Prevention Science

, Volume 7, Issue 2, pp 151–165 | Cite as

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

  • Gerald J. August
  • Michael L. Bloomquist
  • Susanne S. Lee
  • George M. Realmuto
  • Joel M. Hektner
Article

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:

prevention aggression children effectiveness sustainability 

Notes

ACKNOWLEDGMENT

This study was supported by an Award from the National Institute of Mental Health (MH 63328).

REFERENCES

  1. August, G. J., Egan, E. A., Hektner, J. M., & Realmuto, G. M. (2003a). Parceling component effects of a multifaceted prevention program for disruptive elementary school children. Journal Of Abnormal Child Psychology, 31, 515–527.CrossRefPubMedGoogle Scholar
  2. August, G. J., Hektner, J. M., Egan, E. A., Realmuto, G. M., & Bloomquist, M. L. (2002). The early risers longitudinal prevention trial: Examination of 3-year outcomes in aggressive children with intent-to-treat and as-intended analyses. Psychology of Addictive Behaviors, 16, 27–39.CrossRefGoogle Scholar
  3. August, G. J., Lee, S. S., Bloomquist, M. L., Realmuto, G. M., & Hektner, J. M. (2003b). Dissemination of an evidence-based preventive innovation for aggressive children living in diverse, urban neighborhoods. Prevention Science, 4, 271–286.CrossRefPubMedGoogle Scholar
  4. August, G. J., Lee, S. S., Bloomquist, M. L., Realmuto, G. M., & Hektner, J. M. (2004). Maintenance effects of an evidence-based prevention innovation for aggressive children living in culturally diverse urban neighborhoods: The Early Risers effectiveness study. Journal of Emotional and Behavioral Disorders, 12, 194–205.CrossRefGoogle Scholar
  5. August, G. J., Realmuto, G. M., Hektner, J. M., & Bloomquist, M. L. (2001). An integrated components preventive intervention for aggressive elementary school children: The Early Risers program. Journal of Consulting and Clinical Psychology, 69, 614–626.CrossRefPubMedGoogle Scholar
  6. Bamberger, M., & Cheema, S. (1990). Case studies of project sustainability: Implications for policy and operations from Asian experience. Washington, DC: The World Bank.Google Scholar
  7. Bavolek, S. J., & Keene, R. G. (1999). Adult-adolescent parenting inventory AAPI-2. Park City, UT: Family Development Resources, Inc.Google Scholar
  8. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory manual (2nd ed.). San Antonio, TX: Psychological Corp.Google Scholar
  9. Bloomquist, M. L., August, G. J., Lee, S. S., Berquist, B. E., & Mathy, R. M. (2005). Targeted prevention of antisocial behavior in children: The Early Risers “Skills for Success” Program. In R. G. Steele & M. C. Roberts (Eds.), Handbook of mental health services for children, adolescents, and families (pp. 201–214). New York: Kluwer.CrossRefGoogle Scholar
  10. Conduct Problems Prevention Research Group. (1999). Initial impact of the Fast Track Prevention Trial for conduct problems. I. The high-risk sample. Journal of Consulting and Clinical Psychology, 67, 631–647.CrossRefGoogle Scholar
  11. Dane, A. V., & Schneider, B. H. (1998). Program integrity in primary and early secondary prevention: Are implementation effects out of control? Clinical Psychology Review, 18, 23–45.CrossRefPubMedGoogle Scholar
  12. Eddy, J. M., Reid, J., Stoolmiller, M., & Fetrow, R. A. (2003). Outcomes during middle school for an elementary school-based preventive intervention for conduct problems: Follow-up results from a randomize trial. Behavioral Therapy, 34, 535–552.CrossRefGoogle Scholar
  13. Glasgow, R. F., Vogt, T. M., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: The RE-AIM framework. American Journal of Public Health, 89, 1322–1327.PubMedCrossRefGoogle Scholar
  14. Goodman, R. M., & Stechler, A. B. (1988). The life and death of a health promotion program: An Institutionalization case study. International Quarterly of Community Health Education, 8, 5–21.CrossRefGoogle Scholar
  15. Gresham, F. M., & Elliott, S. N. (1990). Social skills rating system manual. Circle Pines, MN: American Guidance Service.Google Scholar
  16. Hollingshead, A. (1975). Four-factor index of social status. Unpublished manuscript, Yale University, New Haven, CT.Google Scholar
  17. Kellam, S. G., & Langevin, D. J. (2003). A framework for understanding “evidence” in prevention research and programs. Prevention Science, 4, 137–153.CrossRefPubMedGoogle Scholar
  18. Lee, S. S., August, G. J., Bloomquist, M. L., Mathy, R. M., & Realmuto, G. M. (2005). Implementing an evidence-based preventive intervention in neighborhood family centers: Examination of perceived barriers to program participation. Manuscript submitted for publication.Google Scholar
  19. Lochman, J. E., & Wells, K. C. (2004). The Coping Power Program for preadolescent aggressive boys and their parents: Outcome effects at the 1-year follow-up. Journal of Consulting and Clinical Psychology, 72, 571–578.CrossRefPubMedGoogle Scholar
  20. Mancini, J. A., & Marek, L. I. (2004). Sustaining community-based programs for families: Conceptualization and Measurement. Family Relations, 53, 339–347.CrossRefGoogle Scholar
  21. Moffitt, T. E. (1993). Adolescent-limited and life—Course persistent antisocial behavior: A developmental taxonomy. Psychological Bulletin, 100, 674–701.Google Scholar
  22. O’Loughlin, J., Renaud, L., Richard, L., Gomez, L. S., & Paradis, G. (1998). Correlates of the sustainability of community-based heart health promotion interventions. Preventive Medicine, 27, 702–717.CrossRefPubMedGoogle Scholar
  23. Patterson, G. E., DeBaryshe, B. D., & Ramsey, E. (1989). A developmental perspective of antisocial behavior. American Psychology, 44, 329–333.CrossRefGoogle Scholar
  24. Peters, R., & Petrunka, K. (2005, May). What happens after the demonstration phase? Examining the sustainability of a prevention project. Paper presented at the annual conference of the Society for Prevention Research, Washington, DC.Google Scholar
  25. Reid, M. J., Webster-Stratton, C., & Hammond, M. (2003). Follow-up of children who received the Incredible Years intervention for oppositional-defiant disorder: Maintenance and prediction of 2-year outcome. Behavior Therapy, 34, 471–491.CrossRefGoogle Scholar
  26. Rosenthal, R. (1994). Parametric measures of effect size. In H. Cooper & L. V. Hedges (Eds.), The handbook of research synthesis (pp. 231–244). New York: Russell Sage Foundation.Google Scholar
  27. SAS Institute (2000). SAS/STAT user's guide, Version 8. Cary, NC: Author.Google Scholar
  28. Shediac-Rizkallah, M. C., & Bone, L. R. (1998). Planning for sustainability of community based health programs: conceptual frameworks and future directions for research, practice, and policy. Health Education Research: Theory and Practice, 13, 87–108.Google Scholar
  29. Smolkowski, K., Biglan, A., Barrera, M., Taylor, T., Black, C., & Blair, J. (2005). Schools and Homes in Partnership (SHIP): Long-term effects of a preventive intervention focused on social behavior and reading skill in Early Elementary School. Prevention Science, 6, 113–125.CrossRefPubMedGoogle Scholar
  30. Tarter, R. E., Sambrano, S., & Dunn, M. G. (2002). Predictor variables by developmental stages: A Center for Substance Abuse prevention multisite study. Psychology of Addictive Behaviors, 16, S1–S10.CrossRefGoogle Scholar
  31. Wells, K. B., Manning, W. G., & Benjamin, B. (1986). Use of outpatient mental health services in HMO and fee-for-service plans: Results from a randomized controlled trial. Health Services Research, 21, 453–474.PubMedGoogle Scholar
  32. Werthamer-Larsson, L., Kellam, S. G., & Wheeler, L. (1991). Effect of first-grade classroom environment on child shy behavior, aggressive behavior, and concentration problems. American Journal of Community Psychology, 19, 585–602.CrossRefPubMedGoogle Scholar
  33. Woodcock, R. W., McGrew, K. S., & Mather, N. (2001). Woodcock-Johnson III Tests of Achievement. Itasca, IL: Riverside.Google Scholar

Copyright information

© Society for Prevention Research 2006

Authors and Affiliations

  • Gerald J. August
    • 1
    • 3
  • Michael L. Bloomquist
    • 1
  • Susanne S. Lee
    • 1
  • George M. Realmuto
    • 1
  • Joel M. Hektner
    • 2
  1. 1.Division of Child and Adolescent PsychiatryUniversity of Minnesota Medical SchoolMinneapolisUSA
  2. 2.Department of Child Development and Family ScienceNorth Dakota State UniversityFargoUSA
  3. 3.Division of Child and Adolescent PsychiatryUniversity of Minnesota Medical SchoolMinneapolisUSA

Personalised recommendations