What does it take? How federal initiatives can support the implementation of evidence-based programs to improve outcomes for adolescents

J Adolesc Health. 2014 Mar;54(3 Suppl):S92-6. doi: 10.1016/j.jadohealth.2013.11.025.

Abstract

Over the last 20 years, there has been a growing emphasis on developing and identifying evidence-based programs and practices for children and families and within the last decade an increasing number of federally funded initiatives have been dedicated to replicating and scaling evidence-based programs with the hope of achieving socially meaningful impact. However, only recently have efforts to promote high-fidelity implementation been given the attention needed to ensure evidence-based practices are used as intended and generate the outcomes they were designed to produce. In this article, we propose that the wide-scale implementation of evidence-based practices requires: (1) careful assessment and selection of the "what"; (2) a stage-based approach that provides adequate time and resources for planning and installation activities; (3) the co-creation of a visible infrastructure by a triad of key stakeholders including funders and policymakers, program developers, and implementing sites; and (4) the use of data to guide decision-making and foster curiosity into continuous improvement among grantees. Each of these strategies is explored in greater detail through the lens of the Teen Pregnancy Prevention (TPP) Program, a $100 million initiative overseen by the Office of Adolescent Health (OAH) in the U.S. Department of Health and Human Services.

Keywords: Data-guided decision-making; Evidence-based practice; Implementation science; Implementation stages; Infrastructure.

MeSH terms

  • Adolescent
  • Adolescent Health Services / economics
  • Adolescent Health Services / organization & administration*
  • Adolescent Health Services / standards
  • Evidence-Based Practice*
  • Female
  • Financing, Government
  • Health Plan Implementation / economics
  • Health Plan Implementation / methods
  • Health Plan Implementation / organization & administration*
  • Humans
  • Pregnancy
  • Pregnancy in Adolescence / prevention & control*
  • Program Evaluation
  • United States