The text in this product is largely drawn verbatim from McKlindon, A. & Sun, S. (2020). Considerations for Scaling Evidence-Based Prevention Programs under the Family First Prevention Services Act


The Family First Prevention Services Act (Family First Act) seeks to keep children safely with their families through the provision of evidence-based services to prevent foster care entry.[1] As states prepare for and begin implementation, they can choose from a small but slowly growing list of prevention programs that meet the Family First Act’s evidence requirements. As of November 2020, only 21 program models met the criteria for a rating of promising or above by the Title IV-E Prevention Services Clearinghouse (Clearinghouse), of which only nine are rated as well-supported.[2]

Program purveyors, who disseminate their program models through activities such as training staff and providing technical assistance, play an essential role in successfully implementing evidence-based models and scaling services. This fact sheet provides an overview of the role of purveyors in implementation and identifies four factors that may impact purveyors’ capacity to scale services under the Family First Act. Addressing these factors will be key to ensuring the Family First Act achieves its aims.

What is a purveyor?

Purveyors hold exclusive rights to the program model and may be the developer of the model or a separate entity. A program model purveyor is responsible for disseminating evidence-based models through activities such as:

  • Training and certifying staff
  • Providing technical assistance
  • Monitoring to ensure the model is implemented as intended (i.e., ensuring fidelity)
  • Increasing program effectiveness
  • Promoting scale

Context

Purveyors face a unique set of challenges as states implement the Family First Act. Many program models were not originally designed with scaling in mind. For example, models developed by researchers based on theory and tested in smaller, controlled settings (e.g., university labs) may be less culturally relevant and harder to implement in real world settings.[3] Other program models have been developed and refined by local providers over time to best serve their communities, and these providers may lack the capacity to support the implementation of their program model in other communities.

The literature highlights other challenges facing purveyors. Purveyors who are the original model developers may be more interested in research and development than dissemination and implementation support.[4] Moreover, developers and purveyors often lack needed skillsets for dissemination (e.g., marketing and management), and they may also lack adequate staffing, sufficient funding, and incentives to expand their model’s reach.[5] Finally, few models were designed specifically for the child welfare context and may require adaptations to better meet the needs of families and systems.[6]


Factors that may impact purveyors’ capacity to scale services

References

[1] The Family First Act includes several other provisions. For an overview of the Act and additional resources, see www.FamilyFirstAct.org.

[2] Three additional programs have been approved for transitional payments through independent systematic reviews.

[3] Fagan, A.A., Bumbarger, B.K., Barth, R.P., Bradshaw, C.P., Rhoades Cooper, B., Supplee, L.H., & Klein Walker, D. (2019). Scaling up evidence-based interventions in US public systems to prevent behavioral health problems: challenges and opportunities. Prevention Science 20, 1147-1168. https://doi.org/10.1007/s11121-019-01048-8

[4] Fagan, A.A., Bumbarger, B.K., Barth, R.P., Bradshaw, C.P., Rhoades Cooper, B., Supplee, L.H., & Klein Walker, D. (2019). Scaling up evidence-based interventions in US public systems to prevent behavioral health problems: challenges and opportunities. Prevention Science 20, 1147-1168. https://doi.org/10.1007/s11121-019-01048-8

[5] Neuhoff, A., Loomis, E., & Ahmed, F. (2017). What’s standing in the way of the spread of evidence-based programs? The Bridgespan Group. https://www.bridgespan.org/insights/library/performance-measurement/the-spread-of-evidence-based-programs 

[6] Aarons, G. & Chaffin, M. (2013). Scaling-up evidence-based practices in child welfare services systems. CYF News. https://www.apa.org/pi/families/resources/newsletter/2013/04/child-welfare

[7] While these two case studies highlight important considerations, additional findings would likely emerge from interviews with more purveyors and implementing providers.