Session: It’s a Grand Challenge: Achieving High Quality Implementation in Routine School Based Prevention Services (Society for Social Work and Research 20th Annual Conference - Grand Challenges for Social Work: Setting a Research Agenda for the Future)

The American Academy of Social Work and Social Welfare created the Grand Challenge Initiative to “identify ambitious yet achievable goals for society that mobilize the profession, capture the public’s imagination, and require innovation and breakthroughs in science and practice to achieve” (Uehara, et al., 2014). The AASWSW declared “Unleashing the Power of Prevention” as one of the Grand Challenges. This Grand Challenge aims to reduce the incidence of behavioral health problems by 20% within a decade (Hawkins, et al., 2015). To achieve population-wide reductions in behavioral health problems, we must “scale up” effective preventive interventions.

Many communities deliver preventive interventions through school-based Social Emotional Learning (SEL) programs (Fagan, Hawkins, & Shapiro, 2015). School-based services have the potential to reach a large proportion of community youth. SEL programs can be cost effective to implement and, when implemented well, have been shown to be effective in achieving a broad array of important child outcomes (e.g., Greenberg et al., 2003).  On the other hand, effective interventions taken to scale can be subverted through inattentive or ineffective implementation approaches, resulting in a negligible impact of the intervention when implemented in routine practice (Nation et al., 2003). Understanding the implementation of SEL interventions is essential for scaling up school-based efforts to prevent behavioral health problems.

Implementation involves engaging in specified activities designed to put an activity or program into practice (Fixsen, et al., 2005). Implementation outputs include adherence, dosage, and participant responsiveness (Durlak & DuPre, 2008). Research and development efforts are typically devoted to creating and evaluating interventions rather than specifying and studying how to implement interventions effectively; knowledge that can actually help professionals use and apply interventions responsibly and reliably (Proctor & Rosen, 2008; Pronovost et al., 2004). This symposium intends to systematically explore lessons learned from three routine implementations of different Social Emotional Learning programs in diverse schools.

The first paper finds that the completion of observations by technical assistance (TA) providers declines over time, but is predictable by elements in the initial observation. Similarly, sustained implementation quality is predictable by elements in the initial observation. Thus, early identification of problems and targeted interventions can potentially enhance completion rates and sustain implementation quality.

The second paper finds that teacher self assessment of the strength of their own implementation is strongly influenced by the number of lessons taught (dosage) and modestly influenced by how closely they followed the approach outlined in the curriculum guide (adherence). This suggests that teachers appreciate dosage more than adherence as essential to implementation success.

The final paper finds reliable differences in the assessment of social emotional competence of the same children by teacher and staff raters; Teachers assess students more favorably. The paper also finds that 60% of the variance in program dosage is attributable to differences between school sites and implementation staff.

Together, these findings contribute to the implementation science underlying school-based prevention practice. An expert implementation researcher will serve as symposium discussant to consider the utility of these finding for resolving the Grand Challenges we face.