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Implementation

"The SPF Process" by Center on the Family. All rights reserved.

Implementation

After a community has carefully chosen and planned their prevention strategy, it is then time to implement the prevention program or programs. Implementation is the next step in the SPF process. At this stage it is important to think about the prevention program’s ‘active ingredients,’ or its goals, objectives, timeline, and protocols. It is likely that a program will need to be adapted to fit local conditions so as to be a good match for the cultural norms, values, and beliefs of a community. If an intervention is not seen as relevant to the target population, it is not likely to be effective. However, communities and organizations should be thoughtful and purposeful about the changes they make to their prevention programs. When making cultural adaptations to a program, changes need to be recorded and should not alter the features of the program that are thought to be the key ingredients for change.

When implementing culturally appropriate programs, service providers and planners often have to strike a balance between fidelity to the original program design and cultural adaption.

  • Adaptation: Any change a prevention program undergoes in order to meet specific needs. Two types of adaptation include changes to program:
  • Content: Making changes or additions to program manuals, tasks, and tools so that the content is more relevant to the target population. In order to be effective these changes should reflect the use of both culturally relevant names, terms, and examples (surface structure) and culturally relevant concepts, themes, and issues (deep structure).
  • Delivery: Making changes to the way programs are carried out (e.g., online vs. in the classroom)
  • Fidelity: The degree that an implemented prevention program stays ‘true’ to what its designers intended. Fidelity can be described along 4 dimensions:
  • Adherence: How much did your program stick to the original design? It is not always possible or even desirable (in the case of cultural adaptations) to administer a program exactly as designed. However, it is important to note any deviations from the design to see if these have impacted your outcomes in some way.
  • Dose: How much of the program did your target population receive? This refers to the number of classes or meetings participants actually attended, as well as the length and intensity of the program activities. It is important to keep track of the dose because it is quite possible that participants who attended more activities will show more change than those who left the program early.
  • Quality of delivery: In the end, how high was the quality of your program delivery? This refers to the level of staffing and training as well as the resources deployed during program activities. It is possible to follow a program manual precisely but without a focus on the quality of the delivery. This is often the result of poor planning, inadequate training, or lack of enthusiasm on the part of program staff.
  • Participant responsiveness: How did your target population respond to the program? A successful prevention program is not only well implemented with a high-level of quality, but it is also relevant to your participants. If your program is not meaningful and useful to your target audience, than even high-quality implementation will result in disappointing outcomes. Therefore, measuring the level of participant engagement is critical to understanding whether a program is effective.

Tools

 

References

Castro, F., Barrera, M., and Martinez, C. (2004). The cultural adaptation of prevention interventions: resolving tension between fidelity and fit. Prevention Science, 5(1), 41-45.
Dusenbury, L., Brannigan, R., Falco, M., and Hansen, W. (2003). A review of research on fidelity of implementation: implications for drug abuse prevention in school settings. Health Education Research Theory & Practice, 18(2), 237-256. 
Moncher, F., and Prinz, R. (1991). Treatment fidelity in outcome studies. Clinical Psychology Review, 11, 247-266.
SAMHSA. (2015, October 1). Step 4: Implement. Retrieved from http://www.samhsa.gov/capt/applying-strategic-prevention-framework/step4-implement

September 2020

Sep 10 Thu
Maui Opioid Series Part 1: The History of the Opioid Epidemic

This virtual training, "The History of the Opioid Epidemic," is part one of a four-part opioid series. This training will inform participants on the opioid timeline in the US and discuss events that led to the "perfect storm" that created the opioid epidemic. The training will present the burden of opioid use in the wider US, and will also present local data on opioid use in Hawai‘i.

Location

Zoom

Sep 16 Wed
Maui Opioid Series Part 2: Opioid Overdose Prevention & Response

This FREE virtual training, "Taking Action on Opioids," is part two of a four-part opioid training series.
This training will focus on ways communities can take action to address the opioid crisis. The training will discuss ways communities can collaborate across sectors to prevent and reduce the harmful consequences of opioid misuse in the community. The training will also discuss effective strategies to address the problem, and local networks and resources already available.

Location

Zoom

Sep 17 Thu
Maui Opioid Series Part 3: Taking Action on Opioids

This FREE virtual training, "Taking Action on Opioids," is part two of a four-part opioid training series.
This training will focus on ways communities can take action to address the opioid crisis. The training will discuss ways communities can collaborate across sectors to prevent and reduce the harmful consequences of opioid misuse in the community. The training will also discuss effective strategies to address the problem, and local networks and resources already available.

Location

Zoom

Sep 24 Thu
Maui Opioid Series Part 4: Non-Opioid Alternatives to Pain Management

This FREE virtual training, "Non-Opioid Alternatives to Pain Management" is part four of a four-part opioid training series.
This training will explore the various evidence-based non-opioid alternatives to pain management recommended by the Centers for Disease Control and Prevention (CDC). Most of the training will focus on non-pharmacological options for that have evidence to support their effectiveness at helping individuals manage pain. Participants will learn about the risks associated with the use of opioids for pain and identify alternative treatments supported by the CDC.

Location

Zoom