Prevention Science

, Volume 7, Issue 2, pp 151–165

Can Evidence-Based Prevention Programs be Sustained in Community Practice Settings? The Early Risers’ Advanced-Stage Effectiveness Trial

Authors

    • Division of Child and Adolescent PsychiatryUniversity of Minnesota Medical School
    • Division of Child and Adolescent PsychiatryUniversity of Minnesota Medical School
  • Michael L. Bloomquist
    • Division of Child and Adolescent PsychiatryUniversity of Minnesota Medical School
  • Susanne S. Lee
    • Division of Child and Adolescent PsychiatryUniversity of Minnesota Medical School
  • George M. Realmuto
    • Division of Child and Adolescent PsychiatryUniversity of Minnesota Medical School
  • Joel M. Hektner
    • Department of Child Development and Family ScienceNorth Dakota State University
Article

DOI: 10.1007/s11121-005-0024-z

Cite this article as:
August, G.J., Bloomquist, M.L., Lee, S.S. et al. Prev Sci (2006) 7: 151. doi:10.1007/s11121-005-0024-z

This study evaluated institutional sustainability of the Early Risers “Skills for Success” conduct problems prevention program. In a previous early-stage effectiveness trial Early Risers had been successfully implemented by a nonprofit community agency with guidance, supervision, technical assistance and fiscal support/oversight provided by program developers. The current advanced-stage effectiveness trial applied a randomized, control group design to determine whether this community agency could replicate earlier positive findings with a new cohort of participants, but with less direct involvement of program developers. An intent-to-intervene strategy was used to compare children randomly assigned to Early Risers or a no-intervention comparison group. Compared to results obtained in an early-stage effectiveness trial, program attendance rates were much lower and only one positive outcome was replicated. Failure to replicate program effects was not attributed to poor program implementation, because data collected pertaining to exposure, adherence and quality of delivery were acceptable, and a participation analysis showed that families who attended at higher levels did benefit. It was difficulties that the community agency experienced in engaging families in program components at recommended levels that primarily accounted for the results. Possible organizational barriers that impeded sustainability included unreliable transportation, poor collaboration between the agency and the local public school system, high staff turnover, agency downsizing, and fiduciary responsibility and accountability. It was concluded that both program developers and program providers need to be proactive in planning for sustainability.

KEY WORDS:

preventionaggressionchildreneffectivenesssustainability

Copyright information

© Society for Prevention Research 2006