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Strategies for Scaling Effective Family-Focused Preventive Interventions to Promote Children's Cognitive, Affective, and Behavioral Health Workshop Summary (2014) / Chapter Skim
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6 Scale-Up Challenges
Pages 51-58

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From page 51...
... Scaling up can also be hampered by an over-reliance on program developers who do not have the expertise or time to scale-up and disseminate their programs, and rigid adherence to the programs which may need to be adapted to specific populations or organizations. McCannon identified additional factors that may impede efforts to successfully scale-up a program, including attempting to scale-up too quickly and a lack of explicit goals and objectives for what needs to be accomplished within a specific timeframe.
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From page 52...
... Office of Management and Budget pointed out that clearinghouses such as the What Works Clearinghouse provided by the Institute of Education Sciences1 could be more robust so they show not only what works but what is needed as far as implementation and technical assistance. MaryBeth Musumeci from Kaiser Commission on Medicaid and the Uninsured noted that Medicaid enables states to offer a wide array of services aimed at improving children's mental, emotional, and behavioral health, and is being expanded in several states with the implementation of the Patient Protection and Affordable Care Act, but a number of children who are eligible for those services are not enrolled in them.
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From page 53...
... However, as Bumbarger pointed out, there is currently no data infrastructure to help communities understand their needs or to continuously monitor progress and quality improvement. He noted that a prevention planning framework called Communities That Care helps communities collect local data so they can identify and prioritize specific risk and protective factors they might want to target and match those to suitable interventions.
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From page 54...
... Carolyn Webster-Stratton added that a major barrier to the successful implementation of The Incredible Years® program was inadequate agency readiness, including a lack of short- or long-term goals clearly mapped out, failure to select motivated clinicians with the expertise or training to deliver the program, and inadequate recruitment and engagement with families, including improper handling of the logistics such as day care for the children while the parents are in groups, providing meals, and scheduling of the programs. LACK OF SUSTAINABLE FUNDING Many speakers noted that a lack of sustainable funding is a major impediment to scaling up interventions.
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From page 55...
... Hoagwood noted that three-quarters of states are facing severe ­ budget crises and are responding by reducing community mental health services and grants (Lutterman and NASMHPD Research Institute, 2012)
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From page 56...
... More frequently there is indirect use of evidence, such as that gleaned from a body of research including impact, epidemiological, or developmental studies but not one specific study. Nutley ­ and colleagues also note that evidence is sometimes used in a political way such that the policy maker cherry picks findings to support a decision, S ­ upplee said.
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From page 57...
... Mr. McCannon, in his presentation on lessons from other fields and sectors on effective spread and scale-up, noted that one lesson learned from efforts to broadly implement practices to improve health care quality is that "Adaptation is what you see in initiatives that are really thriving" (McCannon and Perla, 2009)
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From page 58...
... organizational intervention for im proving youth outcomes in community mental health programs. Journal of the American Academy of Child and Adolescent Psychiatry 52(5)
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Key Terms

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  • nasmhpd research
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  • specific communities
  • olds noted
  • budget crises
  • fiscal crisis
  • wide array

  • including health
  • community organizations
  • including improper
  • programs combined
  • david olds

  • reducing community
  • monitoring videotapes
  • protective factors
  • american journal
  • affordable care

  • inform public
  • suitable interventions
  • health agencies
  • thereby building
  • social policy


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