June Newsletter: The Strategic Prevention Framework

Step 4: Implementation

The key to positive outcomes in substance misuse prevention is using evidence-based programs and practices that produce the intended results. This is accomplished when prevention practitioners select, plan for, and carefully implement those interventions.

Sometimes a practice or program will need to be adapted. This adaptation may be identified early in the planning process or may be discovered later. Monitoring the implementation process is necessary to identify areas of concern. The sooner the need for adaptation is identified, the better your prevention outcomes will be. SAMHSA has identified 5 guidelines to consider when balancing fidelity and adaptation.

• Retain core components. Evidence-based programs are more likely to be effective when their core components are maintained.
• Build capacity before changing the program. Rather than change a program to fit local conditions, consider ways to develop resources or to build local readiness so that it can be delivered as it was originally designed.
• Add rather than subtract. Doing so decreases the likelihood of important program elements (i. e.., those that are critical to program effectiveness) getting lost.
• Adapt with care. Even when programs and practices are selected with great care, there may be ways to improve their appropriateness for a unique focus population.
• If adapting, get help. Knowledge experts, such as program developers, can provide information on how a program has been adapted in the past, how well these adaptations have worked, and what core components should be retained to maintain effectiveness.¹