Impact Challenges in Community Science‐with‐Practice: Lessons from PROSPER on Transformative Practitioner‐Scientist Partnerships and Prevention Infrastructure Development

Abstract

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating communitylevel impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.

PROSPER delivery of universal preventive interventions with young adolescents: long-term effects on emerging adult substance misuse and associated risk behaviors

“…To illustrate, the RRR for lifetime non-prescribed narcotics use (25.8%) suggests that, for every 100 general population young adults (i.e., from non-PROSPER communities/school districts) who have ever misused narcotics, approximately 74 young adults from PROSPER sites would have misused narcotics. The combination of positive outcomes and cost-efficiency of the PROSPER partnership model (Spoth & Greenberg, 2011; Crowley et al 2012) suggests its potential public health benefit, particularly in light of the likely long-term effects of reduced young adult substance misuse (e.g., Hawkins et al 2005, 2008 b ; Spoth et al 2014 a ;Trudeau et al 2016). The National Research Council and Institute of Medicine Report (2009) and the recent US Surgeon General Report (2016), along with other literature (Hawkins et al 2008 a; 2012), note the practical benefits of community-based prevention delivery systems for EBIs, particularly those embedded in national delivery systems and/or those supporting practitioner-scientist partnerships (Grumbach & Mold, 2009; Spoth & Greenberg, 2011).…”

Mixed Picture of Readiness for Adoption of Evidence‐Based Prevention Programs in Communities: Exploratory Surveys of State Program Delivery Systems

“…This capacity and mission suggest considerable systems potential for dissemination and evaluation of evidence-based family and youth programming (Molgaard 1997; Spoth et al 2004). Relevant literature has accumulated over the past two decades specifying how the Extension system offers opportunities for better translating EBPs into widespread community-based practice, especially when linked with other program or service delivery systems (e.g., Molgaard 1997; Spoth and Greenberg 2011; Spoth et al 2015). …”

System tools for system change

“…The formation of the Youth Development Team from two existing state government agencies facilitated a shared YD vision, leading to the collection of robust outcome data incorporated into a technical knowledge database accessible to clinicians, funders, policy makers and local communities 64. Other transformative initiatives have targeted better integration between ‘researchers and practitioners’, including a state-wide depression care improvement initiative in Minnesota66 as well as a partnership-based programme between communities, consumers, practitioners and prevention scientists to reduce youth violence 67. This latter model (the PROSPER partnerships model) has operated within the National Implementation Research Network's view of transformation: working to transform the provision of youth services within a ‘vertical slice’ of the system 67.…”

“…Other transformative initiatives have targeted better integration between ‘researchers and practitioners’, including a state-wide depression care improvement initiative in Minnesota66 as well as a partnership-based programme between communities, consumers, practitioners and prevention scientists to reduce youth violence 67. This latter model (the PROSPER partnerships model) has operated within the National Implementation Research Network's view of transformation: working to transform the provision of youth services within a ‘vertical slice’ of the system 67. This slice, or ‘zone of innovation,’ has provided sufficient experimental conditions to cross all aspects of the system, but which is suitably narrow as to permit continued system function.…”