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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.

SPF in Hawai‘i: Implementation

The SPF-SIG project funded a total of 17 evidence-based prevention programs in the state of Hawai‘i. These included activities which targeted individual-level change by using programs intended to increase the prevention knowledge and skills of teens (prevention education programs). Altogether the prevention education programs reached 10,048 youth participants statewide. Each county also implemented what are known as environmental strategies. These prevention programs target community-level change such as advocating for changes in public policy and increasing community awareness around issues of substance abuse.

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

May 2020

May 06 Wed
ADAD Zoom Training: Advanced Ethics

The purpose of the session is to gain an understanding of ethical guidelines in an advanced setting. Participants will be better equipped to resolve ethical dilemmas in Substance abuse and Mental Health field. This will be beneficial for those that have already completed Ethic's the Basic.

Location

Zoom

May 14 Thu
Tri-Isle Prevention Network: Virtually Managing Staff And Running Programs

This training is for nonprofits in Maui County who are looking for ways to manage staff and run programs in a virtual environment.

Location

Zoom

May 15 Fri
ADAD Zoom Training: What You Need To Know About Kratom
  • Learn the history of kratom
  • Understand the use of kratom and the effects on the body
  • Understand the difference between kratom and kava
  • Explore kratom's rising popularity in the US
  • Understand the current kratom debate over whether the drug is a healthy alternative to opioid misuse
  • Discuss how to assess this emerging drug trend within your work
Location

Zoom

May 21 Thu
Steps to Becoming a Certified Prevention Specialist

This webinar will explain the value of the Certified Prevention Specialist and the steps to become certified.

Location

Zoom

May 21 Thu
ADAD Zoom Training: HIV, Hepatitis, STI 101 & Substance Use Counseling

Participants will be able to:
1. Describe the transmission routes and prevention methods for viral hepatitis, HIV, and STDs.
2. List components of an effective risk assessment for sexually transmitted and other communicable disease.
3. Demonstrate risk reduction counseling techniques for people living with and at-risk for viral hepatitis, HIV, and STDs.

Location

Zoom

May 26 Tue
ADAD Zoom Training: Opioid Overdose Prevention And Response

Overdose is the leading cause of accidental death in Hawaii and around the U.S.  This interactive session will explore the impact of opioids on the body and identify the risks for accidental opioid overdose. Participants will be certified to administer Naloxone, the opioid antagonist.

Location

Zoom

May 27 Wed
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

May 28 Thu
Environmental Prevention 101: How Environments Impact Behaviors

This training will provide an overview of environmental substance misuse prevention and how it shapes substance use behaviors.

Location

Zoom