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Introduction and Overview of the Workshop

Communities provide the context in which programs, principles, and policies are implemented. Their needs dictate the kinds of programs that community organizers and advocates, program developers and implementers, and researchers will bring to bear on a problem. Their characteristics help determine whether a program will succeed or fail. The detailed workings of programs cannot be separated from the communities in which they are embedded.

Communities also represent the front line in addressing many behavioral health conditions experienced by children, adolescents, young adults, and their families. Almost half of Americans will meet one or more clinical criteria for mental and behavioral health or substance abuse disorders sometime in their lives, with the first onset usually in childhood or adolescence. Such disorders convey a tremendous personal burden to the affected individuals and their families, and they impose substantial costs on the broader society. The community setting presents a cardinal opportunity for prevention; early intervention; and treatment of mental, behavioral health, and substance use disorders.

Given the importance of communities in shaping the health and well-being of young people, the Forum on Promoting Children’s Cognitive, Affective, and Behavioral Health held a workshop in Washington, D.C., on June 9-10, 2016, to examine the implementation of evidence-based prevention by communities (see Appendix A, Workshop Statement of Task). The five previous workshops held by the forum have provided many examples of interventions that can improve the health and well-being of children, noted José Szapocznik, professor and chair in the Department of Public

Health Sciences at the University of Miami and cochair of the workshop, in his opening remarks. But how can such knowledge from researchers, practitioners, and community members best be implemented? “We want to take it off the shelf and put it into the real world,” said Szapocznik, “and the question that we’re asking in this workshop is: How do we do that?”

Workshop participants included not just researchers and program directors, but also state and local officials, community leaders, health care providers, patient advocates, and other stakeholders with experience in translating knowledge into action. Their task, said Leslie Walker-Harding, cochair of the workshop and chief of the Division of Adolescent Medicine at Seattle Children’s Hospital and professor and vice chair of faculty affairs in the Department of Pediatrics at the University of Washington School of Medicine, was to examine questions related to scaling up, managing, and sustaining science in communities. Partnerships among stakeholders are obviously essential in implementing evidence-based programs, she noted, but these partnerships have many origins and take many forms. Researchers “need to work with the community, and I don’t see that they’re separate,” she said. “We should all be a part of the communities in which we live, work, and try to move forward and help.”¹

This proceedings of the workshop is meant to be useful for all of those involved in implementing evidence-based programs into communities, including community stakeholders. Some presentations, such as the methodologies discussed in Chapter 4 and the definitions of terms discussed in Chapter 5, are more oriented toward researchers than practitioners, but even in these cases, clear explanations and mutual understandings of concepts can facilitate implementation. For researchers, the report reveals a rich set of issues and questions related to implementation science. For practitioners, it lays out many of the opportunities and challenges in moving evidence-based programs into the field.

OVERVIEW OF THE WORKSHOP

The workshop proceedings parallels the workshop agenda, which appears in Appendix B. Appendix C contains biosketches of workshop presenters and moderators. Boxes at the beginning of each chapter highlight particularly important points emerging from the presentations and discussions, with the workshop participant who made that point identified in parentheses.

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¹ Workshop participants generally used the term community to refer to geographically based units, but their observations, as in this case, often apply to socially defined communities as well, either within a particular geographic area or more broadly.

Chapter 2 summarizes the keynote address by Velma McBride Murry, the Lois Autrey Betts chair in education and human development and Joe B. Wyatt distinguished university professor at Vanderbilt University, on putting prevention science to work in communities to improve the health and well-being of children.

Chapter 3 looks at five different approaches to improving practice as exemplars of how selection, implementation, and adaptation of evidence-based programs can emerge from strong partnerships.

Chapter 4 describes some of the cutting-edge methodologies that have been developed to evaluate complex and multilevel community interventions.

Chapter 5 examines whether it is possible to identify similar component elements in evidence-based programs and disseminate those elements, whether identified as principles, practices, or kernels, rather than the programs themselves.

Chapter 6 explores ways to sustain funding to ensure both continued implementation of evidence-based programs and enduring support for those programs once they are implemented.

Chapter 7 considers what communities need and want in implementing evidence-based interventions within the context of the challenges and opportunities they face.

Finally, Chapter 8 summarizes the observations made by three breakout groups at the workshop and the concluding remarks made by the workshop cochairs.

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