This study came out of my interest in the implementation of research based curriculum and the struggle that I went through as a teacher to attempt to implement them with fidelity and one particular training that I went to were participants were demeaned for the adaptations that they were making the curriculumThis study has significance in that the implementation of these prevention programs can have positive long lasting impact on the health and wellbeing or students as well as health along the life course. A number of curriculum such as Botvins, Life Skills Training Curriculum as well as Sussmans Towards no Tobacco as well as a number of other programs that when implemented in schools have been shown to delay or prevent the onset of tobacco, alcohol and other drug use. These programs have been shown to be effective in random control trials. It has been supported by a number of many researchers that these curricula are implemented as the were written or with fidelity. If the intended outcomes of the curriculum are to be expected the curriculum needs to be implemented with fidelity. However, in the real world setting implementation fidelity may not be the norm.This study was developed a grounded theory to describe how teachers make decisions to adapt research based health education curriculum, types of adaptations, when teachers make adaptations to them. By examining the adaptations that teachers are making in the classroom, researchers, implementers can curriculum designers can be better positioned to ensure implementation of these programs at a greater level of fidelity.
These measures were initially developed to examine the extent that the curriculum is being implemented with fidelity during clinical trials – RC trials. They were developed to ensure that type III errors did not occur, or that the lack of results were not due to the lack of fidelity during the trails and that they were truly due to the inadequacies of the program itself. These factors of fidelity identified by Dane and Schneider examine 1) dosage, 2) adherence to the program, 3) quality of delivery (the way the teacher delivered the program, 4). The responsiveness of participants, 5) the degree that critical components can be differentiated. n a 2008 Durlak and DuPre’s (2008) meta-analysis of nearly 500 studies 59 reported measures of fidelity of those 76% reported that fidelity had a positive association with program outcomes with at least 60% of fidelity measures positive outcomes were shown
Reasons for these adaptations - One pertains to the curriculum itself including its specificity, length, complexity, and the associated training. The other is the context or system in which it is implemented.
In the last few years, controversy about fidelity versus adaptation has given way to a compromise position. The compromise position which you se on the slide, essentially agues that fidelity to the original program on the one hand must be balanced with judicious or wise adaptation on the other hand.Tom Backer is one of the strongest advocates of balancing fidelity and adaptation.This sound logical enough, the problem is knowing when to adapt and when not to. Or, put another way, how to make adaptations without jeopardizing the effectiveness of the model or original program. Baccker proposal is a very complex model of community collaboration, with identification of key components of the curriculum, contact with the researcher, to bring these programs to scale it is very difficult to see how such an extensive process can be applicable in schools.
All participants were teaching the LST curriculum at either the middle school or HS. LST levels 1,3 and HS were observed. Class sizes ranged from 5 to 28 students. Experience ranged from a 5 year teacher to a teacher who was in their last year of teaching. Obviously a broader number of participants would have improved the study. But as I went into the final participant the key themes continued to appear and I do believe that saturation did take place.
Data was was collected from observations and interviews. The curriculum was used to track additions, modifications, and omissions. Lesson plans and materials were collected for analysis. Over 16 hours of observation were analyzed and over 11 hours of interviews were conducted.
I look for themes to emerge from the data this drove additional questions in subsequent interviews.
Sense making is the attention to how individuals make sense of competing external mandates on their work context. (Corburn, 2001)In this study the idea of sense-maker is expanded to the examination of not only mandates but the wide range of inputs.Combined with their beliefs system
Teacher made adaptations to engage students. In order to do this they took a significant amount of time setting the stage for a safe classroom environment, and took the time to add activities to make personal connections with students. For example teachers revisited norms or developed norms for this specific unit due to the potential for controversial topics being discussed. Teachers also added introductory activities to allow students to interact with other students prior to the lesson (warm-up activities, some of these had noting to do with the curriculum but just encourages team building, and communication between students.Teachers also made adaptations to engage students learning tasks or activities.Adaptations to make the curriculum more relevant, to make connections for students, to encourage student sharing and interaction, focused on student learning styles specifically encouraging movement in the classroom and the application of concepts and skills. For example teachers teachers added physical activity to lessons on tobacco asking students to exercise while breathing through a straw. One activity in the curriculum asked for students to discuss the factors that influence drug use. The teacher took this and had student think about influences and write them on post it notes. Then to share with two other students. They then posted the notes on the board and categorized them by types of influence internal, external, media, peers, curiosity etc..All of the teachers moved activities or lessons within the curriculum, they all said that it didn’t make sense to do the activity when it was in the curruclum and that the reason for the moving of the activity or lesson was to make a better connections with students.
My students just don’t get this they need more background knowledge. I had to add a sharing to this lesson because if I try and have student jump right into this activity they would just shut down. Our kids just don’t know the terminology or they need to have a basic understanding of consequences. Our students need to know about steroids, or inhalants. Marijuana use is a real problem in my school and we need to spend more time talking about this. For this reason teachers added a significant number of additional lessons and activities.
Small and large class sizes tended to adapt more often this came out of observation and discussion with participates. Also school wide initiatives.
Participants will be more responsive, thus increasing attendance, active participation, practice, and student satisfaction that supports student needs which will support fidelity itself. These processes identified by Backer and other are very time consuming and involve a wide-range of school and community partners to develop the culturally adapted curriculum.Strengthening families fewer dropouts (Kumfer et al., 2002).Increased student engagement.May support sustainability of the program (Botvin, 2004; Castro et al. 2004).Supported by CDC’s Characteristics of Effective Health Education Curriculum.Berkel (2011) proposed an integrated model that supports quality of implementation.
AERA Adaptation of Health Education Curricula
DEVELOPMENT OF A GROUNDED THEORY FOR TEACHERDECISIONS TO ADAPT RESEARCH- BASED HEALTH EDUCATION CURRICULA James P. Hurley Ph.D. firstname.lastname@example.org Brent G. Wilson Ph.D.
Introduction to the problem Introduction to the study Purpose / Significance of the study
Fidelity Integrity, adherence, or quality of program delivery Refers to the degree to which teachers and other program providers implement programs as intended by the program developers (Dane & Schneider, 1998; Dusenbury et al., 2003)
Adaptation Adaptation is the degree to which an innovation is changed or modified by the user in the adoption and implementation process (Rogers, 1995).
Prevalence of Adaptation A 2003 study reveled that 79.8% of teachers adapted the curriculum based on student needs (Ringwalt et al. 2003). Between 23% and 81% of program activities may be omitted during implementation (Durlak, 1998). Only 19% of schools implemented research-based curricula with fidelity (Hallfors & Godette, 2002).
“Attention to BOTH fidelityand adaptation isessential for successfulimplementation ofscience-based preventionprograms.” (Backer, 2002)
RESEARCH QUESTIONS1. What factors or considerations influence health educators’ decision to adapt curriculum?2. When do health educators make adaptations to the curriculum?3. What types of curricular adaptations do health educators make to curriculum?
RESEARCH DESIGN Grounded Theory (Glaser & Strauss, 1967) Participants Sara Jerry Belinda Kathy
DATA COLLECTION Interviews Observations Lesson plans and materials ObservationPre-CurriculumInterviews Pre- Post-Interview observation Post- observation Interview
DATA ANALYSIS Open Coding Constant comparison Axial coding Identification of Dimensions and Themes Development of grounded theory
FINDINGSWhat are Teachers doing in the real-world of implementation?
Research-Based Curriculum Student Reflection onINPUTS Policy in Practice Student Needs Engagement Practice Local Standards, Unique student Safe, Caring • Teacher Curriculum, and population Learning Experience Assessment Student Environment • Reflection-on- School policies academic Active Learning Practice ability • Teaching Skills Teacher Beliefs Teacher as Sense-maker Teacher Planning Additions, Modifications, OmissionsOUTPUTS Potential Threats to Fidelity Curricular Improvement Research Based Curriculum Enacted
Safe Supportive learning EnvironmentTO Safe environment Make personalENGAGE connections with studentsSTUDENTS To engage students through a learning task or activity Make it relevant for students To make connections for students To encourage student sharing and interacting Student learning styles Application of concepts and skills and practice
Local curriculum,LOCAL standards, and assessmentPOLICIES IN AssessmentPRACTICE Standards Curriculum maps or guides School policies School scheduling Class size School-wide initiatives
WHEN DID ADAPTATIONS OCCUR? Planning Reflection-in-practice Reflection-on-practice
Discussion Teachers aligned adaptations with sound pedagogical practices. Supported culturally responsive practices. Role-play needs to be addressed. Local policies impacted adaptations. (assessment, class size, school wide initiatives). Scare tactics.
Implications/Recommendation s Implementers Curriculum Developers Planning is a key to fidelity Ensure that activities are and adaptations interactive Address student academic Make a point to understand ability the theoretical underpinnings of the curriculum Make theory transparent at the lesson level Use data to drive adaptations Consider goal focused Ensure alignment of all implementation lessons (outside of the curriculum) Provide student assessment
Implications/Recommendation sProfessional Development Educational Reform Training Efforts Build capacity to engage in Balanced approach to fidelity interactive activities Examine how school level Provide role-play inputs will impact the reform opportunities Build teachers belief that the Core component reform is what’s best for their identification students. Implementation of program Guide adaptations as based on school level opposed to discouraging initiatives/policies them
Future Research What is the impact of cultural adaptations on student outcomes? How do teachers beliefs guide curricular adaptations? How can innovative teaching techniques be infused into prevention curriculum to improve student engagement? How do “goal focused” curriculum compare to predefined research-based curriculum?
Conclusion The classroom is a complex system of teaching and learning. Adaptations will occur. Provide guidance for adaptations based on curriculum theory and sound teaching pedagogy.
THANK YOU! QuestionsHurley, J. P. (2011). Development of a grounded theory for teacher decisions toadapt research based health education curricula. Denver, CO: University ofColorado Denver. Doctoral dissertation. Online: http://goo.gl/VWjbN
References Backer, T. E. (2002). Finding the balance: Program fidelity and adaptation in substance abuse prevention - A state-of-the-art review, Conference Edition 2002. Rockville M. D.: Substance Abuse and Mental Health Services Administration Center For Substance Abuse Prevention. Dane, A., & Schneider, B. (1998). Program integrity in primary and early secondary prevention: Are implementation effects out of control? Clinical Psychology Review, 18(1), 23-45. Durlak, J., & DuPre, E. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41(327-350). Dusenbury, L., Brannigan, R., Falco, M., & Hansen, W. B. (2003). A review of research on fidelity of implementation: Implications for drug abuse prevention in school settings. Health Education Research, 18(2), 237-256. Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Publishing Company. Hallfors, D., & Godette, D. (2002). Will the Principles of Effectiveness improve prevention practice? Early findings from a diffusion study. Health Education Research, 17(4), 461-470. Hurley, J. P. (2011). Development of a grounded theory for teacher decisions to adapt research based health education curricula. Denver, CO: University of Colorado Denver. Doctoral dissertation. Online: http://goo.gl/VWjbN Rogers, E. (1995). Diffusion of innovations. New York: Free Press. Ringwalt, C., Ennett, S., Johnson, R., Rohrbach, L., Simons-Rudolph, A., Vincus, A., & Thorne, J. (2003). Factors associated with fidelity to substance use prevention curriculum guides in the nations middle schools. Health Education & Behavior, 30(3), 375-391.