funding for the Colorado Nurse-Family Partnership Program. Recent congressional action related to child abuse programs sets aside funds for competitive state grants to implement evidence-based home visitation models.

Numerous guidelines for best practices in program implementation have been published at the federal and state levels, although somewhat different, and sometimes confusing, criteria have been used for the selection of recommended programs across reviews and federal agencies (see Chapter 12). The Blueprints for Violence Prevention project at the University of Colorado, originally stimulated with federal funds from the U.S. Department of Justice, was institutionalized as an effort to facilitate community-level adoption of specific violence prevention interventions. Similarly, the Safe Schools Healthy Students Initiative, a joint program of three federal agencies, encourages the use of evidence-based programs. However, empirical evidence of the implementation experiences or results of this program are lacking.

One of the most promising approaches to prevention involves early education of children to prepare them for the challenges of reading and learning, as well as to help them develop the social skills necessary to develop positive relations with their peers as well as adults. Yet far fewer children in the United States ages 3-5 receive preschool or center-based early education than is the case in many other developed countries (Yosikawah, Schindler, and Caronongen, 2007). Children from poor families and children with less educated mothers are dramatically less likely to receive these services compared with those with higher incomes and mothers with more education (U.S. Department of Education, 2007).

Although there are exceptions, overall implementation of effective interventions has been modest at best. Scientific evidence of health benefits and standard methods of dissemination alone appear to work only under limited circumstances. Successful examples of implementation that do exist across the life span and across different settings are reviewed below.

Implementation of Prevention Programs in Early Childhood

Chapter 6 outlines a number of early childhood programs that have demonstrated positive outcomes for children and their families. The history of one promising program implemented in multiple states provides important lessons on the significance of implementation fidelity and program design. Healthy Families America (HFA) is a program aiming to prevent child abuse and neglect that was modeled after the Hawaii Healthy Start program and implemented state-wide in several states. The core of this program involves identifying parents at high risk of abuse and neglect of their children. Parents are identified through broad-based screening and then offered voluntary home visiting services delivered by paraprofessionals for a period of three to five years (Duggan, McFarlane, et al., 2004). A study



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