Palinkas Lawrence A, Spear Suzanne E, Mendon Sapna J, Villamar Juan, Valente Thomas, Chou Chi-Ping, Landsverk John, Kellam Shepperd G, Brown C Hendricks
School of Social Work, University of Southern California, Los Angeles, CA, USA.
Department of Health Sciences, California State University, Northridge, CA, USA.
Implement Sci. 2016 Jul 16;11:95. doi: 10.1186/s13012-016-0467-6.
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.
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.
持续开展针对物质使用和心理健康问题的预防工作，是实施科学领域最重大但却最不为人所理解的挑战之一。关于“可持续性”一词的含义以及哪些因素能够预测甚至衡量有效预防项目和支持系统的可持续性，存在着巨大的知识差距。
方法/设计：美国药物滥用和心理健康服务管理局（SAMHSA）支持一系列多样化的预防和治疗资助项目，旨在改善人群和个体层面的行为健康。本研究聚焦于四个SAMHSA预防资助项目，其中两个针对州或单一社区层面的药物滥用预防，一个针对自杀预防，一个针对小学中的攻击性行为/破坏性行为预防。同时对所有四个资助项目进行考察，提供了一个机会来确定“可持续性”一词的含义，并识别和支持每个项目改善可持续性的独特要求，以及开发一个由不同预防方法的可持续性核心组成部分构成的通用框架。基于对这四个项目所支持的10个受资助方的定性和定量数据的分析，我们将开发一个灵活的测量系统，该系统兼具通用和特定组成部分，能够精确监测每种预防方法在基础设施、活动和成果方面的可持续性。然后，我们将对该系统进行改造，用于评估和提高实现预防工作可持续性的可能性。为实现这些目标，我们将：（1）确定预防项目及其支持基础设施可持续性的核心组成部分；（2）设计一个测量系统，用于监测并提供有关SAMHSA四个预防相关资助项目可持续性的反馈；（3）对这个多层次测量系统在这些项目中的可预测性以及该测量系统评估和提高可持续性可能性的可行性和可接受性进行试点测试。
本项目旨在提高由联邦、州、社区和基金会资金资助的预防性支持基础设施、活动和成果的可持续性。
