Question: What type of information do you need to know before selecting an evidence-based program?Ask participants to share responses.
Question: Why is it important to know this information before selecting a program?Ask participants to share responses.After participants share responses in the chat box, review the following point:All evidence-based programs have strengths and limitations: not all programs will work for all groups, organizations and communities. There are some programs that can be easily adapted to fit the needs of certain communities/youth, without compromising fidelity, while with others may not be a good fit.Recognizing the limitations and strengths of programs when going through the process of assessing for fit and selection help us to identify the program (s) that better fit our needs.Fit is essential when selecting programs: the program that might seem a perfect fit for community X might seem limited for community Y because evidence-based programs are not perfect in the sense that they do not fit everyone across the board; each organization, community, and group of youth participants is unique.
Before you can select a program to fit, you should:Complete a needs and resource assessmentSexual risk-taking behaviorsRisk & protective factorsCommunity resources, services, partnershipsEstablish goal & objectives for programResearch potential evidence-based programsIdentify a list of potential programsOnce an organization has gathered this critical information, the organization is ready to move on to assessing potential programs for fit, in order to select a program.When selecting a program to implement, it is important to select a program that fits the youth, community, organization, and stakeholders because it increases the likelihood that you will be able to implement the program with fidelity, thereby increasing the likelihood of achieving the desired health outcomes. So today, we’re going to talk about how you can assess for fit, in order to select an appropriate program.
Remember, an evidence-based program (EBP) is a program proven through rigorous evaluation to be effective at changing sexual risk-taking behavior among youth. To be considered effective at changing sexual risk-taking behavior, EBPs on the OAH list must have demonstrated:Evidence of a positive, statistically significant impact on at least one of the following outcomes:Sexual activity (initiation; frequency; rates of vaginal, oral and/or anal sex; number of sexual partners);Contraceptive use (consistency of use or one-time use, for either condoms or another contraceptive method);Sexually transmitted infections (STIs); and/orPregnancy or birth; as well asA positive, statistically significant impact for either the full analytic sample or a subgroup defined by (1) gender or (2) sexual experience at baseline. Keep in mind that EBPs have been proven effective with specific populations (e.g., race, ethnicity, age, grade-level) and in a particular setting (e.g., schools, clinics, communities). Knowing which population and setting were used in the original evaluation study or replicated studies is important when selecting the most appropriate program for your youth, your organization, and achievement of your health goals. To be considered “rigorous evaluation” a program must have an appropriate evaluation design. The evaluation design may be experimental, with a random assignment of participants into a treatment group (the group that receives the program being evaluated) and a control group (the group that does not receive the program being evaluated). In other words, in experimental design the researcher controls the experiment. On the other hand, the evaluation design may be quasi-experimental, with no random assignment of participants. In this design, the researcher has less control, and there may be confounding variables. Also, to be considered “rigorous evaluation,” the program must have been published in a peer-reviewed journal. For more information on evaluation requirements, see Mathematica Policy Research’s criteria for the OAH study on EBPs: http://www.hhs.gov/ash/oah/prevention/research/review/index.html. ABOUT 10:35 AM
Core components are the program characteristics that must be kept intact when the intervention is being replicated, or adapted, in order for it to produce program outcomes similar to those demonstrated in the original evaluation research. Sometimes core components are referred to as the “essential ingredients” of an evidence-based program. Core components are separated into three categories: content, pedagogy, and implementation.
Core CONTENT Components refer to WHAT is being taught in the program. They include the knowledge, attitudes, values, norms and skills that are addressed in the program’s learning activities and are most likely to change sexual behaviors, such as:knowledge about refusing pressure to have sexperception of HIV riskattitudes about abstinencevalues about monogomynorms about using condomsskills to refuse sexNext are the Core Components that address the PEDAGOGY of the program. These core components refer to HOW the content is taught. Core pedagogical components include teaching strategies, methods, and interactions between the youth and facilitator. All of these contribute to the program’s effectiveness. Some specific examples may include:leading role playsshowing videosleading gamesgiving quizzessmall group workhomework with parents
The first thing to consider when selecting a program is if whether program can be implemented with fidelity. This involves delivering the program “as written,” but it may also involve adapting the program while maintaining the core components—the elements that are essential to the program’s effectiveness. Removing core components negates the validity of any evidence-based program. Maintaining the core components increases the likelihood that the program will generate the same desired outcomesAdaptation is often referred to as the “Adaptation Recipe Metaphor” because, just like a delicious chocolate chip cookie recipe, adapting a program requires the right ingredients, techniques and tools. Consider this, if you do NOT follow the recipe with fidelity- using the same ingredients, and making the batter the same way, assembling them with the same tools, and baking them in the same oven, there is no guarantee that you will achieve the same results.Remember, adapting a program is a process that makes the program more suitable (or a better fit) for a particular population or an organization’s capacity without compromising its core components.Imagine how different the cookie would be if you substituted ingredients, like margarine instead of butter…or if you hand mixed the batter rather than use an electric mixer…or if you tried to speed the cooking time by turning the temperature in the oven up too much! Just like a recipe, programs must be implemented with fidelity to get the same or similar results and to be considered evidence-based.Once you understand how a program you’re considering works and what its core components are, you’re in a position to anticipate the effect of potential adaptations.
It’s important to note that at this point, you are NOT making adaptations; rather, you are considering programs for fit, and as part of that process, you’re thinking through potential adaptations that might be necessary in order for a program to fit the youth, community, organization, and stakeholders.While there is no single standard for making decisions about adapting programs, there is a simple model for adapting programs, but that’s a topic for another webinar…for now, we’re going to focus on how to select a program that fits.
The exact meaning of “community” partly depends on the geographic scope of your work. Your organization could be instituting a school, clinic, city, or regional program, or a set of programs and strategies. Whatever its scope, the program needs to harmonize with the many aspects of the community:CultureValues and practicesReadiness for a program of this natureOrganizational mission and philosophyCharacteristics and context of the youth you are serving (e.g., age, gender, ethnicity, language, urban/suburban/rural, level of need, etc.)Priorities of key stakeholders (e.g., funders, program partners, policymakers, service providers, community leaders, etc.)Existing programs and services that may be doing some of the same activities with some of the same youth
Assessing for fit with the organization also entails considering whether your leadership, staff, facilities, finances, and other resources are adequate to carry out those programs with fidelity and quality. The degree to which your organization’s resources are up to the task is your organizational capacity. Developing capacity therefore involves building and maintaining key stakeholder support for the program by ensuring, from the outset, that it will be properly planned, implemented, and evaluated.You’ll need toUnderstand key capacities you need to support the program implementationDetermine whether you have the right levels of capacity for the potential programsIdentify capacities that must be further developed so that you can proceedConsider:Staff and volunteer capacitiesLeadership capacityPartnership and collaboration capacitiesFiscal, resource, and technical capacities(ABOUT 10:55)
Inter Tribal Council of the Southwest promotes positive youth development and provides services and programs for youth in a community-based setting. The Council is a local CBO, in an urban setting, that provides outreach and education to foster care youth and their families. Staff members noticed that a growing number of program participants were getting pregnant, and staff were concerned about the effect of these early pregnancies. They decided to investigate this more closely, and possibly add a teen pregnancy prevention component to their programs. First, the Council conducted a comprehensive needs and resource assessment to learn the critical information about their youth and community.Next, using the information from their assessment, the Council identified a health goal: to reduce teen pregnancy and STI rates among boys and girls, ages 15-19, who currently attend Council programs. They identified the outcomes they wanted to change, including increased use of condoms & contraception. They identified determinants of those behaviors on which to focus, including increased self-efficacy for using condoms and knowledge about HIV and other STIs. The Council researched the available evidence-based programs approved by OAH and identified the following list of candidate programs: All4You, Making Proud Choices!, and Reducing the RiskThe Council began to examine their candidate programs for fit with their participants, the values of their organization, and the larger community.
Evaluating a program’s fit increases the chances it will be appropriate to and accepted by the community and participating youth. If your program does not fit with the culture and values of your youth, organization, and stakeholders, it will be harder to implement and may be less effective. In order to ascertain fit, therefore, you need to grasp the full context in which your program will operate. The resulting benefits affect all participants and constituents because they:Make your programs work for participating youth as well as your communityComplement the efforts of other groups in the community, reducing duplication, and perhaps boosting results for multiple groupsBuild strong relationships with other providers, funders, and stakeholdersEnsure sufficient participation in a program or strategyAllow you to choose and adapt the right program, increasing your chances of making the changes you want to see.Just as a good fit makes it likely that a person will wear a piece of clothing, good program fit can increase the chances that the program will be accepted by the youth and community.
To start assessing your candidate programs, you need to assemble some basic information about each program, such as content, activities, dosage, and setting. The information should include data on the age, gender, and race/ethnicity of youth participating in the evaluated version of the program. It should cite evaluation results indicating that participants showed a greater understanding of the risks associated with sexual involvement and demonstrating other outcomes consistent with the goals of the program. See the OAH website and the list of evidence-based programs as a first step in gathering this information. If you need more information, you may be able to get information from the developers, organizations currently implementing the program, websites, or published articles.Before moving too far ahead into examining the fit of your program, it is important to understand what you can and can’t change about the program. Less may be known about what can and cannot be changed, but when/if this information is available, this is very helpful in planning for appropriate modifications to the program. For example, can a program originally evaluated as a community-based program be implemented in a school-based setting? Or, can a program originally evaluated when implemented in two four-hour sessions be implemented in eight one-hour sessions? This information will help you to determine if the changes you want to make to achieve fit would maintain or compromise the integrity of the program. If the changes are too substantial, you should consider investigating others.
In order to assess a program and select for fit, you need to understand the values and traditions of youth culture. It’s highly recommended that you involve youth and adults from the community in analysis and assessment activities, such as interviews and discussion groups. Avoid making assumptions about cultural factors.Invite youth and/or community members from different groups to help you learn more and think through appropriate cultural adaptations.Use what you and your team know about the youth you serve in order to think critically about the fit of the program to these youths’ lives, culture, context, and community norms. Consider the information from your needs and resource assessment. To assess for fit, you will complete the following steps, starting with addressing fit for each group individually, then considering adaptations, in order to narrow your list:READ STEPSAscertaining the amount of fit also involves determining whether your community is ready and willing to support a particular program or strategy. This will involve speaking with community leaders and key stakeholders, and sharing what you learn.Finally, there’s no single solution that will make a program fit perfectly. You may need to understand competing interests, first, and then balance them. For example, a program might fit with tech-savvy American youth, but many youth you serve may not have access to all the same gadgets.
To complete 1st step and assess for fit with participants, answer the following questions: READ THE QUESTIONSGather the same basic information about characteristics of your potential participants as you did about the programs: age, gender, and race/ethnicity. Include their level of reading literacy, health literacy, education, geographic location, and setting (i.e., rural/urban/suburban) if known. You should have this information from your needs and resource assessment.Learn about the cultural context. Involve youth and other community members in the process and learn more about their values, practices, beliefs, religion, customs, rituals, and language—especially characteristics relevant to your program. The program may address peer norms, but you need to know if your youth participants’ norms are similar to those in the original program. For example, diverse groups may view teen parenthood differently. Some youth groups may come from cultural or ethnic backgrounds where teen pregnancy is more common and thus perceived less negatively.
To answer these questions:Consider your needs and resource assessment data about the same basic information about characteristics of your potential participants as you did about the programs: age, gender, and race/ethnicity. Include their level of reading literacy, health literacy, education, geographic location, and setting (i.e., rural/urban/suburban) if known. Learn about the cultural context. Involve youth and other community members in the process and learn more about their values, practices, beliefs, religion, customs, rituals, and language—especially characteristics relevant to your program. The program may address peer norms, but you need to know if your youth participants’ norms are similar to those in the original program. For example, diverse groups may view teen parenthood differently. Some youth groups may come from cultural or ethnic backgrounds where teen pregnancy is more common and thus perceived less negatively. Or, for example, research ties culture-related assets and protective factors to positive sexual health outcomes for Latina youth, including high aspirations and strong family relationships (Sue Alford, “The Sexual Health of Latina Adolescents—Focus on Assets”; Advocates for Youth, 2006). Understanding such connections or perceptions in different cultures can improve success in implementing programs and may aid in engaging families.Consider cultural elements that could be important to priority populations and communities: READ THE ELEMENTSIdentify issues arising from special situations in Tribal communities. Once you know more about the context in which your youth live, you can determine whether the program is a good fit as written, or if adaptations would be needed.
Organizations work toward their mission by accomplishing goals. A clear line of sight between mission and goals eliminates doubts about purpose, focuses action, and improves the quality of decisions made by staff, volunteers, and other participants. Thus, an organization’s philosophy and values must be congruent with those embodied in any program or strategy it implements. Staff members are much more likely to deliver the program with fidelity if they believe it fits with their organization's vision and mission. To complete 2nd step and assess for fit with the organization, the implementing organization should answer the following questions: Is the program goal compatible with your organization’s mission? Review each potential program’s goals, and determine if they are compatible with the your organization’s mission.What do board, staff, and leadership think of the potential programs? Involving staff and volunteers in the selection process ensures a good fit with the range of motivations for belonging to, working in, or working with your organization.What is the context/setting in which the program was delivered (and evaluated) versus the one you plan to use? If the program used a school but you plan to use a broader community setting, would you be undermining an important contributing factor to success? Perhaps not, but you should consider the possibility.How realistic is the program dosage (i.e., number & duration of sessions)? Determine how realistic the program dosage is within the scope of your organization, program setting, and timing.
When considering a program for fit, it’s important to consider fit with your organizational capacity. In order to implement the potential program with fidelity, consider the following organizational capacities:e. Do you have the staff capacity necessary to implement the program with fidelity?Skilled facilitators are essential to success and posses a number of skills, including ability to engage, inform, and involve individuals in groups; knowledge of adolescent development; effective classroom management; expertise in program content; cultural competence. You also need to consider the level of effort available for staff capacity, including for support and administrative staff.Do you have the necessary leadership capacity?To successfully achieve your program goals, you need diverse leaders and leaders who stay involved over the long term. Partners and collaborators provide access to new skill sets, assets, and opportunities for leveraging limited community resources in support of youthNo matter what program you select, you’ll need a number of basic tools to do the work, such as meeting space, transportation, incentives, health educator training, computers, internet access, software programs, copies of the program materials, DVDs, audio-visual equipment, anatomy models, contraception kits, condoms, notebooks, referral forms, community resource guides, etc. When considering the total cost to run your program, think well ahead.(ABOUT 11:15 AM)
The next level of fit to consider expands your circle of support to the larger community and specifically calls attention to the priorities and values of key stakeholders, such as funders, policymakers, service providers, and other community leaders. To complete 3rd step and assess for fit with key stakeholders, answer these questions: Is another group already implementing similar efforts? Information you gathered in your needs and resource assessment should help you here:Would our potential program complement or conflict with existing community programs?Would it make sense to collaborate on joint efforts?What void will our program fill in the community?What is the level of readiness, for youth and the community? Depending on the answers to the following questions, you may need to rethink your starting point and spend some time building toward readiness for any program:Are our potential participants and community really ready for the activities in these potential programs?Will the community support the program?Do the participants and community have the health literacy skills necessary to embrace this program?What are key stakeholders’ priorities? Informally survey key stakeholder priorities. If funders and other partners do not share your vision, you may end up wasting time trying to persuade them to support your plans. Also, get to know those who disagree and learn their priorities so that conversation is productive. Talk with stakeholders and identify agreements and differences among them.
Though a program may not match the characteristics of your participants exactly, it may not require much adaptation to achieve an appropriate fit. Of course, you don’t want to make changes that compromise the intent or internal logic of the program—the core components. For example, sharing information about ways to say no to sex is not the same as practicing those ways during a role play. To complete 4th step and consider adaptations to improve for fit, the implementing organization should answer the following questions: READ THE QUESTIONSKeep track of potential adaptations for each potential program. Adaptations could be associated with any of the three stakeholders affected by the program selected: youth, organization, or community.If you cannot implement the program with fidelity, that is, you cannot implement the program without compromising the core components, then the program is NOT a good fit and should NOT be selected.
After going through steps 1-4 to assess fit, discuss any adaptations you will need to make to improve each potential program’s fit. Reconsider each of them in light of achieving the best fit possible. No matter how appealing a program looks on paper, selecting the wrong one for your community may lead to ineffective efforts. If an ill-suited program alienates any of the three stakeholder groups (youth, organization, or community), it may be difficult to garner support for future efforts. Therefore, you should be careful to review a range of potential programs, determine the most appropriate, and make informed adaptations if necessary. It is critical that you are able to implement with fidelity and quality.Finally, select a program that fits, based on the criteria assess in steps 1-4, to implement with fidelity.
Review Program Fit Checklist Tool (ask participants to find this handout in their training packet).
Review Program Fit Checklist Tool (ask participants to find this handout in their training packet).
Review Program Fit Checklist Tool (ask participants to find this handout in their training packet).
Review Program Fit Checklist Tool (ask participants to find this handout in their training packet).ABOUT 11:35 AM
You cannot take fit for granted, even if you have already selected or have been implementing your program for awhile. Besides, you will likely increase your program’s relevance and effectiveness if you consider ways to make it fit your various stakeholder groups better, especially with the priority population. Consider your selected program, from several angles:Discuss program fit. Assemble a small work group, and go through the steps of assessing for program fit together. In an afternoon’s conversation, you may discover several creative ideas for updating your work.Take a fresh look. Explore the overall fit of the program. Perhaps your work group can think of adaptations related to fit that would improve your program.Update adaptations. Review changes you have made. Make sure that your adaptations do not compromise the core components of the program.SOME GRANTEES HAVE INDICATED THAT THEY HAVE SELECTED A PROGRAM. ASK THEM TO DISCUSS WHETHER THEIR PROCESS WAS SIMILAR OR DIFFERENT FROM WHAT WAS DESCRIBED TODAY(ABOUT 11:55 am)
Taking time before you implement a program to make sure it fits for all stakeholder groups increases the likelihood that your community will support it and participate in it. By staying on top of potentially relevant internal and external influences, you’ll be better able to continuously improve fit as well as respond to factors that could affect the longer-term sustainability of your work.Here are some questions to think throughlessons learned during your fit assessment, that will help you as you move on to implementationand evaluation of the program:Do we have organizational support for our program?Are you sure you know whether other staff in your organization support it? How about buy-in from administrators and management? The more everyone understands the potential benefits of your program, the more likely it can be sustained over time. Demonstrating a close compatibility between your programs and/or strategies and the work of your organization as a whole is especially important to internal sustainability.How do we communicate the benefits of our program?You can facilitate better fit within your organization and with your stakeholders and community by telling people your story, explaining the need for this program, and underscoring what everyone will get out of it. Training can be used to help infuse the entire organization with knowledge about the program. Ongoing training and communication are necessary to keep information.Do we have a variety of champions who support our work?Champions are people who understand what you’re trying to do and want to help. A champion can be a program manager, administrator, or a board member. You might have someone out in the community who supports your program.
Teen Pregnancy Prevention Initiative (TPPI) List of Evidence-Based Programs. Office of Adolescent Health (OAH) : http://www.hhs.gov/ash/oah/prevention/research/programs/index.htmlLittle Promoting Science Based Approached (PBSA) to Teen Pregnancy Prevention Using Getting to Outcomes (GTO): www.cdc.gov/reproductivehealth/adolescentreprohealth/PDF/LittlePSBA-GTO.pdfKirby, D. (2007). Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Disease. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy. http://www.thenationalcampaign.org/ea2007/Putting What Works to Work. (2010). Washington DC: National Campaign to Prevent Teen and Unplanned Pregnancy. http://www.thenationalcampaign.org/resources/works/PWWTWabout.aspxScience and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections in the United States. (2008). Washington DC: Advocates for Youth. Full Report (pdf): http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdfExec. Summary (pdf): http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccesses.pdfDoug Kirby et al. 2006 “Sex and HIV Education Programs for Youth: Their Impact and Important Characteristics”:http://www.etr.org/recapp/documents/programs/SexHIVedProgs.pdf“Tools to Assess the Characteristics of Effective Sex and STD/HIV Education Programs.” ETR Associates & Healthy Teen Network: http://www.healthyteennetwork.org/vertical/Sites/%7BB4D0CC76-CF78-4784-BA7C-5D0436F6040C%7D/uploads/%7BAC34F932-ACF3-4AF7-AAC3-4C12A676B6E7%7D.PDF“Tools to Assess the Characteristics of Effective Sex and STD/HIV Education Programs” (in Spanish): “Herramienta de Valoracion de Programas de Educacion Sexual para la Prevencion de VIH y Las ITS.” ETR Associates & Healthy Teen Network:http://www.healthyteennetwork.org/vertical/Sites/%7BB4D0CC76-CF78-4784-BA7C-5D0436F6040C%7D/uploads/%7BBC03E7A5-E1B1-4C25-9621-F30E88D64548%7D.PDFAdaptation Guidelines for Science-Based Adolescent Reproductive Health Programs. ETR Associates: http://programservices.etr.org/index.cfm?fuseaction=projects.Summary&ProjectID=107Adaptation Kits for Science-based Pregnancy and STD/HIV Prevention Programs. ETR Associates: http://www.etr.org/recapp/index.cfm?fuseaction=pages.AdaptationsHome
HAVE A VOLUNTEER READ THE HANDOUT, AND FACILITATE DISCUSSION USING THE DISCUSSION QUESTIONSEND 12:15 pm
Selecting an Intervention Chesbro
PROGRAM FIT AND SELECTION Family and Youth Services BureauTribal Personal Responsibility Education Program (Tribal PREP) Grantee Kick-Off Meeting December 6, 2011 10:15 AM – 12:15 PM RTI International Healthy Teen Network Presenter: Tommy Chesbro
#3 #2 Best #4 #1 Goals Practices Fit #5 Needs/Resources Capacities #10 #6Sustain #7 Plan #9 Implementation #8 Improve / Process Outcome CQI Evaluation Evaluation 2 2
LEARNING OBJECTIVESAt the conclusion of thissession, participants will be able to: Assess how well a program fits the needs of youths they serve and their community Utilize assessment results to determine program fit with the targeted population Identify first steps for incorporating adulthood preparation subjects in their program 3
What type of information do you need to know beforeselecting an evidence-based program? 4
Why is it important to know this information before selecting a program? 5
BEFORE SELECTING A PROGRAM… Complete a needs and resource assessment – Sexual risk-taking behaviors – Risk & protective factors – Community resources, services, partnerships Select a target population and identify their culturally specific indicators Establish goal & objectives for program Research potential evidence-based programs Identify a list of potential programs 6
WHAT IS AN EVIDENCE-BASEDPROGRAM?• Rigorously evaluated• Shown to positively change behavior (proven to be effective)• Approved list of 28 EBPs: http://www.hhs.gov/ash/oah/ prevention/research/programs/index.htmlGrantees are not limited to selecting one of the 28 model EBPs identified in the DHHS study 7
WHAT ARE CORE COMPONENTS?• Core components are the program characteristics that must be kept intact when the program is being replicated or adapted in order for it to produce program outcomes similar to those demonstrated in the original evaluation research.• Three categories: Content Pedagogy Implementation 8
WHAT ARE CORE COMPONENTS?Content: WHAT is being taught knowledge, attitudes, values, norms, &skills addressed in learning activitiesPedagogy: HOW the content is taught teaching methods, strategies, & youth– facilitator interactionsImplementation: LOGISTICS responsible for a conducive learning environment program setting, facilitator-youth ratio, dosage and sequence of sessions 9
WHAT IS ADAPTATION?Adaptation is a process ofmaking changes to anevidence-based program tomake it more suitable for aparticular population or anorganization’s capacity withoutcompromising its corecomponents 10
IT’S IMPORTANT TO REMEMBER…When considering for fit, you are NOTmaking adaptations to the programYou are thinking through potentialadaptations that might be necessary inorder for a program to be a good fit 11
WHAT IS FIT?Fit refers to how well theselected programmatches, or is appropriatefor, thecommunity, organization, stakeholders, and potentialparticipants. 12
ASPECTS OF COMMUNITY• Culture• Values & practices• Readiness for the program• Organizational mission & philosophy• Characteristics & context of the youth• Priorities of key stakeholders• Existing programs & services for youth 13
EXAMPLE: INTER TRIBAL COUNCIL OFTHE SOUTHWEST•Completed needs & resource assessment•Established goal & outcomes•Researched programs•Identified candidate programs*: 1. All4You 2. Making Proud Choices! 3. Reducing the Risk* Sample programs included for instructional purposes only 15
BENEFITS OF A GOOD FIT• More likely to be accepted by youth and community• Complement services & resources in community; reduce duplication & leverage resources• Build strong relationships with other providers, funders, & stakeholders• Ensure sufficient participation in the program• Increase chances of achieving desired outcomes 16
WHAT YOU NEED TO KNOWABOUT POTENTIAL PROGRAMS• Content• Activities• Dosage• Setting• Youth from evaluated version of program – Age, gender, race/ethnicity 17
5 STEPS TO ASSESS A PROGRAM& SELECT FOR FIT1. Assess fit with participants (youth)2. Assess fit with organization3. Assess fit with stakeholders4. Consider adaptations to improve fit5. Narrow list of potential programs & select a program that fits 18
1. ASSESS FIT WITH PARTICIPANTSa. Have youth similar to ours been helped by the same program?b. Are the planned activities socially & developmentally suitable for our youth?c. Are the planned activities culturally & linguistically suitable?d. Would the youth we plan to serve enjoy & 19 attend the program?
1. ASSESS FIT WITH PARTICIPANTS (CONTINUED)• Gather basic information about the characteristics of potential participants.• Learn about the cultural context. o Traditional beliefs about health care o Value of pregnancy, parenthood, & family o Practices around accessing health care & practicing preventative care o Communication about sexuality o Knowledge & understanding of reproduction o Cultural characteristics of other critical organizations o Ways of relating in meaningful & sustained ways• Identify issues arising from special situations in 20 Tribal communities.
2. ASSESS FIT WITH ORGANIZATIONa. Is the program goal compatible with your organization’s mission?b. What do board, staff, and leadership think of the potential programs?c. What is the context/setting in which the program was delivered (and evaluated) versus the one you plan to use?d. How realistic is the program dosage (i.e., number & duration of sessions)? 21
2. ASSESS FIT WITH ORGANIZATION(CONTINUED)e. Do you have the staff capacity necessary to implement the program with fidelity? o LOE, qualifications, comfort levels, training, support stafff. Do you have the necessary leadership capacity? o Diversity, longevity, supportg. Do you have the necessary partnerships & collaborations? o Leverage resources, complement servicesh. Do you have the necessary fiscal, resource, & technical capacities? o Training, space, transportation, computers, software, manua ls, condoms, anatomy models, notebooks, incentives, DVDs, A/V equipment, etc. 22
3. ASSESS FIT WITH STAKEHOLDERSa. Is another group already implementing similar efforts? o Complement or conflict? o Collaboration? o Need?b. What is the level of readiness, for youth and the community? o Really ready for the activities? o Support the program? o Health literacy necessary?c. What are key stakeholders’ priorities? 23 o Shared vision?
4. CONSIDER ADAPTATIONS TOIMPROVE FITa. Will the potential adaptation(s) maintain the program’s core components, so the program can be implemented will be fidelity?b. Are there any costs associated with making the potential adaptation(s)?c. What staff training will be required so facilitators can implement the adapted program with fidelity?d. What is the feasibility of making the potential adaptation(s)?e. What materials or information is needed to make 24 the potential adaptation(s)?
5. NARROW LIST OF POTENTIAL PROGRAMS & SELECT A PROGRAM THAT FITSa. Reconsider each program with information gathered in steps #1-4.b. Narrow list based on information, to determine most appropriate fit. o Implementation with fidelity and quality is critical. c. Select a program that fits, based on criteria assessed in Steps 1-4, to implement with 25 fidelity.
HEALTHY TEEN NETWORK TOOL: PROGRAM FIT CHECKLIST 26
HEALTHY TEEN NETWORK TOOL: PROGRAM FIT CHECKLIST 27
HEALTHY TEEN NETWORK TOOL: PROGRAM FIT CHECKLIST 28
HEALTHY TEEN NETWORK TOOL: PROGRAM FIT CHECKLIST 29
IF YOU HAVE ALREADYSELECTED A PROGRAM…• Consider your needs assessment results• Discuss program fit• Take a fresh look• Review adulthood preparation subjects handout to identify ways to incorporate these• Update adaptations 30
LESSONS LEARNED• Do we have organizational support for our program?• How do we communicate the benefits of our program?• Do we have a variety of champions who support our work? 31
SELECTED RESOURCES• Healthy Teen Network: www.HealthyTeenNetwork.org• Program Fit Checklist Tool by Healthy Teen Network http://healthyteennetwork.org/vertical/Sites/%7BB4D0CC76-CF78- 4784-BA7C-5D0436F6040C%7D/uploads/Fit_Checklist_Tool.pdf• Healthy Teen Network: Fit and Selection Case Study http://healthyteennetwork.org/vertical/Sites/%7BB4D0CC76-CF78- 4784-BA7C-5D0436F6040C%7D/uploads/HTN_GTO_Community- wide_initiative__Case_Study_FINAL.pdf• Advocates for Youth: www.advocatesforyouth.org• CDC DRH: www.cdc.gov/TeenPregnancy/index.htm• ETR Associates: www.etr.org/recappp• National Campaign to Prevent Teen & Unplanned Pregnancy: 32 www.nationalcampaign.org