TABLE 11-1Comparison of Three Implementation Approaches

Implementation of an existing evidence-based programHigh program fidelity

Relatively high likelihood of achieving intended impact

Known resources and requirements for effective implementation

Likely continued funding under federal and state supported evidence-based prevention
Program may not fit community needs, strengths, or capacities

Real-world implementation may differ dramatically from the way originally tested

Lack of ownership in the program

Few evidence-based programs have the capacity to provide technical assistance and training

An evidence-based program may not target outcomes relevant to community
Adaptation of an existing program to meet community needsOwnership and high support from community and potentially high adoption

Program more relevant to ethnic, racial, or linguistic characteristics of community

Reasonably likely to achieve impact
Key program components may be modified, thereby reducing outcomes

Essential program components not always evident
Community- driven implementationCan develop high community acceptance and ownership

Potential for broader implementation across different organizations and institutions within the community

Opportunity to empirically evaluate the outcomes of programs accepted by the community and use quality improvement methods to enhance outcomes over time
Lengthy period to develop community awareness, common vision, and program

Potential for ineffectiveness or iatrogenic effects

Challenges in obtaining funding for sustaining a unique program

From: 11, Implementation and Dissemination of Prevention Programs

Cover of Preventing Mental, Emotional, and Behavioral Disorders Among Young People
Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities.
National Research Council (US) and Institute of Medicine (US) Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions; O'Connell ME, Boat T, Warner KE, editors.
Washington (DC): National Academies Press (US); 2009.
Copyright © 2009, National Academy of Sciences.

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