TABLE 11-1 Comparison of Three Implementation Approaches




Implementation of an existing evidence-based program

High program fidelity

Program may not fit community needs, strengths, or capacities

Relatively high likelihood of achieving intended impact

Real-world implementation may differ dramatically from the way originally tested

Known resources and requirements for effective implementation

Lack of ownership in the program

Likely continued funding under federal and state supported evidence-based prevention

Few evidence-based programs have the capacity to provide technical assistance and training


An evidence-based program may not target outcomes relevant to community

Adaptation of an existing program to meet community needs

Ownership and high support from community and potentially high adoption

Key program components may be modified, thereby reducing outcomes

Program more relevant to ethnic, racial, or linguistic characteristics of community

Essential program components not always evident

Reasonably likely to achieve impact


Community-driven implementation

Can develop high community acceptance and ownership

Lengthy period to develop community awareness, common vision, and program

Potential for broader implementation across different organizations and institutions within the community

Potential for ineffectiveness or iatrogenic effects

Challenges in obtaining funding for sustaining a unique program

Opportunity to empirically evaluate the outcomes of programs accepted by the community and use quality improvement methods to enhance outcomes over time

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