This section is intended as a companion
to the best and promising practices
database. It provides information and
resources to support appropriate and
effective implementation of evidence based
practices.
Why consider adopting
an evidence-based practice?
Program participants deserve the most
effective services possible. Many of the
service strategies in use today, were
developed at a time when there wasn’t any
better information than practice wisdom and
theory. A clearly articulated theory for how
a program will promote good results is a
step in the right direction.
In most areas of service, there is new
information that tells us what is most
likely to help people meet their goals and
improve their lives and we have an ethical
imperative to use that knowledge to improve
services.
When is the right
time to adopt an evidence-based practice?
In order to change your services to adopt
a research based model or evidence-based
practice, several considerations are
important:
Make sure you have clear,
outcome-oriented goals for the your program.
Understand the level of evidence for what
works to achieve similar goals, and how
adopting an evidence based practice will
improve your program results.
Understand the research available on use
of the practice or practices with your
population. If the model you are considering
for adoption has not been researched with
your population, consider whether the theory
and methods are transferable to your
population, and what adaptations might be
necessary. You might need to discuss
adaptations with experts on the practice.
Be sure the conditions for successful
adoption of a new practice exist in your
program.
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What conditions are
necessary for successful adoption of a
research-based model?
The first necessary condition is a
commitment at all levels of the organization
to making the change. Adopting a new
practice or model of service will likely
mean at least some level of change for
everyone. Support from leadership is
important to ensuring adequate resources,
financial management, data management, and
other administrative support. Direct service
providers must be amenable to the change and
must have the appropriate skills and
abilities to implement the new practice.
External support from the larger service
systems or community are important to
successful implementation of many evidence
based practices.
The second necessary condition is access
to adequate resources to support full
implementation. Nearly all proven practices
have been attempted in organizations without
the resources or commitment to implement all
aspects of the practice as it was evaluated
and demonstrated to be effective.
In most cases, positive results could not
be replicated in low-fidelity
implementations, and time, energy, resources
were wasted. In some cases, poor
implementation of an evidence based model
had a negative effect. So if it can’t be
done right, it is probably better to put
that energy for change into developing
better resources for later implementation
and/or improving existing programs in other
ways[1].
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How can you go about
adopting a new practice to make sure it is
successful?
Information gathering: first be clear on
what your program goals are, what it is
doing now, and who is being served. Then
learn all you can about what research says
is most effective within your context.
When you have a new model of services or
best practice that looks like it would be
beneficial, work to engage your organization
in commitment to change.
Planning: What will it take to
implement the new model with fidelity?
Identify the necessary resources and get the
staffing, supervision, data management,
financial management, and logistical support
in place.
Implementation: The process of
implementing evidence based practices has
been researched, and best practices have
been identified for successful
implementation:
Staff selection: Staff must have
the appropriate knowledge and skills as well
as a philosophical framework consistent with
the practice being adopted.
Existing staff members who are resistant
to change or committed to a treatment
modality or theory that is not consistent
with the new practice will not get good
results with the new practices.
Staff Training: Staff who will
implement the practice must receive
comprehensive, quality training in how to do
it with fidelity. Training must be of
adequate duration and must include actual
rehearsal of new skills.
Coaching, supervision and monitoring:
Supervision and coaching specifically
focused on maintaining fidelity to the model
has been shown to be essential in successful
implementation of many proven practices.
Monitoring of adherence to the standards for
the model should be ongoing.
Community/Systems-level
resources/partnerships: Most evidence
based practices require interaction,
coordination or collaboration with other
service providers, family members or
community. Part of the implementation is
developing relationships and systems to
support necessary partnerships for success.
Evaluation: Both outcome and
process evaluation have been shown to be an
important component of successful
implementation. It is important to begin at
initial implementation to measure the
activities, intensity and nature of
services, to monitor fidelity to the model,
and to measure outcomes to provide ongoing
quality assurance.
Outcomes should be compared to research
on the model to identify fidelity problems,
population or contextual issues requiring
adaptation and to contribute to knowledge in
the field[2].
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What if there is no
researched-base practice to meet the needs
of my participants or conditions
are not right for adopting a new model?
You can still try to use what knowledge
is available to ensure that your services
are as effective as possible.
Read more about general best practices
that will help
Resources
| TITLE |
LINK |
|
King County
Guidebook to Elements of Successful Programs |
http://www.metrokc.gov/dchs/csd/Youth&Family/Elements/Guidebook.pdf |
|
Program
Assessment and Improvement Plan |
http://www.metrokc.gov/dchs/csd/Youth&Family/Elements/Assessment-Improvement.pdf |
|
Child Trends |
www.childtrends.org |
| |
|
| |
|
Footnotes
[1]Child Trends, Research to Results Brief #2007-29.
Downloaded 4/08 from www.childtrends.org
[2]Child Trends (2007) Implementing Evidence-Based Practices;
Six “Drivers” of Success.
Ashley, N (2005) Guidebook to Elements of Successful Programs To
Reduce Juvenile Justice Recidivism,
Delinquency and Violence. King County
community Services Division, Seattle, WA.
Fixsen, DL, Naoom, SF, Blase, KA,
Friedman, RM & Wallace, F (2005) Impelementation Research: A Synthesis
of the Liturature. The National Implementation Research Network,
University of South Florida. Downloaded on 5/28/08 from
http://nirn.fmhi.usf.edu/resources/publications/Monograph/pdf/Monograph_full.pdf.
Further Reading
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