What’s Standing in the Way of Evidence-Based Programs?

Evi­dence-based pro­grams could be a real game chang­er as they ensure that ser­vices intend­ed to improve well-being out­comes have been proven to work. But for these tried-and-test­ed inter­ven­tions to have any impact at scale, they must first reach the chil­dren and fam­i­lies who need them. Accord­ing to a new study by the Bridges­pan Group, fund­ed by the Annie E. Casey Foun­da­tion, many evi­dence-based pro­grams face a prob­lem of large-scale reach — and that prob­lem is direct­ly relat­ed to how they are being disseminated.

What’s Stand­ing in the Way of the Spread of Evi­dence-based Pro­grams? ana­lyzes the chal­lenges of extend­ing the reach and dif­fer­ence made by evi­dence-based pro­grams. It focus­es on the activ­i­ties of pur­vey­ors — orga­ni­za­tions tasked with dis­sem­i­na­tion after the pro­grams have been devel­oped. These activ­i­ties include steps to increase pro­gram effec­tive­ness, ensure pro­gram fideli­ty through­out the repli­ca­tion process and proac­tive­ly expand the program’s use.

Includ­ed in the study were pur­vey­ors of 46 evi­dence-based pro­grams in juve­nile jus­tice and child wel­fare — focus areas for the Foun­da­tion. While the study found that the vast major­i­ty of the pur­vey­ors engaged in efforts to improve pro­grams and offer train­ing and sup­port in repli­ca­tion, there was a steep drop-off in pur­vey­or par­tic­i­pa­tion when it came to pro­mot­ing adop­tion on a broad­er scale.

Why such a decline in engage­ment from these orga­ni­za­tions so clear­ly com­mit­ted to the suc­cess of their evi­dence-based pro­grams? The paper iden­ti­fies three prin­ci­pal causes:

1. Lack of resources. Pur­vey­ors described hav­ing to short­change expan­sion efforts to con­cen­trate time and mon­ey on effec­tive­ness and fidelity.
2. Lack of exper­tise. Like many of their social sec­tor peers, pur­vey­ors often do not pos­sess the sales, mar­ket­ing and oth­er skills need­ed to expand reach.
3. Lack of incen­tives to expand. The dri­ving force behind some evi­dence-based pro­grams is more the desire to under­stand a prob­lem and test a the­o­ry on how to solve it than it is to get a proven inter­ven­tion into the field.

These fac­tors, often work­ing in com­bi­na­tion, mean that most evi­dence-based pro­grams — even those that have achieved remark­able out­comes, even those sup­port­ed by the strongest evi­dence — will reach only those with­in the pur­vey­ors’ lim­it­ed scope, unless there is a more con­cert­ed effort to pro­mote them.

Along with rec­om­men­da­tions for mul­ti­ple stake­hold­ers to address this chal­lenge, the paper includes case stud­ies that illus­trate the growth his­to­ry of four evi­dence-based pro­grams and offer key insights about accel­er­a­tors and bar­ri­ers to their sig­nif­i­cant growth. The expe­ri­ence of one high­light­ed pro­gram, Mul­ti­sys­temic Ther­a­py (MST) — an inten­sive fam­i­ly ther­a­py for high-risk youth — pro­vides a valu­able exam­ple of how find­ing the right orga­ni­za­tion­al mod­el can lay the ground­work for broad expansion.

“Our goal is for research and evi­dence to lead to improved prac­tice. The more wide­spread evi­dence-based pro­grams become, the more oppor­tu­ni­ties there will be for fam­i­lies to ben­e­fit from what works,” says Ilene Berman, a senior asso­ciate with the Casey Foundation’s Evi­dence-Based Prac­tice Group. ​“This paper iden­ti­fies an impor­tant bar­ri­er to the suc­cess of evi­dence-based pro­grams and presents fun­ders, devel­op­ers and pur­vey­ors with valu­able rec­om­men­da­tions for address­ing it.”

Learn more about Casey’s approach to build­ing evidence