In gratitude to George W. Albee, prevention's true north.
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History, 20th Century↗
Biomedical subjects
Linda Dusenbury
Publications and source records attributed to Linda Dusenbury.
Substance abuse prevention program content: systematizing the classification of what programs target for change.
We conducted an analysis of programs listed on the National Registry of Effective Programs and Practices as of 2003. This analysis focused on programs that addressed substance abuse prevention from among those on the effective or model program lists and that had manuals. A total of 48 programs met these inclusion criteria. We coded program manuals for content that was covered based on how much time was devoted to changing targeted mediating variables. The value of this approach is that program content can be judged using an impartial standard that can be applied to a wide range of intervention approaches. On average, programs addressed eight of 23 possible content areas. Our analyses suggested there were seven distinguishable approaches that have been used in substance abuse prevention programs. These include (i) changing access within the environment, (ii) promoting the development of personal and social skills, (iii) promoting positive affiliation, (iv) addressing social influences, (v) providing social support and helping participants develop goals and alternatives, (vi) developing positive schools and (vii) enhancing motivation to avoid substance use. We propose that the field use such analyses as the basis of future theory development.
Attitude to Health↗
Simplifying the delivery of a prevention program with web-based enhancements.
The ease with which prevention programs can be delivered may impact whether or not they are implemented as designed. This paper presents a website with enhancements designed to make delivery of the All Stars substance use prevention program easier. Administrative tasks, such as completing paperwork associated with program delivery were automated using web technology. A pilot study of the web site was conducted with program instructors. There was a significant improvement in teachers' perceived ease of program delivery. Modest correlation coefficients were found for the relationship between ease of delivery of specific program activities and adherence to these activities.
Adolescent↗
Quality of implementation: developing measures crucial to understanding the diffusion of preventive interventions.
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.
Accident Prevention↗
Pursuing the course from research to practice.
Diffusion of Innovation Theory describes the typical course by which innovations become standard practice. Research-based prevention programs are one such innovation. These programs have passed through the early phases of diffusion-innovation development and adoption by progressive schools that seek out innovations. With one quarter of the nation's schools having adopted a research-based program, the field is currently in the early majority phase of diffusion. If the patterns of normal diffusion hold true, this phase is likely to be characterized by emerging tensions between program developers and adopting schools. There are several concerns that require attention from researchers and practitioners. Practitioners need to develop their capacity to implement programs with fidelity and to adapt programs appropriately to meet their circumstance. Program developers need to simplify and redesign programs to make them appealing and useful to teachers. Operational capacity to fulfill orders and provide training needs to be developed.
Diffusion of Innovation↗
A review of research on fidelity of implementation: implications for drug abuse prevention in school settings.
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.
Curriculum↗