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fund rigorous impact evaluation to help understand what interventions are making a difference.

Replicability and scaling up to a larger program are also of great concern to researchers, policy makers, funders, and implementers. The IMAGE study was a small intervention, but when it received additional funding, it was able to scale up to 1,800 clients—nearly double the original enrollment. Watts identified several issues for consideration when scaling up from a small research intervention to a much larger implementation including operational and organizational issues, whether there is programmatic compromise when scaling up occurs, whether any revisions have to be made, and whether there are health, social, and economic development mechanisms or vehicles for synergistic linkages and integration other than microfinance—such as literacy, HIV/AIDS, or malaria.

QUESTIONS AND ANSWERS

The highlights of the discussion with participants focused on examples of the participatory approach in research coupled with epidemiological data from a specific program in El Salvador. The intervention was implemented by a former guerrilla, and while it targeted the entire community, it also targeted those at highest risk (18-25 years) for violence by focusing on job skill development, employment, and other structured activities that address alcohol and drug use to reduce the risk for this population. The community used data from the hospital injury surveillance system to monitor the violence-related injuries that occurred in the city.



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