Original articleChallenges in Replicating Interventions
Section snippets
The Replication Projects
The 6 studies selected by NIH peer review for funding all provided evidence in their applications of community acceptance and willingness to cooperate in the intervention selected by the principal investigator. Each study took a unique approach to the problems inherent in adaptation. Table 1 provides a quick reference point, and thumbnail sketches of the 6 projects follow:
Borawski replicated Jemmott’s Be Proud! Be Responsible! (BPBR) among older adolescents in 5 urban and suburban high schools
General Issues in Program Implementation
Although this group of studies was initiated to address challenges relevant to program adaptation, each had also to address the common concerns of intervention programs. These issues have been extensively discussed (see specifically, References 6 and 10, and the papers from each investigator about their programs). The issues varied across locations. Briefly, the components are: community support, program fidelity, and staff selection and training.
A variety of different tools were used to
Challenges in the Adaptation Process
There are excellent articles on the technology transfer processes necessary to get a proven product into the field. See the special issue of the Journal of AIDS Education and Prevention in 2000 [volume 12, supplement A]. However, those studies looked for “fit” between the original program and the new venue, rather than changing the intervention to match the community. One [6] did call for a careful examination of the “core elements” of a program when replicating it, although the author did not
Conclusions
Many elements must come together for a prevention program to be replicated and to produce behavior change in a different environment. In replicating their programs, investigators encountered both structural and cultural challenges. Some changes made to the original programs were theory-driven, to bring the examples closer to home, such as in vignettes selecting names of youth from the local community or making references to single- as well as 2-parent families. Some changes were driven by local
Acknowledgments
The 6 principal investigators in this study were awarded funding through an NIH-issued Request for Applications. Stephanie Bell was a Presidential Management Scholar at NICHD when the paper was initiated. The studies upon which this paper is based were funded by 2 NIH institutes, NICHD and NIMH, through the following grants: R01-HD038456 (Borawski), R01-HD039109 (Jemmott), R01-HD038420 (Morrison), R01-MH061761 (Stanton), R01-HD038457 (Tortolero), and R01-MH061187 (Zimmerman).
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