The influence of contextual factors on the processes of adoption and implementation of evidence-based substance use prevention and tobacco cessation programs in schools

2012-04-24Although considerable resources have been spent developing and disseminating effective school-based substance use prevention programs, many school districts in the United States fail to use prevention programs with proven effectiveness. Moreover, there is a dearth of research understanding the factors that promote adoption, implementation fidelity, and sustained use of these programs in schools. Consequently, a significant gap remains in what we know about how to effectively “translate” evidence-based programs from research to practice (L. A. Rohrbach, Grana, Sussman, & Valente, 2006). ❧ Research grounded in the diffusion of innovations theory (Rogers, 1983), theory driven evaluations (Chen, 1998), systems models (Estabrooks & Glasgow, 2006) and recent reviews of the literature (Durlak & DuPre, 2008) have identified some community-, organizational-, and individual-level factors that are correlated with the translation of evidence-based programs in schools. The studies presented here explore the relationships between factors at several levels of the ecological framework and program adoption, implementation fidelity and sustained use of evidence-based substance use prevention and tobacco cessation programs in schools. ❧ The findings presented in these studies suggest that school-based substance use prevention programming is influenced by a variety of contextual factors occurring at multiple ecological levels. Characteristics of the community and organization, beliefs of key decision makers, and funding were important factors in promoting adoption, implementation fidelity and sustained use of evidence-based substance use prevention programs in schools. In order to move the field ahead, researchers need to account for the multiple systems at play in schools when designing research trials and school-based programs. Ultimately, translational research can be used to increase the use of evidence-based prevention programs in schools, which should lead to reductions in substance use and other problem behaviors among adolescents