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What criteria must interventions meet to be considered for the REP
collection?
For REP, an intervention cannot already be packaged or widely used and must have either best- or promising-evidence of efficacy. The standards for best-and promising-evidence of efficacy can be found on the
Prevention Research Synthesis project website.
Back to Questions What are the procedures for adding intervention packages
to the REP collection?
Each year or two CDC announces a request for applications to translate
the science-based protocols of proven interventions. Researchers with effective
interventions apply for competitive funding to translate their research
protocols into intervention packages for use by prevention providers. The
highest scoring applicants are selected. Various letters of support may
need to accompany applications. For example, if the research was part of
a multisite project with a common protocol, applicants need letters from
all of the original developers of the intervention indicating their commitment
to participate in developing the intervention materials and specifying
the nature of their participation. Of particular importance is narrative
that discusses generalizing the intervention to other target populations.
If the applicant is not the intervention's original researcher, the applicant
also needs letters of permission from the intervention's originator(s)
to develop and market materials for the proposed intervention package.
CDC staff then work with the funded researchers to develop technical assistance
guides, training materials, posters, and any other materials necessary
to implement the intervention, all of which become part of the intervention
package. Once the intervention packages have been developed, CDC posts
fact sheets on the REP+ Web site and alerts REP+ listserv subscribers to
the availability of the added packages.
Back to Questions What products are prepared with a REP-packaged intervention?
By the end of their REP cooperative agreement, the researchers will have
developed all of the materials that a prevention provider would need to
conduct the intervention. Two of the main products are a (1) starter kit,
which includes information on intervention logistics, intervention costs,
and an intervention protocol checklist for program administrators, and
(2) an intervention package, which includes an implementation manual, promotional
material, and nonconsumable items needed to implement the intervention.
The researchers also will have developed materials to support the adoption
and delivery of their intervention by prevention providers, such as a curriculum
for training of facilitators, which includes a training quality assurance
plan, and a technical assistance guide.
To view pictures of a package’s
contents, click the corresponding link below:
If CDC’s
Diffusion of Effective Behavioral Interventions (DEBI) project
disseminates a REP-packaged intervention, DEBI may add enhancements
to the packages, such as logic models and evaluation guides. The
DEBI project is a national-level strategy to provide high-quality training
and ongoing
technical assistance for selected evidence-based HIV/STD prevention
interventions, including those packaged by REP, to state and community
HIV/STD program
staff.
Back to Questions
What is the process for packaging an intervention for
the REP collection?
Interventions are packaged under
a 2-year cooperative agreement. A cooperative agreement differs from
a grant in that CDC staff are substantially involved
in the program activities, above and beyond routine grant monitoring. For
example, CDC staff review and approve the packages’ contents. See
www.cdc.gov/od/pgo/funding/gfaq-general.shtm for more details on cooperative
agreements.
In the first year of the cooperative agreement, researchers (1) form an
advisory committee of HIV prevention providers, community members, and
members of the target population; (2) translate the science-based protocol
into everyday language; (3) develop package contents and format with advisory
committee; (4) recruit at least two HIV prevention agencies as case study
agencies that will field test the package during the second year; (5) develop
and pilot test a training curricula for agency staff; and (6) develop a
process evaluation plan.
In the second year of the cooperative
agreement, researchers (1) orient the case study agencies to the intervention;
(2) collaboratively tailor
and adapt the intervention; (3) train agency staff how to deliver the intervention
and teach them the technical skills needed for intervention delivery; (4)
provide technical assistance on implementation and problem-solving; (5)
evaluate the process of implementation and debrief the agency staff; (6)
develop technical assistance guidance manuals on the basis of the researcher’s
and agencies’ experience; (7) refine the intervention package and
training curricula based on agency input; and (8) produce refined versions
of all materials for dissemination.
The REP project is considered
to be a nonresearch activity by CDC and, therefore, does not require
institutional review board (IRB) review. However,
the investigators’ research/academic institutions can decide to make
an independent determination.
If CDC’s Diffusion of
Effective Behavioral Interventions (DEBI) project disseminates a REP-packaged
intervention, DEBI will update the
package when medical information, such as guidance on condom efficacy,
changes and may further refine the materials based on the experiences of
implementing agencies.
Back to Questions What materials make up an intervention package?
A REP intervention package consists of an implementation manual, promotional
or marketing material, handouts, posters, brochures, and any other nonconsumable
items needed to implement the intervention.
The implementation manual has
several sections, beginning with a brief description of the intervention
and the science behind it. A section on
getting started steps covers the intervention’s core elements related
to preparation, time line of necessary preparation steps, list of collaborators,
material resources, facilities, staff, recruitment of participants, quality
assurance plan, and cost categories for conducting the intervention. A
section on implementation steps covers the intervention’s core elements
related to implementation, protocols and examples for implementing the
intervention and ensuring quality and consistency, identification of barriers
to implementation, and advice on how these barriers may be overcome. A
section on steps to keep the intervention going covers the intervention’s
core elements related to maintenance and deals with issues of staff turnover
and retraining. Last, an evaluation assistance section contains an intervention
logic model, evaluation plan, process and outcome monitoring methods, and
sample instruments.
In addition, REP packages usually have a starter kit, which contains information
on intervention logistics, intervention costs, and an intervention protocol
checklist for program administrators.
Back to Questions What are an intervention’s
core elements?
At the request of case study
agencies, core elements were developed. Core elements are a tool to help
researchers and agencies make interventions
fit agencies’ settings, circumstances, and populations while maintaining
fidelity to what the research has determined to be effective. Core elements
serve as parameters for the parts of an intervention that should not be
changed, benchmarks for intervention fidelity, and references for quality
assurance of intervention implementation. Researchers articulated what
defines their intervention—those fundamental components that, if
changed, would transform their intervention into something other than what
they had deemed to be effective.
Core elements are critical features
of an intervention’s intent
and design. They are thought to be responsible for an intervention’s
effectiveness and put an intervention’s underlying theoretical constructs
into operation. Core elements can be identified by using one or all of
the following three methods: (1) practical application of the intervention’s
underlying theory, (2) experience using the intervention, and (3) if available,
a component analysis of procedures.
The number of core elements in an intervention can vary from as few as
three to as many as nine. However, the median number of core elements for
the current REP packages is five. The nature of core elements in interventions
can vary by concepts or underlying principles, the specific set and/or
sequence of methods, the intended outcomes, the specific set of components
and their venues, the number and type of persons delivering the intervention,
and restrictions to certain settings or populations.
Back to Questions Do all prevention programs using a REP package need to adhere to CDC’s
HIV Content Guidelines?
The HIV Content Guidelines ensure that HIV prevention materials contain
messages on ways by which individuals can protect themselves from acquiring
the virus or reduce their risk of acquiring or spreading the virus. The
Guidelines provide a framework for developing and using educational materials
and require that Program Review Panels (PRPs) consider the appropriateness
of messages designed for various groups. According to the Guidelines, the
PRPs must be composed of at least 5 members, include at least one employee
of the state or local health department, and represent a reasonable cross-section
of the general population.
Investigators receiving
CDC funds for HIV intervention research are required to identify a local
PRP in their jurisdiction to review and approve any
materials used with the study participants. Agencies implementing a CDC-funded
program should have their local PRP review and approve all materials that
will be viewed by or given to persons receiving the intervention. Members
of the PRP record their approval on CDC Form 0.1113, which can be obtained
at www.cdc.gov/od/pgo/forms/hivpanel.htm.
To view the Guidelines, go to http://www.cdc.gov/od/pgo/forms/hiv.htm
Back to Questions Do you have an intervention for my population?
REP packages behavioral
and social interventions for HIV prevention. REP does not package policy
or structural interventions, such as needle exchange
programs. You may search for REP-packaged HIV prevention interventions
with demonstrated evidence of effectiveness by visiting our
REP Packages by Topic page.
If after searching the Web site, you are unable to find an intervention
that suits your needs, please contact us at dhaprep@cdc.gov.
Back to Questions Do you plan to package non-US interventions?
At this time, REP does not have plans to package non-US interventions. Back to Questions
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