behavioral health problems (Catalano et al., Lancet 379:1653–1664, 2012; National Research Council and Institute of Medicine, 2009). Yet these evidence-based interventions (EBIs) are not widely used in public systems, and they have limited reach (Glasgow et al., American Journal of Public Health 102:1274–1281, 2012; National Research Council and Institute of Medicine 2009; Prinz and Sanders, Clinical Psychology Review 27:739–749, 2007). To address this challenge and improve public health and well-being at a population level, the Society for Prevention Research (SPR) formed the Mapping Advances in Prevention Science (MAPS) IV Translation Research Task Force, which considered ways to scale up EBIs in five public systems: behavioral health, child welfare, education, juvenile justice, and public health. After reviewing other efforts to scale up EBIs in public systems, a common set of factors were identified as affecting scale-up in all five systems. The most important factor was the degree to which these systems enacted public policies (i.e., statutes, regulations, and guidance) requiring or recommending EBIs and provided public funds for EBIs. Across systems, other facilitators of scale-up were creating EBIs that are ready for scale-up, public awareness of and support for EBIs, community engagement and capacity to implement EBIs, leadership support for EBIs, a skilled workforce capable of delivering EBIs, and data monitoring and evaluation capacity. It was concluded that the following actions are needed to significantly increase EBI scale-up in public systems: (1) provide more public policies and funding to support the creation, testing, and scaling up of EBIs; (2) develop and evaluate specific frameworks that address systems level barriers impeding EBI scale-up; and (3) promote public support for EBIs, community capacity to implement EBIs at scale, and partnerships between community stakeholders, policy makers, practitioners, and scientists within and across systems.