In recent years, researchers have developed numerous empirically supported interventions to assist individuals with mental health issues, intellectual and developmental disabilities, and substance use disorders, family members, and caregivers. Even though many of these interventions have demonstrated improved outcomes, few have been adopted and widely implemented due to challenges related to training, supervision, fidelity to the model, and cost. Yet, the need for scaling up evidence-based practices (EBPs) in public service systems remains a priority of the North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services.
Last month, Lauren Supplee, Ph.D., Director, Division of Family Strengthening, Office of Planning Research and Evaluation, Administration for Children and Families, gave a keynote speech, The House that Evidence-Based Practice Built: Moving from Program Development to Real World Outcomes, for the Institute of Medicine. She suggested reasons why wide-scale implementation continues to be elusive:
• Most evidence still comes from small-scale tightly controlled efficacy trials with limited external validity.
• Little evidence has been provided on replication (or what replication means).
• Little empirical knowledge has been provided on the core components.
• Researchers have provided little evidence on why and how impacts vary by specific population groups, settings, and other variables.
Dr. Supplee embraced the need to build the infrastructure at both the local and state levels to support dissemination where interventions would be tested and result in a menu of evidence-based, high-demand, practice-ready interventions. She also felt that meaningful collaborations need to be developed and sustained between the practice community and the developers/researchers so that program design and efficacy would be improved. To view her presentation, click here. The accompanying slides may be downloaded here.
Articles of Interest
• Chamberlain P, Roberts R, Jones H, Marsenich L, Sosna T, Price JM. Three collaborative models for scaling up evidence-based practices. Adm Policy Ment Health, 2011
• Nadeem E, Gleacher A, Pimentel S, Campbell Hill L, McHugh M, Hoagwood KE. The role of consultation calls for clinic supervisors in supporting large-scale dissemination of evidence-based treatments for children. Adm Policy Ment Health, 2013;40:530-40
• Poduska J, Kellam S, Brown CH, Ford C, Windham A, Keegan N, Wang W. Study protocol for a group randomized controlled trial of a classroom-based intervention aimed at preventing early risk factors for drug abuse: Integrating effectiveness and implementation research. Implementation Science, 2009