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Brian K. Bumbarger

New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

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Page 1: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

Brian K. Bumbarger

Page 2: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

• To improve outcomes, we must bridge the gap between science and practice

• PCCD’s Approach: Create sustained, community-wide public health impact through effective community coalitions using proven-effective programs targeted at strategically identified risk and protective factors

Page 3: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

• Prevent dependency, delinquency, youth violence and SA to the greatest degree possible (narrowing the “funnel”)

• Intervene effectively with youth for whom primary prevention is not sufficient (reducing further system penetration)

• Allow communities flexibility to select strategies that best meet local needs

• Create community-level infrastructure for strategic prevention planning and coordination

• Provide accountability and use scarce resources efficiently

Page 4: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

• Successor to earlier CTC initiative that promoted community coalitions/risk & resource assessments

• State funding for program startup, after identification of need by local community

• Nearly 200 EBP’s funded since 1998 (+~200 through other sources)

• Big Brothers/Sisters, LST, SFP 10-14, PATHS, OlweusBullying Program, TND, Incredible Years, ART (& MST, FFT, MTFC, NFP)

Page 5: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

5

Programs can be placed along a continuum of confidence based on their evidence or theory

How confident are we that this program or practice is a good use of resources AND improves outcomes for children and families?

Very Confident

Evidence‐based“This program has been rigorously evaluated and shown to work”

Research‐based“This program is based on sound theory informed by research”

Promising Approaches“We really think this will work…  but we need time to prove it”

Best Practices“We’ve done it and we like it”

EFFECTIVEHARMFUL

Iatrogenic (Harmful)“This program has been rigorously evaluated and shown to be harmful”

Ineffective“This program has been evaluated and shown to have no positive or negative effect”

PromisingIneffective unknownVery 

Confident

*Bumbarger & Rhoades, 2012

Page 6: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

Pennsylvania’s EBP dissemination in 1999…

Page 7: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

Pennsylvania’s EBP dissemination in 2012…

Page 8: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

• Synthesis and translation of research to practice, (and practice to research)

• EBP dissemination, selection, and uptake• Ensuring sufficient implementation quality and fidelity• Understanding adaptation and preventing program drift • Measuring and monitoring implementation and outcomes• Policy, systems, and infrastructure barriers• Coordination across multiple programs and developmentally• Sustainability in the absence of a prevention infrastructure Bumbarger, B. and Perkins, D. (2008). After Randomized Trials: Issues related to dissemination of evidence-based interventions. Journal of Children’s Services,3(2), 53-61.

Bumbarger, B., Perkins, D., and Greenberg, M. (2009). Taking Effective Prevention to Scale. In B. Doll, W. Pfohl, & J. Yoon (Eds.) Handbook of Youth Prevention Science. New York: Routledge.

Page 9: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

Build general prevention capacity

Build program‐specific capacity

Facilitate interaction/ communication between systems

Tran

slationa

l Re

search EPISCenter 

(Prevention Support System)

Build general prevention capacity among practitioners and policy makers 

Technical Assistance

Continuous Quality 

Improvem

ent

EBP Grantees & Community Coalitions

(Prevention Delivery System)

Penn State’s Prevention Research Center

(Prevention Synthesis & Translation System)

Resource Center Steering Committee

(Policy Makers & Funders)

Rhoades, Bumbarger & Moore (in press). The Role of a State-Level Prevention Support System in Promoting High-Quality Implementation and Sustainability of Evidence-based Programs. American Journal of Community Psychology.

Page 10: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

Support to Community PreventionCoalitions

Resource Center for Evidence‐based Prevention and Intervention 

Programs and Practices

Quality of Juvenile Justice 

Services

Support to Evidence-based

Programs

Multi-Agency Steering Committee(Justice, Welfare, Education, Health)

The EPISCenter is a project of the Prevention Research Center, College of Health and Human Development, Penn State University,and is funded by the Pennsylvania Commission on Crime and Delinquency and the Pennsylvania Department of Public Welfare

as a component of the Resource Center for Evidence‐Based Prevention and Intervention Programs and Practices.

A unique partnership between policymakers, researchers, and communities to bring science to bear on issues of public health and 

public safety

Page 11: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

• Cross-sectional quasi-experimental study of 98,000 students in 147 communities

• Used propensity score matching to minimize potential selection bias

• Found youth in CTC communities reported lower rates of risk factors, substance use, and delinquency than youth in similar non-CTC communities (7x as many as by chance)

• Communities using EBPs showed better outcomes on twice as many R/P factors and behaviors (14x as many as by chance)

Page 12: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

5 year Longitudinal Study of PA Youth% Improvement of CTC/EBP Youth Over

Comparison Group419 age-grade cohorts over a 5-year period:

Youth in CTC communities using

EBPs had significantly lower rates of

delinquency, greater resistance to negative

peer influence, stronger school engagement and

better academic achievement

Feinberg, M.E., Greenberg, M.T., Osgood, W.O., Sartorius, J., Bontempo, D.E. (2010). Can Community Coalitions Have a Population Level Impact on Adolescent Behavior Problems? CTC in Pennsylvania, Prevention Science.

Page 13: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

33.07%

36.42%

35.30%

32.38%

30%

31%

32%

33%

34%

35%

36%

37%

2006 2010

Per

cen

t of

You

th

Percent of Youth In Care, ages 10-17, In a Restrictive Placement on March 31

Counties without an EBI(n=10)

Counties that initiated an EBIin '07, '08, or '09 (n=10)

Bumbarger, B. K., Moore, J., & Rhoades, B. (2010). Impact of evidence-based interventions on delinquency placement rates.Presentation at 2011 Society for Prevention Research annual meeting. Washington, DC.

Page 14: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

Program B-C per youth

Avg. Return/ Community

# Programs Statewide

Est. Total PA Return

Big Brothers/Sisters $54 $13,500 28 $378,000

LifeSkills Training $808 $161,600 100 $16,160,000

Multi. Treatment Foster Care

$79,331 $475,986 3 $1,427,958

Multisystemic Therapy $16,716 $2,507,400 12 $30,088,800

Functional Family Therapy

$32,707 $12,395,953 11 $136,355,483

Nurse-Family Partnership

$36,878 $4,782,976 25 $119,574,400

Strength. Families $6,541 $872,133 15 $13,082,000

TOTAL $317,066,641

Page 15: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

www.episcenter.psu.edu

Page 16: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

www.episcenter.psu.edu

Page 17: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,
Page 18: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

If you don’t know where you’re going, any road will get you there…

The Cheshire Cat

Page 19: New Grantee Orientation 2012 - EBP Rationale and Impact...Counties without an EBI (n=10) Counties that initiated an EBI in '07, '08, or '09 (n=10) Bumbarger, B. K., Moore, J., & Rhoades,

Thank You!

Evidence‐based Prevention and Intervention Support CenterPrevention Research Center, Penn State University

206 Towers Bldg.University Park, PA  16802

(814) 863‐[email protected]

www.episcenter.psu.edu