working smarter: the implementation journey to improve student outcomes
DESCRIPTION
Working Smarter: The implementation journey to improve student outcomes. Michelle A. Duda, Ph.D., BCBA, Dean L. Fixsen, Ph.D. & Karen A. Blase Ph.D., Melissa Van Dyke, LCSW Frank Porter Graham Child Development Institute University of North Carolina – Chapel Hill. - PowerPoint PPT PresentationTRANSCRIPT
Michelle A. Duda, Ph.D., BCBA,Dean L. Fixsen, Ph.D.
& Karen A. Blase Ph.D.,
Melissa Van Dyke, LCSWFrank Porter Graham Child Development Institute
University of North Carolina – Chapel Hill
Working Smarter: The implementation journey to
improve student outcomes
Implementation FluencyPart 2
Science to Service
SCIENCE SERVICEGAPIMPLEMENTATION
Science to Service
• Science to Service Gap What is known is not what is adopted to help
students, families, and communities
• Implementation Gap o What is adopted is not used with fidelity and good
outcomes for consumers.o What is used with fidelity is not sustained for a useful
period of time. o What is sustained is not used on a scale sufficient to
impact societal outcomes.
Making use of Science
• Letting it happeno Recipients are accountable
• Helping it happeno Recipients are accountable
• Making it happeno Implementation teams are accountable
Based on Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou, 2004
What is Implementation?
• What do we mean by implementation?
• A specified set of purposeful activities at the practice, program, and system level designed to put into place a program or intervention of known dimensions with fidelity.
In Other Words…
It’s all about changing the behavior of well intentioned people including practitioners, providers, community stakeholders, policy makers and funders!
Ineffective Methods
Excellent evidence for what does not work• Implementation by mandate does not work• Implementation by “following the money” does
not work• Implementation without changing supporting
roles and functions does not work
Paul Nutt (2002). Why Decisions Fail
Ineffective Methods
Excellent experimental evidence for what does not work• Diffusion/dissemination of information by
itself does not lead to successful implementation (research literature, mailings, promulgation of practice guidelines)
• Training alone, no matter how well done, does not lead to successful implementation
Implement Innovations
Effective NOT Effective
Effective
NOT Effective
IMPLEMENTATION
INT
ER
VE
NT
ION Student
Benefits
PLACEBO: Something of no intrinsic remedial value that is used to appease or reassure another
Placebo
What Works
Effective intervention practices
+Effective implementation practices
=
Good outcomes for consumers
Common Components of Fidelity Measures
• Adherence
• Dosage/Exposure
• Quality of Program Delivery
Fidelity Data Collection Methods
• Direct Observation
• Practitioner Self-report
• Consumer Self-report
Why are programs not implemented with fidelity?
• Lack of teacher training,• Lack of required materials• Use of some (but not all) of the required
lessons and teaching strategies l• Limited time
_____________________________• Lack of funding• Inadequate infrastructure • Decentralized decision making• Lack of administrative support
Why are programs adapted?
• Inadequate training/lack of understanding of program’s underlying theory
• Barriers (time, money, resources, accessing target population)
• Programs that are not user-friendly• Lack of perceived efficacy, relevance,
acceptanceBrian Bumbarger, Prevention Research Center
Strategies for Maintaining Fidelity
• Creating awareness around the importance of maintaining fidelity
• Improving practitioner understanding of program’s underlying theory and rationale
• Developing sustainable infrastructure and processes for monitoring implementation and fidelity
• Monitoring fidelity continually
Evidence-Based Movement
The “evidence-based movement” is an international experiment to make better use of research findings in typical service settings.The purpose is to produce greater benefits to students and society.
EBPs & Implementation
Core intervention components• Clearly described (who/what)• Practical measure of fidelity• Fully operationalized (do/say)• Field tested (recursive revision)• Contextualized (org./systems fit)• Effective (worth the effort)
EBPs & Implementation
• The usability of a program/practice has little to do with the quality or weight of the evidence regarding that programo Evidence on intervention effectiveness
for specific populations helps us choose what to implement
o Evidence on the effectiveness of the intervention does not help implement the program or practice successfully
EBPs & Implementation
• From an implementation perspective, what do we need to know about innovations such as evidence-based programs?
Successful and sustainable implementation of evidence-based programs always requires
organization and systems change.
Implementation Frameworks
In order to ensure that an EBP maintains and sustains producing benefits to students over time, it is critical to ensure that the system is both multi-dimensional and fully integrated through :
• Implementation Stages (PART 3)• Implementation Drivers (PART 4)• Improvement Cycles (PART 5)
For More Information
Dean L. Fixsen, Ph.D.• 919-966-3892• [email protected]
Michelle A. Duda, Ph.D.• 919-636-0843• [email protected]
At the Frank Porter Graham Child Development InstituteUniversity of North Carolina
Chapel Hill, NC
www.scalingup.org http://nirn.fpg.unc.edu/
http://www.fpg.unc.edu/~nirn/resources/publications/Monograph/
For More Information
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005). Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).Download all or part of the monograph at:http://www.fpg.unc.edu/~nirn/resources/publications/Monograph/ To order the monograph go to:https://fmhi.pro-copy.com/