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Studying diffusion of a model indicated prevention program in a multi-site effectiveness trial

Shereen Khatapoush, PhD1, Samruddhi Thaker, MBBS, MHA2, Denise Hallfors, PhD1, Victoria Sanchez, DrPH1, and Allan Steckler, DrPH3. (1) Prevention Research Center, Pacific Institute for Research and Evaluation, 1995 University Avenue, Suite 450, Berkeley, CA 94704, 510-883-5721, shereen_khatapoush@yahoo.com, (2) Health Policy and Administration, University of North Carolina at Chapel Hill, 725 Airport Road, CB 7590, Sheps Center for Health Services Research, Chapel Hill, NC 27599-7590, (3) Health Behavior and Health Education, University of North Carolina, CB# 7400, 302 Rosenau Hall, School of Public Health, Chapel Hill, NC 27599-7400

Background: Tremendous resources have been devoted to the development and testing of preventive interventions, but relatively little to either effectiveness trials or diffusion studies; yet, both are critical to understanding the gap between research and practice. The present study is an effectiveness trial of Reconnecting Youth (RY) in two school districts. The study consists of a randomized control trial (RCT) and a diffusion study. We describe the design of the diffusion study and mid-project findings, including plans for institutionalization. Methods: The diffusion study includes quantitative self administered questionnaires, followed by qualitative interviews of district- and school-level ATOD and administrative staff, and RY teachers at one-year intervals. Present analyses are based on two data points for each district, assessing variables including: school climate and culture, organizational capacity, organizational turbulence and staff turnover; training, administrative leadership, presence of a program champion, communication and perceived innovation of the program. Results: A total of 10 schools (5 in each district) participated in the RCT. Expected determinants of adoption and diffusion included perceived program effectiveness and organizational capacity, including funding and staffing, at both district and school levels. Discussion: Schools face many barriers that impede diffusion of this complex model program. Primary among these barriers are lack of adequate resources, deep budget cuts, organizational turbulence and staff turnover. Schools in both districts had difficulty implementing the program during the RCT, when study funds and additional resources were available. Without a strong program champion, even positive outcome findings may not be enough to institutionalize the program.

Learning Objectives:

Keywords: School-Based Programs, Research

Related Web page: www.ryevaluation.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: These abstracts are part of an independent effectiveness study (including both a RCT and diffusion component) of the Reconnecting Youth program, developed by Eggert and colleagues at the University of Washington.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Alcohol and Health: The Good and Bad News Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA