@article{bcfd7506ac314f668477265224a6cc5c,
title = "Measuring sustainment of prevention programs and initiatives: A study protocol",
abstract = "Background: Sustaining prevention efforts directed at substance use and mental health problems is one of the greatest, yet least understood, challenges in the field of implementation science. A large knowledge gap exists regarding the meaning of the term {"}sustainment{"} and what factors predict or even measure sustainability of effective prevention programs and support systems. Methods/design: The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) supports a diverse portfolio of prevention and treatment grant programs that aim to improve population and individual level behavioral health. This study focuses on four SAMHSA prevention grant programs, two of which target substance abuse prevention at the state or single community level, one targets suicide prevention, and one targets prevention of aggressive/disruptive behavior in elementary schools. An examination of all four grant programs simultaneously provides an opportunity to determine what is meant by the term sustainment and identify and support both the unique requirements for improving sustainability for each program as well as for developing a generalizable framework comprised of core components of sustainment across diverse prevention approaches. Based on an analysis of qualitative and quantitative data of 10 grantees supported by these four programs, we will develop a flexible measurement system, with both general and specific components, that can bring precision to monitoring sustainment of infrastructure, activities, and outcomes for each prevention approach. We will then transform this system for use in evaluating and improving the likelihood of achieving prevention effort sustainment. To achieve these goals, we will (1) identify core components of sustainment of prevention programs and their support infrastructures; (2) design a measurement system for monitoring and providing feedback regarding sustainment within the four SAMHSA's prevention-related grant programs; and (3) pilot test the predictability of this multilevel measurement system across these programs and the feasibility and acceptability of a measurement system to evaluate and improve the likelihood of sustainment. Discussion: This project is intended to improve sustainment of the supporting prevention infrastructure, activities, and outcomes that are funded by federal, state, community, and foundation sources.",
keywords = "Implementation, Instruments, Measures, Prevention, Substance use, Suicide, Sustainment",
author = "Palinkas, {Lawrence A.} and Spear, {Suzanne E.} and Mendon, {Sapna J.} and Juan Villamar and Thomas Valente and Chou, {Chi Ping} and John Landsverk and Kellam, {Shepperd G.} and Brown, {C. Hendricks}",
note = "Funding Information: The project is innovative in three specific respects. First, unlike other projects that focus on only one practice or program, we will be simultaneously examining sustainment of infrastructure, activities, and outcomes in four different sets of SAMHSA-funded programs. This will give us a rare opportunity to identify a set of common elements of sustainment that can be used to generate a model and set of testable hypotheses that apply to a broad array of drug abuse/mental disorder/suicide prevention programs, practices, and initiatives, regardless of objectives, outcomes, and infrastructure to achieve these outcomes. Second, we are developing a measure of sustainment that can be used validly and reliably across this broad array of programs, practices, and initiatives with varying levels of evidence to support their effectiveness. This will enable us to determine whether the extent to which a program or practice is evidence-based or evidence-informed determines whether it can be sustained [19–21]. Third, we will tailor this measure so that it can be used to monitor progress toward sustainment and provide feedback to stakeholders as to how to increase the likelihood of sustainment. This measurement system will thus have use as a tool for program management as well as research purposes. Although this project targets programs funded by SAMHSA, the work should have general applicability across diverse federal, state-wide, and local prevention implementation initiatives. Funding Information: Methods/design: The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) supports a diverse portfolio of prevention and treatment grant programs that aim to improve population and individual level behavioral health. This study focuses on four SAMHSA prevention grant programs, two of which target substance abuse prevention at the state or single community level, one targets suicide prevention, and one targets prevention of aggressive/disruptive behavior in elementary schools. An examination of all four grant programs simultaneously provides an opportunity to determine what is meant by the term sustainment and identify and support both the unique requirements for improving sustainability for each program as well as for developing a generalizable framework comprised of core components of sustainment across diverse prevention approaches. Based on an analysis of qualitative and quantitative data of 10 grantees supported by these four programs, we will develop a flexible measurement system, with both general and specific components, that can bring precision to monitoring sustainment of infrastructure, activities, and outcomes for each prevention approach. We will then transform this system for use in evaluating and improving the likelihood of achieving prevention effort sustainment. To achieve these goals, we will (1) identify core components of sustainment of prevention programs and their support infrastructures; (2) design a measurement system for monitoring and providing feedback regarding sustainment within the four SAMHSA{\textquoteright}s prevention-related grant programs; and (3) pilot test the predictability of this multilevel measurement system across these programs and the feasibility and acceptability of a measurement system to evaluate and improve the likelihood of sustainment. Discussion: This project is intended to improve sustainment of the supporting prevention infrastructure, activities, and outcomes that are funded by federal, state, community, and foundation sources. Publisher Copyright: {\textcopyright} 2016 Palinkas et al.",
year = "2016",
month = jul,
day = "16",
doi = "10.1186/s13012-016-0467-6",
language = "English (US)",
volume = "11",
journal = "Implementation Science",
issn = "1748-5908",
publisher = "BioMed Central",
number = "1",
}
