Strand D Sustaining & Scaling Implementation of SWPBS: Systems & Applications

1. Strand DSustaining & Scaling Implementation of SWPBS: Systems & Applications Rob Horner & George Sugai OSEP Center on PBIS April 4, 2008 www.pbis.org robh@uoregon.edu george.sugai@uconn.edu

2. www.pbis.org

3. www.scalingup.org

4. Problem Statement “We give schools strategies & systems for developing positive, effective, achieving, & caring school & classroom environments, but implementation is not accurate, consistent, or durable. Schools need more than training.”

5. Sessions 8:30 – Overview of Sustainability & Scaling (Kent & Dean) 9:45 – State Examples I (Susan, Howard, & Char 1:15 – State Examples II (Steve, Diann, & Kiki 3:45 – Secondary & Tertiary Tier Interventions & Systems (Cindy, Lucille, & Leanne

6. Local Demonstration w/ Fidelity Need, Agreements, Adoption, & Outcomes 1. IMPLEMENTATION PHASES 2. Sustained Capacity, Elaboration, & Replication 4. Systems Adoption, Scaling, & Continuous Regeneration 3.

7. Sustainability + Scaling Organizational capacity for & documentation of accurate (90%) & expandable implementation of evidence-based practice across desired context(e.g., district, classroom, school-wide, nonclassroom) over time w/ local resources & systems for continuous regeneration.

8. SUSTAINABLE IMPLEMENTATION & DURABLE RESULTS THROUGH CONTINUOUS REGENERATION Continuous Self-Assessment Relevance Priority Efficacy Fidelity Valued Outcomes Effective Practices Practice Implementation Local Implementation Capacity

9. Priority Effectiveness Valued Outcomes Identifying & Modifying Practices Data- Based Prob. Solving Continuous Regeneration Capacity Building Continuous Measurement Practice Implementation Fidelity Efficiency School Context

10. Sustaining School-wide Positive Behavior Support CEC Conference Kent McIntosh

11. “The distribution and adoption of an innovation are only significant if its use can be sustained...” (Coburn, 2003, p. 6)

12. Definitions • Sustainability • Durable implementation of a practice at a level of fidelity that continues to produce valued outcomes (Han & Weiss, 2005) • Scaling Up • Durable implementation of a practice at a level of fidelity that continues to produce valued outcomes on a scale of social importance

13. Efforts to Implement and Sustain • “Train and Hope” • Not an effective approach to implement a practice • “Implement and Hope” • Not an effective way to sustain a practice

14. Effectiveness Priority Valued Outcomes Identifying & Modifying Practices Data- Based Prob. Solving Continuous Regeneration Capacity Building Continuous Measurement Practice Implementation Fidelity Efficiency (McIntosh, Horner, & Sugai, in press) School Context

15. Effectiveness Priority Valued Outcomes Identifying & Modifying Practices Data- Based Prob. Solving Continuous Regeneration Capacity Building Continuous Measurement Practice Implementation Fidelity Efficiency (McIntosh, Horner, & Sugai, in press) School Context

16. PRIORITY Importance in comparison to other practices Connection to other initiatives Incorporation into core system components Priority Valued Outcomes

17. Priority Effectiveness Valued Outcomes Identifying & Modifying Practices Data- Based Prob. Solving Continuous Regeneration Capacity Building Continuous Measurement Practice Implementation Fidelity Efficiency School Context

18. EFFECTIVENESS • Extent to which the practice results in desired outcomes • Choice of practices should be based on proven effectiveness • Effects must be observed and attributed to the practice Effectiveness Identifying & Modifying Practices

19. Priority Effectiveness Valued Outcomes Identifying & Modifying Practices Data- Based Prob. Solving Continuous Regeneration Capacity Building Continuous Measurement Practice Implementation Fidelity Efficiency School Context

20. FIDELITY and EFFICIENCY • Without fidelity of implementation, effectiveness of the practice is compromised • Relationship between continued effort and continued effectiveness • Weighed against other potential practices Practice Implementation Fidelity Efficiency

21. Priority Effectiveness Valued Outcomes Identifying & Modifying Practices Data- Based Prob. Solving Continuous Regeneration Capacity Building Continuous Measurement Practice Implementation Fidelity Efficiency School Context

22. CONTINUOUS REGENERATION • Iterative monitoring of fidelity, outcomes, and context • Adaptation and re-implementation over time while keeping critical features intact • Ongoing investment in training and spread Data- Based Prob. Solving Continuous Regeneration Capacity Building Continuous Measurement

23. Priority Effectiveness Valued Outcomes Identifying & Modifying Practices Data- Based Prob. Solving Continuous Regeneration Capacity Building Continuous Measurement Practice Implementation Fidelity Efficiency School Context

24. A Tool for Sustainable Implementation of SWPBS • SWPBS Implementers’ Blueprint(Center on PBIS, 2004) • Available at www.pbis.org • Intended for use at the state, regional, or district level

25. SWPBS Implementers’ Blueprint Elements Visibility Political Support Funding Leadership Team Evaluation Training Coaching Local School Teams/Demonstrations

26. SWPBS Implementers’ Blueprint Leadership Team • Representation from key stakeholders • Meet regularly with a regular process • Complete regular self-assessment and long term action planning • Led by Coordinator with FTE

27. SWPBS Implementers’ Blueprint • BUILD CAPACITY • (training expertise) • Support coaches • Ensure coaches • implement with • fidelity • Establish community • of learning • BUILD CAPACITY • (implementation • expertise) • Support school • teams • Ensure teams • implement with • fidelity • DATA-BASED • DECISION MAKING • Create data systems • Fidelity • Student outcomes • Design process for • evaluation • Establish eval cycles Evaluation Training Coaching COORDINATION ACTIVITIES

28. SWPBS Implementers’ Blueprint Visibility Political Support Funding • Identify recurring • funding sources • 3 to 5 yrs. of support • Disseminate results • to multiple audiences • Websites • Newsletters • Conferences • Media (TV, etc.) • Presentations to: • school boards, • state departments • Write into policy • Connect with key • administrators LEADERSHIP ACTIVITIES

29. SWPBS Implementers’ Blueprint • Support schools implementing SWPBS • Coaching • Funding • Showcase schools with high fidelity and positive outcomes • Present data linking fidelity to student outcomes • Arrange visits from key stakeholders Local School Teams/Demonstrations

30. Contact Information • Kent McIntosh kent.mcintosh@ubc.ca University of British Columbia 2125 Main Mall Vancouver, BC V6T 1Z4

31. Sustaining Implementation with Benefits to Students Dean L. Fixsen, Karen A. Blase, Michelle A. Duda, Sandra F. Naoom, Melissa Van Dyke, Frances Wallace Bailey National Implementation Research NetworkLouis de la Parte Florida Mental Health Institute CEC Conference April 2008

32. Education • 65 million kids • 6 million teachers and staff • 100,000 schools • 3,143 counties • 60 states & U.S. jurisdictions

33. SERVICE SCIENCE IMPLEMENTATION Science to Service GAP

34. Science to Service • Science to Service Gap • What is known is not what is adopted to help children, families, and caregivers • Implementation Gap • What is adopted is not used with fidelityand good outcomes for consumers. • What is used with fidelity is not sustained for a useful period of time. • What is used with fidelity is not used on a scale sufficient to impact social problems.

35. Implementation Reviews • Human service prevention and treatment programs (e.g. substance abuse, adult / children’s MH, justice, health, education) • Advanced manufacturing technologies • AMA clinical guidelines • Engineering: bridge maintenance • Hotel service management • National franchise operations • Cancer prevention & treatment

36. Ineffective Methods Excellent experimental evidence for what does not work • Diffusion/dissemination of information by itself does not lead to successful implementation (research literature, mailings, promulgation of practice guidelines) • Training alone, no matter how well done, does not lead to successful implementation

37. Ineffective Methods Excellent evidence for what does not work • Implementation by edict by itself does not work • Implementation by “following themoney” by itself does not work • Implementation without changing supporting roles and functions does not work Paul Nutt (2002). Why Decisions Fail

38. Sustainability • EBPs now are boutique operations • Now have convincing demonstrations that EBPs can work in the real world • Pretty neat but not used on a sustainable scale sufficient to solve social problems • What will it take to have 100,000 replications that produce increasingly effective outcomes for 100 years? • Start with the end in mind

39. A Sobering Observation "All organizations [and systems] are designed, intentionally or unwittingly, to achieve precisely the results they get." R. Spencer Darling Business Expert

40. Sustainability • Innovative practices do not fare well in old organizational structures and systems • Organizational and system changes are essential to successful implementation • Expect it • Plan for it

41. Sustainability • To scale up interventions we must first scale up implementation capacity • Building implementation capacity is essential to sustaining EBPs and other innovations

42. Sustainability • Interventions that are and remain effective through several generations of teachers, principals, superintendents, and state and national leaders • Implementation supports that are and remain effective through several generations of interviewers, trainers, coaches, evaluators, administrators, and state leaders

43. Prepare schools faculty, staff Prepare Communities Implementation Team Prepare Districts Work with Researchers Assure Implementation Implementation Team Assure Student Benefits

44. Teacher • School • Management (leadership, policy) • Administration (HR, structure) • Supervision (nature, content) District State and Community Context Implementation Team Simultaneous, Multi-Level Interventions Implementation Team

45. Creating Implementation Capacity • Start with too many overqualified people • “Generation 1” practitioners become: • Generation 2 interviewers, trainers, coaches, evaluators • Generation 3 administrators, directors, and leaders • Generation 4 state and federal officials

46. Systems Change Implementation Teams Federal Departments State Department Districts ALIGNMENT Schools Teachers/ Staff Effective Practices FORM FOLLOWS FUNCTION

47. A Functional System Policies Bureaucracy Agencies Practitioners

48. Creating Implementation Capacity New OSEP Center State Implementation and Scaling up of Evidence-based Practices (SISEP) www.scalingup.org

49. Thank You We thank the following for their support Annie E. Casey Foundation (EBPs and cultural competence) William T. Grant Foundation (implementation literature review) Substance Abuse and Mental Health Services Administration (implementation strategies grants; NREPP reviews; SOC analyses of implementation; national implementation awards) Centers for Disease Control & Prevention (implementation research contract) National Institute of Mental Health (research and training grants) Juvenile Justice and Delinquency Prevention (program development and evaluation grants Office of Special Education Programs (Capacity Development Center contract) Agency for Children and Families (Child Welfare Leadership Development contract)

50. Dean L. Fixsen 813-974-4446 dfixsen@fmhi.usf.edu Karen A. Blase 813-974-4463 kblase@fmhi.usf.edu For More Information • National Implementation Research Network • At the Louis de la Parte Florida Mental Health Institute • University of South Florida • http://nirn.fmhi.usf.edu