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Putting the Pieces Together: An Integrated Model of Program Implementation

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Abstract

Considerable evidence indicates that variability in implementation of prevention programs is related to the outcomes achieved by these programs. However, while implementation has been conceptualized as a multidimensional construct, few studies examine more than a single dimension, and no theoretical framework exists to guide research on the effects of implementation. We seek to address this need by proposing a theoretical model of the relations between the dimensions of implementation and outcomes of prevention programs that can serve to guide future implementation research. In this article, we focus on four dimensions of implementation, which we conceptualize as behaviors of program facilitators (fidelity, quality of delivery, and adaptation) and behaviors of participants (responsiveness) and present the evidence supporting these as predictors of program outcomes. We then propose a theoretical model by which facilitator and participant dimensions of implementation influence participant outcomes. Finally, we provide recommendations and directions for future implementation research.

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Notes

  1. We distinguish between the concepts of attendance and dosage. Although attendance is sometimes described as “dosage” in the implementation literature (e.g., Charlebois et al. 2004a; Spoth and Redmond 2002), this confounds a participant behavior with an element of program design. We suggest that dosage should refer to the number of sessions offered, and is thus under the purview of program designers and administrators, while attendance should be used to describe number of sessions participants attend.

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Acknowledgements

Cady Berkel and Erin Schoenfelder’s involvement in the preparation of this manuscript were supported by Training Grant T32MH18387.

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  1. Prevention Research Center, Arizona State University, Phoenix, AZ, USA

    Cady Berkel, Anne M. Mauricio, Erin Schoenfelder & Irwin N. Sandler

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  1. Cady Berkel
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  2. Anne M. Mauricio
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Correspondence to Cady Berkel.

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Berkel and Mauricio contributed equally to the development of this manuscript.

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Berkel, C., Mauricio, A.M., Schoenfelder, E. et al. Putting the Pieces Together: An Integrated Model of Program Implementation. Prev Sci 12, 23–33 (2011). https://doi.org/10.1007/s11121-010-0186-1

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