To help inform drug abuse prevention research in school settings about the issues surrounding implementation, we conducted a review of the fidelity of implementation research literature spanning a 25-year period. Fidelity has been measured in five ways: (1) adherence, (2) dose, (3) quality of program delivery, (4) participant responsiveness and (5) program differentiation. Definitions and measures of fidelity were found not to be consistent across studies, and new definitions are proposed. While there has been limited research on fidelity of implementation in the social sciences, research in drug abuse prevention provides evidence that poor implementation is likely to result in a loss of program effectiveness. Studies indicate that most teachers do not cover everything in a curriculum, they are likely to teach less over time and training alone is not sufficient to ensure fidelity of implementation. Key elements of high fidelity include teacher training, program characteristics, teacher characteristics and organizational characteristics. The review concludes with a discussion of the tension between fidelity and reinvention/adaptation, and ways of resolving this tension. Recommendations are made for developing a consistent methodology for measuring and analyzing fidelity of implementation. Further, researchers and providers should collaborate to develop ways of introducing flexibility into prevention programs.

Drug abuse prevention programs conducted during junior high school can produce meaningful and durable reductions in tobacco, alcohol, and marijuana use if they (1) teach a combination of social resistance skills and general life skills, (2) are properly implemented, and (3) include at least 2 years of booster sessions.

Students (N = 4,466) attending 56 schools in New York State were involved in a 3-year study testing the effectiveness of a cognitive-behavioral approach to substance abuse prevention. In a randomized block design, schools were assigned to receive (a) the prevention program with formal provider training and implementation feedback, (b) the prevention program with videotaped provider training and no feedback, or (c) no treatment. After pretest equivalence and comparability of conditions with respect to attrition were established, students who received at least 60% of the prevention program (N = 3,684) were included in analyses of program effectiveness. Significant prevention effects were found for cigarette smoking, marijuana use, and immoderate alcohol use. Prevention effects were also found for normative expectations and knowledge concerning substance use, interpersonal skills, and communication skills.

As prevention programs become disseminated, the most serious threat to effectiveness is maintaining the quality of implementation intended by the developers. This paper proposes a methodology for measuring quality of implementation in school settings and presents data from a pilot study designed to test several of the proposed components. These methods included assessments of adherence, quality of process, the positive or negative valence of adaptations, teachers' attitudes and teachers' understanding of program content. This study was conducted with 11 teachers who had varying degrees of experience who taught Life Skills Training. Observation and interview data were collected during visits to schools. Results suggest that quality of implementation can be measured through observation and interview. Teachers varied in adherence and quality of program delivery. All teachers made adaptations to the program. Experienced teachers were more likely to adhere to the curriculum, deliver it in a way that was more interactive and engaging to students, communicate the goals and objectives better, and make positive adaptations. The field can use these findings as the basis for exploring strategies for measuring and improving quality of implementation.

A review of school-based drug abuse prevention programs was conducted for 1989-1994. In addition to a comprehensive literature review, interviews were conducted with a panel of 15 leading experts in prevention research. Key elements of promising prevention curricula were identified. Effective prevention programs were found to be based on a sound theoretical or research foundation. They included developmentally appropriate information about drugs, social resistance skills training, and normative education. Broader based personal and social skills training appeared to enhance program effects. Effective programs used interactive teaching techniques and teacher training, and provided adequate coverage and sufficient follow-up. Cultural sensitivity to the target population was found to be critical to program success. Additional program components were expected to enhance curriculum effectiveness. Finally, experts agreed that adequate evaluation of prevention curricula was critical. Unfortunately, despite information about the types of curricula that are effective, the most promising prevention curricula are not widely disseminated. Reasons for under-utilization are explored, and recommendations made for correcting the situation.

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Social and emotional learning (SEL) has become more central to education because of demand from educators, parents, students, and business leaders alongside rigorous research showing broad, positive impacts for students and adults. However, all approaches to SEL are not equal. Systemic SEL is an approach to create equitable learning conditions that actively involve all Pre-K to Grade 12 students in learning and practicing social, emotional, and academic competencies. These conditions require aligned policies, resources, and actions at state and district levels that encourage local schools and communities to build the personal and professional capacities of adults to: implement and continuously improve evidence-based programs and practices; create an inclusive culture that fosters caring relationships and youth voice, agency, and character; and support coordinated school-family-community partnerships to enhance student development. Promoting social and emotional competencies-including the abilities to understand and manage emotions, achieve positive goals, show caring and concern for others, establish and maintain positive relationships, and make responsible decisions-are important for success at school and in life. In this article, we summarize key concepts and evidence for systemic SEL. Next, we explain interrelated Theories of Action and resources developed by the Collaborative for Academic, Social, and Emotional Learning (CASEL) to implement and continuously improve systemic SEL in schools, districts, and states. We discuss research on nested, interacting settings and processes involved in systemic SEL at proximal (classrooms, schools, families, and communities) and distal (districts, states, national, and international) ecological levels. We conclude with recommendations for future SEL research, practice, and policy.

The present study was designed to test the feasibility, acceptability, and effectiveness of a 15-session smoking prevention intervention with a predominantly hispanic (74%) sample of seventh-grade students (N = 471) in eight urban schools in the New York area. The smoking prevention curriculum teaches social resistance skills within the context of a broader intervention promoting general personal and social competence and was implemented in this study by regular classroom teachers. Results of logistic regression analyses provided preliminary evidence of the efficacy of this type of smoking prevention strategy with urban minority youth when implemented with a reasonable degree of fidelity. The significance of these findings is that they provide support for the generalizability of an approach previously found to be effective with white middle-class populations to a predominantly hispanic inner-city population.