Adapting Evidence-Based Interventions Using a Common Theory, Practices, and Principles

Abstract

Objective Hundreds of validated evidence-based intervention programs (EBIP) aim to improve families’ well-being, however, most are not broadly adopted. As an alternative diffusion strategy, we created wellness centers to reach families’ everyday lives with a prevention framework. Method At two wellness centers, one in a middle-class neighborhood and one in a low-income neighborhood, popular local activity leaders (instructors of martial arts, yoga, sports, music, dancing, zumba), and motivated parents were trained to be Family Mentors. Trainings focused on a framework which taught synthesized, foundational prevention science theory, practice elements, and principles, applied to specific content areas (parenting, social skills, and obesity). Family Mentors were then allowed to adapt scripts and activities based on their cultural experiences, but were closely monitored and supervised over time. The framework was implemented in a range of activities (summer camps, coaching) aimed at improving social, emotional, and behavioral outcomes. Results Successes and challenges are discussed for: 1) engaging parents and communities; 2) identifying and training Family Mentors to promote children and families’ well-being; and 3) gathering data for supervision, outcome evaluation, and continuous quality improvement (CQI). Conclusion To broadly diffuse prevention to families, far more experimentation is needed with alternative and engaging implementation strategies that are enhanced with knowledge harvested from researchers’ past 30 years of experience creating EBIP. One strategy is to train local parents and popular activity leaders in applying robust prevention science theory, common practice elements, and principles of EBIP. More systematic evaluation of such innovations is needed.

Feasibility of Using Soccer and Job Training to Prevent Drug Abuse and HIV

“…Young men historically and universally underutilize medical care [23]. Most existing behavioral evidence-based interventions (EBI) for HIV are based on counseling models and are consistent with women’s “tend and befriend” coping styles, rather than men’s “ fight-flight” styles [24, 25]. The developmental and societal challenges facing young men have not been the focus of EBI [25–27].…”

Interaction of Theory and Practice to Assess External Validity

“…It represents challenges and opportunities given four combinations of novice and expert practitioners and researcher-developers, with deeper shading indicating greater challenges and lighter quadrants indicating the combinations that are most likely to contribute to generalizability and spread of EBIs. The dynamics in Figure (e.g., Rotheram-Borus et al, 2014, for the bottom two quadrants; quality improvement in medicine for the bottom right quadrant).…”

Toward Dynamic Adaptation of Psychological Interventions for Child and Adolescent Development and Mental Health

“…One example would be to search for alternative models for delivering mental health treatments in pediatric health care, including training the primary care provider in mental health skills (Kolko & Perrin, 2014). The training of practitioners in school settings is another promising strategy to high-quality dissemination (Rotheram-Borus et al, 2014). Ultimately, this may help practitioners not only to apply developmental principles and core intervention strategies but also to identify individual needs of children and adapt for developmental variability and ethnic diversity Another step toward solutions is to shift focus from programs to systems and gather an understanding of the best practices that can be dynamically adapted to the changing demands of a complex system that is organized within a set of principles, decisions, and structures.…”

“…However, there is good reason to believe that large-scale dissemination requires dynamic adaptation of interventions. This latter term refers to the discussion around core principles of interventions and adaptive features, such as flexibility around the decision of which evidence-based curricula to choose for a specific behavioral issue, the use of modular designs to therapeutic interventions (e.g., Chorpita, Daleiden, & Weisz, 2005;Weisz et al, 2012), or the adaptation of scripts and activities to train core features (e.g., Rotheram-Borus, Swendeman, & Becker, 2014). Dynamic adaptation of mental health prevention and developmental intervention approaches thus refers to a process of flexible decision making regarding the selection, implementation, and evaluation of evidence-based practices and approaches to enhance child mental health and development so that it is tailored to a given context, population, and need (see Aarons et al, 2012;Huey & Polo, 2008).…”