Search PubMed⌕ Search

Biomedical subjects

D Hallfors

Publications and source records attributed to D Hallfors.

8 recordsLinked to original sources
PubMed2006

Fidelity of implementation in a treatment effectiveness trial of Reconnecting Youth.

In 'a treatment effectiveness trial', a program is evaluated in a real-world setting, with an emphasis on achieving high implementation fidelity. Through fidelity assessment, the link between program implementation and outcomes is systematically evaluated and ultimately leads to a greater understanding of program success or failure. This paper reports the results of an implementation fidelity study of the 'Reconnecting Youth' (RY) prevention program. The research questions were (i) was the program implemented with fidelity? and (ii) did better fidelity predict better outcomes? RY is an indicated drug abuse prevention program for high school students that seeks to 'reconnect' high-risk youth to school before they drop out. The results reported here were part of a randomized controlled effectiveness trial of the RY prevention program conducted in two urban school districts in which 15 teachers taught 41 RY classes. Overall, implementation fidelity was high with an average 90% of core lessons being taught. Unexpectedly, increased quality of implementation predicted increased alcohol use and anger. Adherence (teaching more of the curriculum) predicted increased marijuana use, while exposure (student attendance) significantly increased bonding to high-risk peers, alcohol use and anger.

Adult↗
PubMed2002

Measuring perceptions of innovation adoption: the diffusion of a federal drug prevention policy.

The purpose of this paper is to describe the testing of a new scale to assess the perceived attributes of a federal drug prevention policy. The 17-item scale was administered to 107 Safe and Drug Free Schools (SDFS) coordinators in 12 states as a part of a larger investigation examining the diffusion of a federal drug prevention policy. In developing this scale, the authors drew from theory, previously validated measures, expert review and pre-testing with SDFS coordinators. Factor analysis revealed three underlying constructs representing relative advantage/compatibility, complexity and observability. The constructs found were internally consistent with a Cronbach's alpha ranging from a high of 0.89 for relative advantage/compatibility to a low of 0.71 for observability. Each of these constructs was correlated with a district's adoption of the policy in predictable ways. The construct of relative advantage/compatibility appears to be especially useful in assessing policy adoption. This scale was developed to assess a specific innovation; however, we believe that it can be easily adapted to understand the adoption of other health education interventions.

Diffusion of Innovation↗
PubMed2002

Will the 'principles of effectiveness' improve prevention practice? Early findings from a diffusion study.

This study examines adoption and implementation of the US Department of Education's new policy, the 'Principles of Effectiveness', from a diffusion of innovations theoretical framework. In this report, we evaluate adoption in relation to Principle 3: the requirement to select research-based programs. Results from a sample of 104 school districts in 12 states indicate that many districts appear to be selecting research-based curricula, but that the quality of implementation is low. Only 19% of the responding district coordinators indicated that schools were implementing a research-based curriculum with fidelity. Common problems included lack of teacher training, lack of requisite materials, use of some but not all of the required lessons and teaching strategies, and failure to deliver lessons to age-appropriate student groups. This study represents the first attempt to assess the quality of implementation of research-based programs as required by the Principles of Effectiveness. We conclude that low levels of funding, inadequate infrastructure, decentralized decision making and lack of program guidance have contributed to the slow progress in improving school-based prevention.

Curriculum↗
PubMed1994

Stability of frailty in the social/health maintenance organization.

Although many long-term care (LTC) programs assume that the disabilities of their frail elderly participants are stable in nature, there has been suggestive evidence to the contrary. This study tests stability of disability among social/health maintenance organization (S/HMO) members who were judged eligible for admission into a nursing home. Identified persons were reassessed quarterly. By the end of 1 year, less than 50 percent were still considered to be nursing home eligible. Logit analysis revealed an increased likelihood of instability for persons who were newly identified as functionally disabled after hospitalization. Policy implications for capitated managed-care programs for the elderly are discussed.

Aged↗