Effectiveness, Transportability, and Dissemination of Interventions: What Matters When?

Abstract

The authors identify and define key aspects of the progression from research on the efficacy of a new intervention to its dissemination. They highlight the role of transportability questions that arise in that progression and illustrate key conceptual and design features that differentiate efficacy, effectiveness, and dissemination research. An ongoing study of the transportability of multisystemic therapy is used to illustrate independent and interdependent aspects of effectiveness, transportability, and dissemination studies. Variables relevant to the progression from treatment efficacy to dissemination include features of the intervention itself as well as variables pertaining to the practitioner, client, model of service delivery, organization, and service system. The authors provide examples of how some of these variables are relevant to the transportability of different types of interventions. They also discuss sample research questions, study designs, and challenges to be anticipated in the arena of transportability research.

Fidelity of Implementation in Project Towards No Drug Abuse (TND): A Comparison of Classroom Teachers and Program Specialists

“…As public polices such as the federal Safe and Drug Free Schools and Community Act (U.S. Department of Education, 2005) move us toward broad dissemination of evidence-based substance abuse prevention programs, there is a need for more research on all aspects of program implementation (Dusenbury et al, 2003;Domitrovich & Greenberg, 2000;Rohrbach, Grana, Sussman, & Valente, 2006;Schoenwald & Hoagwood, 2001). Specifically, studies that examine whether proven prevention programs are effective when implemented in "real world" settings by providers who differ from those in the efficacy trials are important for at least two reasons.…”

In Dreams Begin Responsibility: Why and How to Measure the Quality of Graduate Training in Applied Behavior Analysis

“…To justify the last point, it is important to distinguish efficacy evidence, which indicates whether a therapeutic approach can work when the contextual stars are properly aligned, from effectiveness evidence, which indicates whether this approach works under normative field conditions (Schoenwald and Hoagwood 2001). ABA is empirically supported but much of the relevant research examines efficacy (i.e., it takes place in fairly well-controlled training clinics, employs well-supervised staff, and taps into a variety of university resources).…”

Crucial Issues in the Applied Analysis of Verbal Behavior: Reflections on Crucial Conversations: Tools for Talking When the Stakes Are High

“…Most innovations, in fact, diffuse at a disappointingly slow rate, at least in the eyes of the inventors and technologists who create innovations and promote them to others. (Rogers, 2003, p. 7) Thus, a major concern is how members of the general public might encounter the fruits of the applied analysis of verbal behavior and how they can be convinced to give these fruits a try in the first place (e.g., Schoenwald & Hoagwood, 2001).…”

“…People do not necessarily line up to obtain a better mousetrap, no matter how many peer-reviewed publications extol its virtues. The means by which end-users may be persuaded to embrace an innovation is the focus of considerable discussion elsewhere (e.g., Rogers;Schoenwald & Hoagwood, 2001), so I will not attempt to summarize except to say that sometimes a good story line, of the sort that popular-press authors clearly have mastered, can make a big difference. To be clear, a ''story line'' means more than a titillating narrative.…”