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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

March 2021

Mar 05 Fri
ADAD Zoom Training: Substance Abuse and Suicide Prevention

The outbreak of COVID-19 is stressful - it can be difficult to cope with fear and anxiety, changing daily routines and a general sense of uncertainty. Our communities are struggling with economic, financial, and mental stressors. During these uncertain times, drinking and drug use tend to rise and those who abuse alcohol and/or other drugs, are particularly vulnerable to high risk events. The purpose of this training is to bring additional awareness and resources to assist when our communities are stressed.  The content will also include helpful tools and resources that offer substance abuse and suicide prevention assistance for our community. 

Location

Zoom

Mar 12 Fri
ADAD Zoom Training: Client Centered Therapy

This training will provide an overview of Carl Roger’s Client-Centered Therapy (aka Person-Centered Therapy). Objectives will include:

·       Introduce Client-Centered Therapy/Approach
·       Review key terms/techniques by Carl Rogers (including unconditional positive regard)
·       Being where the client is at – present focused approaches
·       How to achieve congruence in therapy
·       The Gentle Push – how to make progress with clients in therapy
·       Activities to promote change in therapy

Location

Zoom

Mar 16 Tue
ADAD Zoom Training: LGB&T Cultural Humility

This SAMHSA training was developed to provide practitioners and administrators familiarity and knowledge about the interaction between LGBT issues and substance use disorders. The curriculum offers skill-building knowledge enhancing practical abilities to offer sensitive, affirmative, culturally relevant, and effective treatment to LGBT individuals in substance use disorders treatment.

Location

Zoom