Adapting Evidence-Based Intervention Strategies for your Community

1. Adapting Evidence-Based Intervention Strategies for your Community CHIP Learning Session # 2 • March 11 ,2014 Sarah Hartsig, M.S. Kansas Health Institute

2. Review: Why Use Evidence-Based Intervention Strategies? • Don’t have to re-invent the wheel • Confidence in your approach • Not wasting resources (time AND money) • More attractive to funders • Standardization of approach across communities (allows for peer learning)

3. Review: Why Use Evidence-Based Intervention Strategies? • Provide high-quality, filtered information to make informed decisions • Help to support the identified course of actions • Help to demonstrate benefits of public health interventions • Add to the body of evidence

4. Funding Example • http://kansashealth.org/sites/default/files/HLG%20RFP.pdf

5. Type of Evidence Source: Health Policy Institute of Ohio. Guide to Evidence-Based Prevention. 2013.

6. Review: Steps for Choosing Evidence-Based Practice • Conduct a community-based assessment • Find practices or interventions that have successfully addressed the issue • Determine what elements of a promising intervention will work in your community, and which ones need to be changed

7. Why Adapt? • A well-adapted program can • Increase relevance • Decrease the possibility of surprises • Increase support and involvement of stakeholders, especially if the intervention is targeted to a specific group • Build trust and cooperation • Scale to fit resources

8. Why Adapt? • Intervention strategies are not one-size-fits-all • Every community is different • Differences in ‘culture’ may require adjustment of pieces of the practice

9. Looking at “Contextual Evidence” • Cultural differences to consider: • Does your population differ from the model practice’s population in their: • Language • Race/ethnicity • Urban/Rural • Age • Gender • Social Class • Employment • Family Background

10. Cultural Differences: Health Beliefs • How do members of various groups in the community define health and illness? • Where do people go for health information? • Who are the formal and informal leaders in the community, and what role do they have in the area of health promotion?

11. Socio-economic differences: Information from CHA • What are the different socio-economic levels of groups within the community? • Make sure interventions are accessible (i.e. provide childcare at evening meetings) • What are the different education levels? • Be sure that information is digestible • What are the predominant family structures? • How many languages and dialects are spoken? • Create bi-lingual materials, if needed

12. Resource Differences to Consider • Does your group have the money that it will take to implement the intervention? • If not, are grants available? • Does your group have the people power to implement the intervention? • If not, can you implement one part of a successful multi- part intervention?

13. Stakeholder Differences to Consider • Is there engagement from listed partners (i.e. school, faith groups) • If not, can you engage them? • What is the political climate for this intervention? • Will you need to seek buy-in from decision-makers prior to planning this intervention? • Example: Needle-exchange programs

14. An Important Question: • Does an Intervention Strategy always need to be adapted? • Not necessarily • Depends on the answers to the questions: • How closely is the practice aligned with our, Goal, Population, Outcome Measure? • Do we have the needed resources? • Is there political support for the intervention?

15. Tips for Successful Adaptation • Preserve the essence of a successful intervention • Individual components can be adapted • Scale to fit available resources if needed • Multi-part interventions can be broken into individual parts • Implement the intervention, making adjustments as you go along

16. Adaptation of Practices for Target Groups • Ask THEM if it will work • Include them in the planning • Example: Education classes for high school students about teenage pregnancy • Involve teens and their parents in reviewing the practice you have found, planning curriculum and structure

17. Adaptation of Practices for Target Groups • Remember that intervention strategies should be conducted IN that community and WITH them, not AT them

18. “Experiential Evidence” • Make sure that everyone has the capacity to do what is proposed • Keep people in the loop, maintain communication • If you’re not implementing the practice, make sure the person who is implementing • Knows why it was chosen • Has the knowledge to implement • Will give feedback on how it’s going

19. A Word on Evaluation • IF you change the original practice (i.e. specific target population, scale of the practice, or key activities) • THEN: Evaluate rigorously • Adds to the body of evidence, making the practice more useful for other groups in the future

20. Resources: • KU Community Toolbox: • Chapter 19, sections 4 and 5 • http://ctb.ku.edu/en/table-of-contents

21. Questions? Tatiana Lin, M.A. Senior Analyst and Strategy Team Leader, Kansas Health Institute tlin@khi.org Sarah Hartsig, M.S. Analyst, Kansas Health Institute shartsig@khi.org 785-233-5443

22. Sources • Health Policy Institute of Ohio. Guide to Evidence-Based Prevention. 2013. • Brownson, Fielding and Maylahn. Evidence-based public health: A fundamental concept for public health practice. Annual Review of Public Health. 2009. • KU Community Toolbox: http://ctb.ku.edu/en/table-of-contents

23. Kansas Health Institute Information for policy makers. Health for Kansans.