A school superintendent faces a host of common challenges in the 22 schools she oversees, including bullying, teen pregnancy, childhood obesity and childhood depression. While she’s heard that evidence-based programs can help to thwart these problems, she has no idea how to find programs that best fit her district’s needs and budget, much less how to implement them with quality and make them last.
That’s where University of South Carolina community psychologist Abe Wandersman, PhD, comes in. He and colleagues at the Centers for Disease Control and Prevention developed the Interactive Systems Framework for Dissemination and Implementation (ISF), an implementation and dissemination model that attempts to address and solve the practical and often complex issues faced by people who want to adopt prevention and treatment program interventions — as well as the people who study, fund, support and implement them.
The framework does this by proactively addressing the many implementation barriers that program deliverers may face and by building in details that address these potential snafus in systematic ways.
“It includes all the components and steps that program deliverers need to reach a good outcome,” Wandersman says. It’s also designed so that funders, practitioners and researchers can provide essential input to promote high-quality implementation: The school superintendent, for instance, may educate researchers and trainers on how the schools in her district differ, so they can tailor programs accordingly.
The ISF model has three parts:
A system to improve synthesis and translation. The framework recommends that researchers make concerted efforts to synthesize and present the research literature in ways practitioners can easily use. These might include listing programs with the best evidence base, summarizing program features that can help practitioners make informed decisions, and providing steps for putting an intervention into place via user-friendly books, websites or manuals, for example.
A system to improve the science and practice of support for practitioners, including the improvement of training, coaching and technical assistance. Compared with other aspects of translational and implementation research, this area is sparsely researched — a void Wandersman’s team is helping to fill by conducting literature reviews on what is most effective in each area and highlighting research that still needs to be done.
A system to improve the science and practice of program delivery, maintenance and improvement. To achieve this, the model recognizes that program-delivery settings need both sufficient general capacity — strong leadership, resources and partnerships, for example — as well as the specific capacity to implement the intervention with quality. That means helping sites to garner the particular resources, staff, support or infrastructure they need to make the intervention work on a practical level.
Of particular interest to Wandersman is the middle system: supportive activities like coaching that can build a delivery system’s general and specific capacity. This area has been little studied, yet is vital to whether or not people adopt and sustain a program with quality, he says. Program staff may receive expensive training, for instance, but if there’s no individualized follow-up, they may forget the material or implement the program in ineffective ways.
“You can’t satisfy everyone’s needs in four or eight hours of group training because each person enters with a different initial level of skill and motivation, and has a different job to do when they leave the training,” he says. Wandersman believes that continuing education, whether in professional psychology or in other professions, needs to include such components in order to have lasting impact.
The ISF model was introduced in a 2008 special issue of the American Journal of Community Psychology (Vol. 41, No. 3/4). Since then, it’s been shared at major conferences worldwide. It’s being used in a five-year CDC-funded cooperative agreement project on teen pregnancy called Promoting Science-Based Approaches to Teen Pregnancy Prevention. Results show it is helping to promote the capacity of delivery systems to use science-based approaches.
The framework also will be the focus of another special issue of AJCP in 2011, which will include articles that broaden and deepen the framework, in part by examining how it might apply to other areas such as mental health treatment and emergency preparedness.
While the framework is part of Wandersman’s long-held passion to bridge the divide between research and practice, it is more than that, he adds.
“The goal is to get better outcomes in schools, youth development programs and other settings that deliver interventions,” he says. “We want to make a difference in people’s lives, whether through treatment, prevention or education.”
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