Search results

On 20 April 1999, at Columbine High School in Colorado, two students, Eric Harris (aged 18) and Dylan Klebold (17), embarked on a massacre, killing 12 students and one teacher. The pair then committed suicide. The event provoked vigorous debate around topics such as the gun culture, bullying, violent video games, goth culture and teenage use of the internet and anti‐depressants. In nearby Boulder is the Center for the Study and Prevention of Violence, part of the University of Colorado. Del Elliott, a world‐renowned criminologist and sociologist, has been director there since 1993. Columbine was the catalyst for Del and a team of researchers, policy‐makers and practitioners to develop the Blueprints for Violence Prevention database of evidence‐based programmes. On 2 July 2009, Del gave the annual Social Research Unit, Dartington, lecture at the Commonwealth Club in London. This article is based on his talk.

The aims of this study were to determine (1) the degree to which an evidence‐based intervention (EBI) delivered outside the context of a research trial remained faithful to the content and design of the programme as intended and as reported in experimental trials of the same programme, and (2) whether implementation quality affected programme outcomes. We report results of an observational study of 11 sites involved in the statewide dissemination of a popular family‐focused prevention programme, the Strengthening Families Programme for Parents and Youth 10‐14. We found numerous differences between the community‐based implementations we observed and researcher‐driven implementations of the same programme, but variability in programme delivery and adherence to content were unrelated to programme outcomes. We conclude that short‐term outcomes of well‐designed EBIs delivered by well‐trained facilitators may be robust to minor changes in delivery and content. However, the effects of implementation quality on longer‐term outcomes are unknown.

The purpose of this paper is to synthesize the effects of gang prevention programs on gang membership.

The authors conducted a systematic literature review across 19 bibliographic databases and a meta-analysis of the effectiveness of these strategies.

The database search resulted in 3,850 hits. Of the 162 studies that were screened in full, six involved a prevention program with outcomes commensurate for meta-analysis. Pooled log odds ratios indicate a significant, positive effect of gang prevention programs at reducing gang membership; however, sensitivity analysis demonstrates that the results are driven by the effects of a single study.

Despite the small sample size, the current study presents the best available evidence regarding the effectiveness of gang membership prevention programs. There is a critical need in the field of gang control for rigorous evaluation of prevention strategies.

The purpose of this paper is twofold: first, to identify the types of adaptations made by service providers (i.e. practitioners) during a large-scale US statewide implementation of SafeCare®, an evidence-based intervention to reduce child neglect; and second, to place adaptations within a taxonomy of types of adaptations.

Semi-structured interviews and focus groups were conducted with 138 SafeCare providers and supervisors. Grounded theory methods were used to identify themes, specific types of adaptations and factors associated with adaptation.

Adaptations were made to both peripheral and core elements of the evidence-based practice (EBP). The taxonomy of adaptations included two broad categories of process and content. Process adaptations included presentation of materials, dosage/intensity of sessions, order of presentation, addressing urgent concerns before focusing on the EBP and supplementing information to model materials. Content adaptations included excluding parts of the EBP and overemphasizing certain aspects of the EBP. Adaptations were motivated by client factors such as the age of the target child, provider factors such as a providers’ level of self-efficacy with the EBP and concerns over client/provider rapport. Client factors were paramount in motivating adaptations of all kinds.

The present findings highlight the need to examine ways in which adaptations affect EBP implementation and sustainment, client engagement in treatment, and client outcomes.

Implementers and EBP developers and trainers should build flexibility into their models while safeguarding core intervention elements that drive positive client outcomes.

This study is unique in examining and enumerating both process and content types of adaptations in a large-scale child neglect implementation study. In addition, such adaptations may be generalizable to other types of EBPs.

Over the past 30 years, researchers have documented effective, theory‐based programmes and practices that improve the health and well‐being of children. In order to produce measurable improvements in public health, such practices must be institutionalised; however, there are a number of barriers to translating what we know from science to what we do in practice. In the present article, we discuss a number of those barriers, including: cultural differences between those who espouse a public health, prevention science approach versus those who espouse a strengths‐building, health promotion approach; practical difficulties in documenting the evidence base for existing or newly developed programmes and practices; and inflexibility of standardised programmes and resulting insensitivity to local contexts. We discuss common ground between prevention and promotion perspectives and highlight emerging methods that facilitate the adoption of science‐based practice into community‐based services.

This study aims to examine the extent to which “What Works” reviews in youth justice enable understanding of the features of effectiveness (what works, for whom, in what circumstances and why?) specified in the Effects–Mechanisms–Moderators–Implementation–Economic cost (EMMIE) framework.

The EMMIE framework examined findings within a sample of “What Works” style reviews of preventative youth justice intervention effectiveness.

“What Works” style reviews of evaluations of preventative youth justice interventions often omit the requisite details required to examine all of the necessary elements of effectiveness contained within the EMMIE framework. While effectiveness measures were typically provided, the dominant evaluation evidence-base struggles to consider moderators of effect, mechanisms of change, implementation differences and cost-effectiveness. Therefore, “What Works” samples cannot facilitate sufficient understanding of “what works for whom, in what circumstances and why?”. The authors argue that Realist Synthesis can fill this gap and shed light on the contexts that shape the mechanisms through which youth justice interventions work.

The authors extended the approach adopted by an earlier review of effectiveness reviews (Tompson et al., 2020), considering more recent reviews of the effectiveness of preventative interventions using the EMMIE framework. Unlike previous reviews, the authors prioritised the utility of the EMMIE framework for assessing the factors affecting the effectiveness of preventative interventions in youth justice.

As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based falls prevention programmes demonstrate efficacy in reducing the rate and risk of falls among older adults, but their use in Irish occupational therapy practice is unknown. This study aims to investigate the implementation of falls prevention programmes by occupational therapists working with older adults in Ireland.

A cross-sectional survey was used to gather data on the use of falls prevention programmes among occupational therapists working with older adults in any clinical setting across Ireland. Purposeful, convenience and snowball sampling methods were used. The Association of Occupational Therapists of Ireland acted as a gatekeeper. Descriptive statistics and summative content analysis were used to analyse quantitative and qualitative data, respectively.

In all, 85 survey responses were analysed. Over 85 per cent of respondents reported “Never” using any of the evidence-based falls prevention programmes. The “OTAGO” Exercise Programme was the most “Frequently” used programme (9.5 per cent, n = 7); 29 respondents reported using “in-department” developed falls prevention programmes and 14 provided additional comments regarding current falls prevention practices in Ireland.

In the absence of Irish data on the subject, this study provides a benchmark to describe the use of evidence-based falls programmes by Irish occupational therapists with older adults.

Demonstrating the efficacy and effectiveness of prevention programmes in rigorous randomised trials is only the beginning of a process that may lead to better public health outcomes. Although a growing number of programmes have been shown to be effective at reducing drug use and delinquency among young people under carefully controlled conditions, we are now faced with a new set of obstacles. First, these evidence‐based programmes are still under‐utilised compared to prevention strategies with no empirical support. Second, when effective programmes are used the evidence suggests they are not being implemented with quality and fidelity. Third, effective programmes are often initiated with short‐term grant funding, creating a challenge for sustainability beyond seed funding. We discuss each of these challenges, and present lessons learned from a large‐scale dissemination effort involving over 140 evidence‐based programme replications in one state in the US.

Health is inextricably linked to the productivity and therefore the economic viability of individuals, populations and nations. A global strategy for health enhancement would yield a multitude of benefits for humankind. The root cause of the escalating healthcare cost crisis is driven by a health crisis from a growing burden of health risks that are leading to an expanding burden of chronic illness yielding an unsustainable economic burden. This paper aims to present a general review of the business value of health and the power of prevention in addressing solutions for managing total health and productivity costs.

The paper reviews the scientific and economic business case for investing in health enhancement.

Highlights of employer case studies and published research demonstrate that comprehensive, integrated population health enhancement can lower health risks, reduce the burden of illness, improve productivity and lower total health‐related costs. The dominant components of the solution are a substantial commitment to prevention and a culture of health rather than just more treatment and cure. In addition there needs to be a focus on the quality and effectiveness of care rather than just the quantity and efficiency of the care.

The healthcare cost conundrum can be impacted by reducing the burden of chronic illness and health risk in populations, thereby improving the health and productivity of the workforce, the health of the bottom line for engaged employers and ultimately the health of a nation's economy. Ultimately, the broader value proposition of integrated population health and productivity enhancement should drive this strategy by leveraging the value of health and the power of prevention.

The demand for evidence‐based health practices has created a cultural challenge for Indigenous people around the world. This paper reports on the history and evolution of evidence‐based care into its mainstream status within the behavioural health field. Through the leadership of an Alaska Native tribal organisation, an international forum was convened to address the challenges of evidence‐based practice for Indigenous people. Forum participants developed a model for gathering evidence that integrates rigorous research with Indigenous knowledge and values. The model facilitates development of practices and programmes that are culturally congruent for Indigenous people, accepted and validated by the research community, and deemed supportable by private and governmental sponsors.