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Learning from Communities: Overcoming Difficulties in Dissemination of Prevention and Promotion Efforts

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American Journal of Community Psychology

Abstract

The model of prevention science advocated by the Institute of Medicine (P. J. Mrazek & R. J. Haggerty, 1994) has not lead to widespread adoption of prevention and promotion programs for four reasons. The model of dissemination of programs to communities fails to consider community and organizational capacity to implement programs, ignores the need for congruence in values between programs and host sites, displays a pro-innovation bias that undervalues indigenous practices, and assumes a simplistic model of how community organizations adopt innovations. To address these faults, researchers should locate, study, and help disseminate successful indigenous programs that fit community capacity and values. In addition, they should build on theoretical models of how locally developed programs work to make existing programs and polices more effective.

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References

  • Aber, J. L., Brown, J. L., & Henrich, C. C. (1999). Teaching conflict resolution: An effective school-based approach to violence prevention. Research Brief. National Center for Children in Poverty. Retrieved February 12, 2004 from http://www.esrnational.org/es/rccptext.pdf

  • Aber, J. L., Brown, J. L., & Jones, S. M. (2003). Developmental trajectories toward violence in middle childhood: Course, demographic differences, and response to school-based intervention. Developmental Psychology, 39, 324–348.

    PubMed  Google Scholar 

  • Abrahamson, E. (1991). Managerial fads and fashions: The diffusion and rejection of innovations. Academy of Management Review, 16, 586–612.

    Google Scholar 

  • Allen, J. P., Kuperminc, G., Philliber, S., & Herre, K. (1994). Programmatic prevention of adolescent problem behaviors: The role of autonomy, relatedness, and volunteer service in the Teen Outreach Program. American Journal of Community Psychology, 22, 617–638.

    PubMed  Google Scholar 

  • Altman, D. (1994). Power and community: Organizational and cultural responses to AIDS. Bristol, PA: Taylor & Francis.

    Google Scholar 

  • Barker, R. G. (1968). Ecological psychology: Concepts and methods for studying the environment of human behavior. Stanford, CA: Stanford University Press.

    Google Scholar 

  • Barton-Villagrana, H., Bedney, B. J., & Miller, R. L. (2002). Peer relationships among community-based organizations providing HIV prevention services. Journal of Primary Prevention, 23, 217–236.

    Google Scholar 

  • Bauman, L. J., Stein, R. E. K., & Ireys, H. T. (1991). Reinventing fidelity: The transfer of social technology among settings. American Journal of Community Psychology, 19, 619–639.

    PubMed  Google Scholar 

  • Cain, R. (1993). Community-based AIDS services: Formalization and depoliticization. International Journal of Health Services, 23, 665–684.

    PubMed  Google Scholar 

  • Campbell, R. C., Baker, C. K., & Mazurek, T. L. (1998). Remaining radical? Organizational predictors of rape crisis centers’ social change initiatives. American Journal of Community Psychology, 26, 457–483.

    PubMed  Google Scholar 

  • Caracelli, V. J., (2000). Evaluation use at the threshold of the twenty-first century. New Directions for Evaluation, Number, 88, 99–111.

    Google Scholar 

  • Casteneda, D., & Collins, B. (1997). Structure and activities of agencies providing HIV and AIDS education and prevention to Latina/Latino communities. AIDS Education and Prevention, 9, 533–550.

    Google Scholar 

  • Chen, H. T. (1990). Theory-driven evaluation: A comprehensive perspective. Newbury Park, CA: Sage.

    Google Scholar 

  • Chng, C. L., Sy, F. S., Choi, S. T., Bau, I., & Asutdillo, R. (1998). Asian and Pacific Islander American HIV community-based organizations: A nationwide survey. AIDS Education and Prevention, 10(Suppl. A), 48–60.

    PubMed  Google Scholar 

  • Cochrane, S. H. (1979). Fertility and education: What do we really know? Baltimore: Johns Hopkins University Press (for the World Bank).

    Google Scholar 

  • Cronbach, L. J. (1980). Toward reform of program evaluation. San Francisco: Jossey-Bass.

    Google Scholar 

  • Cronbach, L. J. (1982). Designing evaluations of educational and social programs. San Francisco: Jossey-Bass.

    Google Scholar 

  • Cross, J. E., Saunders, C. M., & Bartelli, D. (1998). The effectiveness of educational and needle exchange program: A meta-analysis of HIV prevention strategies for injection drug users. Quality and Quantity, 32, 165–180.

    Google Scholar 

  • Des Jarlais, D. C., & Friedman, S. R., (1998). Fifteen years of research on preventing HIV infection among injection drug users: what we have learned, what we have done, what we have not done. Public Health Reports, 113(Suppl. 1), 182–188.

    PubMed  Google Scholar 

  • Des Jarlais, D. C., Marmor, M., Paone, D., Titus, S., Shi, Q., Perlis, T., et al. (1996). HIV incidence among injecting drug users in New York City syringe exchange programs. Lancet, 348, 987–991.

    PubMed  Google Scholar 

  • DiFranciesco, W., Kelly, J. A., Otto-Salaj, L., McAuliffe, T. L., Somlai, A. M., & Hackl, K. (1999). Factors influencing attitudes within AIDS organizations toward the use of research-based HIV prevention interventions. AIDS Education and Prevention, 11, 72–86.

    Google Scholar 

  • DiMaggio, P. J., & Powell, W. W. (1983). The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48, 147–160.

    Google Scholar 

  • Elliott, S. J., O’Loughlin, J., Robinson, K., Eyles, J., Cameron, R., Harvey, D., Raine, K., & Gelskey, D. (2003). Conceptualizing dissemination research and activity: The case of the Canadian Heart Health Initiative. Health Education & Behavior, 30, 267–282.

    Google Scholar 

  • Elmore, R. F. (1983). Social policymaking as strategic intervention. In E. Seidman (Ed.) Handbook of Social Intervention (pp. 212–236), Beverly Hills: Sage.

    Google Scholar 

  • Emerson, R. E. (1962). Power-dependence relations. American Sociological Review, 27, 31–41.

    Google Scholar 

  • Fernandez, I., Bowen, S. G., Gay, C. L., Mattson, T. R., Bital, E., & Kelly, J. A. (2003). HIV, sex, and social change: Applying ESID principles to HIV prevention research. American Journal of Community Psychology, 32, 333–344.

    PubMed  Google Scholar 

  • Flood, R. L. (1999). Rethinking The Fifth Discipline: Learning within the unknowable. New York: Routledge.

    Google Scholar 

  • Foster-Fishman, P. G., Berkowitz, S. L., Lounsbury, D. W., Jacobsen, S., & Allen, N. A. (2001). Building collaborative capacity in community coalitions: A review and integrative framework. American Journal of Community Psychology, 29, 241–261.

    PubMed  Google Scholar 

  • Fredericksen, P., & London, R. (2000). Disconnect in the hollow state: The pivotal role of organizational capacity in community-based development organizations. Public Administration Review, 60, 230–239.

    Google Scholar 

  • Ginsburg, A., & Rhett, N. (2003). Building a better body of evidence: New opportunities to strengthen evaluation utilization. American Journal of Evaluation, 24, 489–498.

    Google Scholar 

  • Grasso, P. G. (2003). What makes an evaluation useful? Reflections from experience in large organizations. American Journal of Evaluation, 24, 507–514.

    Google Scholar 

  • Grob, G. F. (2003). A truly useful bat is one found in the hands of slugger. American Journal of Evaluation, 24, 499–506.

    Google Scholar 

  • Goodman, R. M., Speers, M. A., McLeroy, K., Fawcett, S., Kegler, M., Parker, E., Smith, S. R., Sterling, T. D., & Wallerstein, N. (1998). Identifying and defining the dimensions of community capacity to provide a basis for measurement. Health Education and Behavior, 25, 257–278.

    Google Scholar 

  • Gulcur, L., Stefancic, A., Shinn, M., Tsemberis, S., & Fischer, S.N. (2003). Housing, hospitalization and cost outcomes for homeless individuals with psychiatric disabilities participating in Continuum of Care and Housing First programmes. Journal of Community and Applied Social Psychology, 13, 171–186.

    Google Scholar 

  • Hawe, P., Noort, M., King, L., & Jordens, C. (1997). Multiplying health gains: The critical role of capacity-building within health promotion programs. Health Policy, 39, 29–42.

    PubMed  Google Scholar 

  • Heimer, R. (1998). Syringe exchange programs: Lowering the transmission of syringe-borne diseases and beyond. Public Health Reports, 113(Suppl. 1), 67–74.

    PubMed  Google Scholar 

  • Henry, G. T. (2003). Influential evaluations. American Journal of Evaluation, 24, 515–524.

    Google Scholar 

  • Hira, A., & Hira, R. (2000). The new institutionalism: Contradictory notions of change. American Journal of Economics and Sociology, 59, 267–282.

    Google Scholar 

  • Holtgrave, D. R., & Pinkerston, S. D. (1998). The cost-effectiveness of small group and community-level interventions. In D. R. Holtgrave (Ed.), Handbook of economic evaluation of HIV prevention programs (pp. 119–134). New York: Plenum Press.

    Google Scholar 

  • Homer, J., & Milstein, B. (2004). Optimal decision making in a dynamic model of community health. Big Island, Hawaii: Hawaii International Conference on System Science

    Google Scholar 

  • Jason, L. A., Keys, C. B., Suarez-Balcazar, Y., Taylor, R. R., Davis, M. I., Durlak, J., & Isenberg, D. H. (2004). Participatory community research: Theories and methods in action. Washington, DC: American Psychological Association.

    Google Scholar 

  • Katz, D., & Kahn, R. L. (1966). The social psychology of organizations. New York, NY: Wiley.

    Google Scholar 

  • Kegler, M. C., & McLeroy, K. R. (2003). Commentary on “Conceptualizing dissemination research and activity: The case of the Canadian Heart Health Initiative.” Health Education & Behavior, 30, 283–286.

    Google Scholar 

  • Kelly, J. A., St. Lawrence, J. S., Diaz, Y. E., Stevenson, L. Y., Hauth, A. C., & Brasfield, T. L. (1991). HIV risk behavior reduction following intervention with key opinion leaders of a population: An experimental analysis. American Journal of Public Health, 81, 168–171.

    Article  PubMed  Google Scholar 

  • Kelly, J. A., St. Lawrence, J. S., Stevenson, L. Y., Hauth, A. C., Kalichman, S. C., & Diaz, Y. E. (1992). Community AIDS/HIV-risk reduction: The effects of endorsements by popular people in three cities. American Journal of Public Health, 82, 1483–1489.

    PubMed  Google Scholar 

  • Kelly, J. A., Sogolow, E. D., & Neumann, M. S. (2000). Future directions and emerging issues in technology transfer between HIV prevention researchers and community-based service providers. AIDS Education and Prevention, 12(Suppl. 5A), 126–141.

    PubMed  Google Scholar 

  • Kelly, J. G. (2003). Science and community psychology: Social norms for pluralistic inquiry. American Journal of Community Psychology, 31, 213–217.

    PubMed  Google Scholar 

  • Kirkhart, K. E. (2000). Reconceptualizing evaluation use: An integrated theory of influence. New Directions for Evaluation, Number, 88, 5–24.

    Google Scholar 

  • Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of Management Review, 21, 1055–1080.

    Google Scholar 

  • Kontos, S., Howes, C., Shinn, M., & Galinsky, E. (1995). Quality in family child care and relative care. New York: Teachers College Press.

    Google Scholar 

  • Labonte, R., & Laverack, G. (2001). Capacity building in health promotion, part I: For whom? And for what purpose? Critical Public Health, 11, 111–127.

    Google Scholar 

  • Leviton, L. C. (2003). Evaluation use: Advances, challenges, and applications. American Journal of Evaluation, 24, 525–536.

    Google Scholar 

  • Lipsey, M. W. (1993). Theory as method: Small theories of treatment. New Directions for Evaluation, Number, 57, 5–38.

    Google Scholar 

  • Lipsey, M. W. (1997). What can you build with thousands of bricks? Musings on the cumulation of knowledge in program evaluation. New Directions for Evaluation, Number, 76, 7–24.

    Google Scholar 

  • Lipsky, M., & Smith, S. R. (1989–90). Nonprofit organizations, government, and the welfare state. Political Science Quarterly, 104, 625–648.

    Google Scholar 

  • Martin, J. L., Dean, L., Garcia, M. A., & Hall, W. (1989). The impact of AIDS on a gay community: Changes in sexual behavior, substance use, and mental health. American Journal of Community Psychology, 17, 269–293.

    PubMed  Google Scholar 

  • Mayer, J. P., & Davidson, W. S. (2000). Dissemination of innovation as social change. In J. Rappaport & E. Seidman (Eds.), Handbook of community psychology (pp. 421–438). New York: Kluwer Academic/Plenum Publishers.

    Google Scholar 

  • Meyer, J. W., & Rowan, B. (1977). Institutional organizations: Formal structures as myth and ceremony. American Journal of Sociology, 83, 340–363.

    Google Scholar 

  • Miller, R. L. (2001). Innovation in HIV prevention: Organizational and intervention characteristics affecting program adoption. American Journal of Community Psychology, 29, 195–205.

    Google Scholar 

  • Miller, R. L. (2003). Adapting an evidence-based intervention: Tales of The Hustler Project. AIDS Education and Prevention, 15(Suppl. 1), 127–138.

    PubMed  Google Scholar 

  • Miller, R. L., Bedney, B. J., Guenther-Grey, C., & the Community Intervention Trial for Youth (CITY) Project Study Team (2003). Assessing organizational capacity to deliver HIV prevention services collaboratively: Tales from the field. Health Education and Behavior, 30, 583–600.

    Google Scholar 

  • Miller, R. L., & Greene, G. J. (2004). Transferring HIV prevention technology to community-based organizations. In E. J. Trickett & W. Pequegnat (Eds.), Context and culture in HIV/AIDS interventions: Ecological strategies for increasing community impact. New York, NY: Oxford University Press. In press.

    Google Scholar 

  • Miller, R. L., Klotz, D., & Eckholdt, H. M. (1998). HIV prevention with male prostitutes and patrons of hustler bars: Replication of an HIV prevention intervention. American Journal of Community Psychology, 26, 97–131.

    PubMed  Google Scholar 

  • Mitchell, R. E., Florin, P., & Stevenson, J. F. (2002). Supporting community-based prevention and health promotion initiatives: Developing effective technical assistance systems. Health Education and Behavior, 29, 620–639.

    PubMed  Google Scholar 

  • Morrill, C., & McKee, C. (1993). Institutional isomorphism and informal social control: Evidence from a community mediation center. Social Problems, 40, 445–463.

    Google Scholar 

  • Mrazek, P. J., & Haggerty, R. J. (Eds.). (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press.

    Google Scholar 

  • Oliver, C. (1991). Strategic responses to institutional processes. Academy of Management Review, 16, 145–179.

    Google Scholar 

  • Pfeffer, J. & Salancik, G. R. (2003). The external control of organizations: A resource dependence perspective. Stanford, CA: Stanford University Press.

    Google Scholar 

  • Phillips, D. A., Howes, C., & Whitebook, M. (1992). The social policy context of child care: Effects on quality. American Journal of Community Psychology, 20, 25–51.

    PubMed  Google Scholar 

  • Preskill, H., & Torres, R. (2000). The learning dimension of evaluation use. New Directions for Evaluation, Number, 88, 25–38.

    Google Scholar 

  • Price, R. H., & Behrens, T. (2003). “Working Pasteur’s quadrant” Harnessing science and action for community change. American Journal of Community Psychology, 31, 219–223.

    PubMed  Google Scholar 

  • Riger, S. (1984). Vehicles for empowerment: The case of feminist movement organizations. Prevention in Human Services, 3, 99–117.

    Google Scholar 

  • Rogers, E. M. (1995). Diffusion of innovations, 4th edn. New York, NY: The Free Press.

    Google Scholar 

  • Saidel, J. R. (1989). Dimensions of interdependence: The state and voluntary-sector relationship. Nonprofit and Voluntary Sector Quarterly, 18, 335–347.

    Google Scholar 

  • Saidel, J. R. (1991). Resource interdependence: The relationship between state agencies and nonprofit organizations. Public Administration Review, 51, 543–553.

    Google Scholar 

  • Salem, D. A., Foster-Fishman, P. G., & Goodkind, J. R. (2002). The adoption of innovation in collective action organizations. American Journal of Community Psychology, 30, 681–710.

    PubMed  Google Scholar 

  • Sarason, S. B. (2003). The obligations of the moral-scientific stance. American Journal of Community Psychology, 31, 209–211.

    PubMed  Google Scholar 

  • Schachter, S. B. (1982). Recidivism and self-cure of smoking and obesity. American Psychologist, 37, 436–444.

    PubMed  Google Scholar 

  • Scott, W. R., & Meyer, J. W. (1994). Institutional environments and organizations: Structural complexity and individualism. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Semaan, S., & Sogolow, E. (Eds.) (2002). Do behavioral HIV interventions work? A review and meta-analysis. Journal of Acquired Immune Deficiency Syndromes, 30(Suppl. 1).

  • Schweinhart, L. J., Barnes, H.V., & Weikart, D. P. (Eds.) (1993). Significant benefits: The High/Scope Perry Preeschool Study through age 27. Ypsilanti, MI: High/Scope Press.

    Google Scholar 

  • Shadish, W. R. (1984). Lessons from the implementation of deinstitutionalization. American Psychologist, 39, 725–738.

    PubMed  Google Scholar 

  • Sikkema, K. J., Heckman, T. G., Kelly, J. A., Anderson, E. S., Winett, R. A., & Solomon, L. J. (1996). Prevalence and predictors of HIV-risk behavior among women living in low-income, inner-city housing developments. American Journal of Public Health, 86, 1123–1128.

    Article  PubMed  Google Scholar 

  • Steckler, A., & Goodman, R. M. (1989). How to institutionalize health promotion programs. American Journal of Heath Promotion, 3, 34–44.

    Google Scholar 

  • Stokes, D. (1997). Pasteur’s quadrant: Basic science and technological innovation. Washington, DC: Brookings Institute Press.

    Google Scholar 

  • Trickett, E. J. (1996). A future for community psychology: The contexts of diversity and the diversity of contexts. American Journal of Community Psychology, 24, 209–234.

    Google Scholar 

  • Tsemberis, S. (1999). From streets to homes: An innovative approach to supported housing for homeless adults with psychiatric disabilities. Journal of Community Psychology, 27, 225–241.

    Google Scholar 

  • Tsemberis, S., Moran, L. L., Shinn, M., Asmussen, S. M., & Shern, D. L. (2003). Consumer preference programs for homeless individuals with psychiatric disabilities: A drop-in center and a supported housing program. American Journal of Community Psychology, 32, 305–317.

    PubMed  Google Scholar 

  • Vlahov, D., & Junge, B. (1998). The role of needle exchange programs in HIV prevention. Public Health Reports, 113(suppl. 1), 75–80.

    PubMed  Google Scholar 

  • Wandersman, A. (2003). Community science: Bridging the gap between science and practice with community-centered models. American Journal of Community Psychology, 31, 227–242.

    PubMed  Google Scholar 

  • Weiss, C. H. (1995). Nothing as practical as a good theory. In J. Connell, A. Kubisch, L. B. Schorr, & C. H. Weiss (Eds.), New approaches to evaluating community initiatives (pp. 65–92). New York: Aspen Institute.

    Google Scholar 

  • Weiss, C. H. (1997). Theory based evaluation: Past, present, future. New Directions for Evaluation, Number, 76, 41–55.

    Google Scholar 

  • Wohlfeiler, D. (2002). From community to clients: The professionalisation of HIV prevention among gay men and its implication for intervention selection. Sex Transm Infect, 78(Suppl. 1), 176–182.

    Article  Google Scholar 

  • Wong, F. Y., Chng, C. L., & Lo, W. (1998). A profile of six community-based HIV prevention programs targeting Asian and Pacific Islander Americans. AIDS Education and Prevention, 10(Suppl. A), 61–76.

    PubMed  Google Scholar 

  • Yoshikawa, H. (1994). Prevention as cumulative protection: Effects of early family support and education on chronic delinquency and its risks. Psychological Bulletin, 115, 28–54.

    PubMed  Google Scholar 

  • Yoshikawa, H., Wilson, P. A., Peterson, J. L., & Shinn, M. (in press). Multiple pathways to community-level impacts in HIV prevention: Implications for conceptualization, implementation, and evaluation of interventions. In E. J. Trickett & W. Pequegnat (Eds.) Context and culture in HIV/AIDS interventions. Ecological strategies for increasing community impact. New York: Oxford University Press.

  • Yoshikawa, H., Wilson, P. A., Hsueh, J., Rosman, E. A., Chin, J., & Kim, J. H. (2003). What front-line CBO staff can tell us about culturally anchored theories of behavior change in HIV prevention for Asian/Pacific Islanders. American Journal of Community Psychology, 32, 143–158.

    PubMed  Google Scholar 

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Miller, R.L., Shinn, M. Learning from Communities: Overcoming Difficulties in Dissemination of Prevention and Promotion Efforts. Am J Community Psychol 35, 169–183 (2005). https://doi.org/10.1007/s10464-005-3395-1

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