The Evidence-based Prevention & Intervention Support Center:
A State-Level Support System for High Quality Implementation & Sustainability of Evidence-based Programs
Brittany Rhoades & Brian Bumbarger
The Pennsylvania State University
Background & Mission
A Conceptual Model
• Significant advances in the science of prevention and the identification of
empirically-supported interventions
The EPISCenter’s conceptual model builds on Wandersman’s Interactive System’s Framework,
which outlines the people, organizations, & contexts needed to move science to practice.
• Funders and policy makers promoting the use of evidence-based programs
(EBPs)
• Few EBPs have been “scaled up” in a way that is likely to achieve populationlevel public health impact
• Key barriers include implementation quality & fidelity, sustainability, data
collection and management, and overall infrastructure for training and
technical assistance
Systems in the Interactive System’s Framework:
1) The Prevention Delivery System: responsible for ultimately providing prevention services to
consumers
2) The Prevention Support System: provides support to and connects the systems to facilitate and
support knowledge transfer among the systems
3) The Prevention Synthesis and Translation System: responsible for developing and synthesizing
basic prevention science knowledge into interventions, and conducting and disseminating
translational research
The EPISCenter’s mission is to: promote the wide-scale adoption of evidencebased prevention and intervention programs; support their high-quality
implementation and long-term sustainability; facilitate learning communities
among EBP practitioners; and conduct translational research to advance the field.
Resource Center Steering Committee
(Policy Makers & Funders)
Increased Capacity to
Address Key Barriers
EBP Grantees & Community Coalitions
(Prevention Delivery System)
Prevention Policy & Practice in PA
• These CTC coalitions created a
local infrastructure for organizing
prevention within a county or
community – creating fertile ground
for the implementation of EBPs.
Wide-Scale
Dissemination of
EBPs
Technical Assistance
The Communities that Care Process
Form local coalition
of key stakeholders
Re-assess risk
and protective
factors
Collect local data
on risk and
protective factors
Leads to community
synergy and
focused resource allocation
Translational
Research
Build general prevention capacity among
practitioners and policy makers
EPISCenter
(Prevention Support System)
High Quality
Implementation of
EBPs
Improved
Public Health
Impact from
EBPs
Long-term
Sustainability of
EBPs
Use data to
identify
priorities
Select and implement
evidence-based program that
targets those factors
Continuous Quality
Improvement
• The PA Commission on Crime and
Delinquency (PCCD) began a
statewide effort in 1994 to support
the development of Communities
That Care (CTC) prevention
coalitions.
Translational Research
Penn State’s
Prevention Research Center
Using an annual survey of EBP implementers we have
explored several areas related to implementation
quality and sustainability.
Research Question
Sample
Results
Dariotis et al. (2008):
What characteristics
(rated as a barrier or
asset to
implementation)
distinguished low and
high fidelity
implementations?
N = 32
programs
-Programs with more assets (positive characteristics of the
implementer, the implementation organization, the program,
the recipient and the community) reported higher fidelity,
while programs with fewer of these assets reported more
changes to the program.
-Program-specific predictors also emerged: For example, for
community programs, insufficient time for the program, and
problems with participant recruitment and sustainability were
related to lower fidelity and community context support was
related to higher fidelity.
Tibbits et al. (2010):
What characteristics/
factors predict if a
program sustains
functioning two years
or more beyond initial
seed funding?
N = 60,
two years
beyond
seed
funding
-Implementers were able to accurately predict whether they
would sustain their program several years in advance
-Significant correlates of achieving sustainability included
program staff characteristics and support, school and
community support, school administrator support, and
training/technical assistance
Rhoades et al. (in
preparation): What
characteristics/factors
predict if a program
sustains functioning
two years or more
beyond initial seed
funding? Do these vary
by program-type?
N = 73, two
years
beyond
seed
funding
-Regardless of program type, the characteristics found to be
universally important for sustainability include community
coalition functioning, implementers’ knowledge of the
program’s logical model, ongoing communication with
trainer, sustainability planning, and communication to key
external stakeholders.
-Program-specific predictors of sustainability were also found:
For example, for community/mentoring programs, connection
to a well-functioning coalition was particularly important.
Moore et al. (in
preparation): What type
of adaptations do
programs make and
why do they make
these changes?
N = 94
programs,
154
instances
of
adaptation
-The most commonly cited adaptations were to procedures,
dosage, and content.
-The most commonly reported reasons for making
adaptations were lack of time, difficulty retaining participants,
difficulty recruiting participants, and limited resources.
-Program-type differences emerged as well: For example,
school-based programs reported making more changes to the
dosage, content, and procedures; they cited lack of time as
the main reason for these changes
-Qualitative data: majority of changes were negative; reaction
to logistic barriers
Capacity Building
(Prevention Synthesis & Translation System)
• Through this effort, communities
identified prevention priorities and
selected from a menu of EBPs to
address those priorities.
• This initiative has led to nearly 200
replications of a variety of EBPs.
EBPs Initiated through PCCD: 1998-2008
• The EPISCenter was created in 2008
to provide support and technical
assistance to each of these
programs, and use the initiative as a
test-bed for translational research.
• The EPISCenter provides a link to the PSTS and a bridge between the PDS and the policy and
funding macro-system.
• EPISCenter’s three key functions: 1) Build general prevention capacity, 2) Build program-specific
capacity, 3) Facilitate interaction/communication across systems.
• Recognizes the policy and funding macro-system as a key, active partner in these processes.
The EPISCenter is uniquely positioned to translate prevention research, which informs the
technical assistance provided to the Prevention Delivery System and funders/policy-makers,
thus constantly improving the state’s initiative.
Based on the above research, we have implemented strategies
to increase capacity to address key barriers to high quality,
sustained implementations of EBPs:
• Regulatory Requirements: involvement with collaborative
board, outcomes reports to key stakeholders, Quality
Assurance process
• General Proactive TA: regular one-on-one site consultations,
site-specific implementation plans
• Program-specific Proactive TA: TA providers specialize in
specific programs, program-specific networking meetings and
resources
The EPISCenter is a project of the Prevention Research Center, College of Health and Human Development, Penn State University, and is funded by the Pennsylvania Commission on Crime and Delinquency and the
Pennsylvania Department of Public Welfare as a component of the Resource Center for Evidence-Based Prevention and Intervention Programs and Practices. Please visit www.episcenter.psu.edu