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Text for Figures and Slides in TB Behavioral and Social Science Research Forum Proceedings

DIFFUSION OF EFFECTIVE BEHAVIORAL INTERVENTIONS

Agatha Eke, Ph.D.
Behavioral Scientist,
Division of HIV/AIDS Prevention,
Centers for Disease Control and Prevention

Slide #1: Diffusion of Effective Behavioral Interventions (DEBI)

Capacity Building Branch
Division of HIV/AIDS Prevention
CDC

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Slide #2: Handoff Between Research (PRB) and Practice (CBB)

  • SYNTHESIS
  • REP
  • DEBI
  • FAST TRACK

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Slide #3: Goal of Diffusion of Effective Behavioral Interventions (DEBI) Project

To develop and coordinate a national-level strategy to provide high quality training, technical assistance, and other capacity building activities to diffuse science-based HIV interventions to state- and community-level HIV programs.

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Slide #4: Diffusion of Effective Behavioral Interventions: A Nine-Step Process

  1. Planning: system level; individual intervention level
  2. Needs assessments and Customer Profiling
  3. Marketing and Satellite Broadcast
  4. Intervention program package design
  5. Training curricula/TA guide development
  6. Training trainers, coaches, providers
  7. TA to CBOs and HDs implementing programs
  8. Evaluate process and outcomes
  9. Refine diffusion strategy based on lessons learned

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Slide #5: DEBI Three Phases

  • Planning Phase (12-months): design/pilot/ conduct interest/needs assessment; produce pkg. copies; design/pilot evaluation tools; build partnerships; plan marketing & diffusion strategy; develop/pilot TOT/TOC, TOF guide, & TA Guide
  • Implementation Phase (3-months): train master trainers & coaches (“Training Institute”)
  • Roll-Out Phase (24-months): train 700 agency facilitators, provide TA, evaluate process, monitor outcomes

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Slide #6: Training Components

  • Curricula design to teach prevention providers the methods to implement the intervention.
  • Intervention institutes to teach trainers how to train direct prevention service providers.
  • Regional, state-wide, and local intervention trainings to widely diffuse the intervention technology to direct prevention service providers.

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Slide #7: Intervention Training Curricula

  • Approved by original researchers
  • Highly explicit, detailed guidance
  • Based on Adult Learning Principles
  • Appropriate for as a TOT or direct provider curriculum
  • Piloted/revised prior to major roll-out.

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Slide #8: Intervention Institutes
Train the Trainer/Coach

  • Researcher involvement
  • Intensive skill-building around the intervention
  • Develops trainer/coach partnerships
  • Develops training/coaching implementation plans

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Slide #9: Regional, state-wide, and local intervention trainings

  • Coordinated by AED
  • Provided by training teams
  • Intervention manuals and other intervention materials will be distributed

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Slide #10: Training Partners

  • CBB Training Team
  • Prevention Training Centers
  • Education Training Network
  • CBA Trainers

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Slide #11: Family of Coaches

  • CBA Priority Area 2 Providers
  • BSSV
  • CBB Science Application Team
  • Health Department capacity building providers

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Slide #12: Coaching

Coaching is on-site, phone, or e-mail technical consultation by a mentor or role-model technical assistance or capacity building provider

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Slide #13: Other supports for diffusing effective interventions

  • Satellite Broadcasts
  • Chat rooms or list serve
  • Newsletters
  • Follow-up conference calls
  • Distribution of package updates
  • Conference affinity session for current users of an intervention package

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Slide #14: 2002: Started Blending REP & DEBI

In REP’s Year 1, DEBI:

  • Helps REP PIs with their TOF curriculum
  • Provides TA Guide template
  • Develops a TOT/TOC curriculum
  • Starts planning diffusion strategy with REP PI

In REP’s Year 2, DEBI:

  • Observes facilitator training
  • Trains trainers & coaches
  • Has coaches observe REP implementation
  • Makes plans for package production

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Slide #15: Lessons Learned

  • In order to move research to practice, an active partnership is needed at all stages among communities, researchers, prevention agencies and diffusion agents.
  • Need to strengthen communication between communities, applied scientists, researchers, and all partners.

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Slide #16: Lessons Learned

  • Diffusion is a multidisciplinary effort that includes people with shared vision: peers, frontline staff, community/agency change agents, curriculum writers, trainers, TA providers, researchers, and agency administrators.

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Slide #17: Lessons Learned

  • Understanding more about the relationship between agency capacity and implementing with fidelity will improve diffusion efforts.
  • What researchers identify as an “effective intervention” be not be perceived as “effective” by the community.

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Slide #18: Lessons Learned

  • Everybody wants to “adapt” interventions to make them their own.
  • Adaptation and tailoring are absolutely critical to maintaining the efficacy of the intervention.
  • “Playing” with or implementing part of an intervention may build conceptual utility and lead to adoption.

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Slide #19: Lessons Learned

Successful diffusion involves overcoming many myths such as:

  • CBOs don’t want or can not handle science based interventions.
  • Researchers and communities do not work well together
  • Interventions can not be changed or updated
  • Interventions are meant to replace the current work of communities

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Slide #20: For more information

Visit the Disseminating Effective Behavioral Interventions (DEBI) website at:
http://www.effectiveinterventions.org

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