|
Education
Materials > The Tuberculosis Behavioral
and Social Science Research Forum Proceedings > Two CDC Models
from HIV Prevention: Replicating Effective Programs and Diffusion
of Effective Behavioral Interventions
The Tuberculosis Behavioral and Social Science Research Forum
Proceedings
Section II. Presentations and Panel Discussions
DAY TWO
Two CDC Models from HIV Prevention: Replicating Effective
Programs and Diffusion of Effective Behavioral Interventions
Agatha Eke, Ph.D.
Behavioral Scientist, Behavioral Intervention Research
Branch, Division of HIV/AIDS Prevention, Centers for Disease Control
and Prevention
Day 2, Afternoon Session
Dr. Eke described two sequential CDC initiatives to translate research
into practice: Replicating Effective Programs (REP) and Diffusion
of Effective Behavioral Interventions (DEBI). REP is involved with
translation and packaging of science-based HIV interventions, while
DEBI supports the diffusion of the translated interventions into
practice. Both models are generally applicable to interventions
on other public health topics such as TB.
The REP project is in line with the recommendations made in the
Institute of Medicine HIV prevention report of September 2000 and
CDC’s HIV Prevention Strategic Plan; both spoke to the need for
development and use of effective, evidence-based HIV prevention
interventions at all levels. REP sought to move HIV prevention beyond
the endpoint of researchers publishing their results to a new paradigm
in which researchers, practitioners, and communities are in active
collaboration to translate research into improved prevention practice.
Initiated in 1996, REP has thus far produced packages for seven
HIV prevention interventions whose effectiveness has been documented
through rigorous research methods. Four more intervention packages
are currently in development. These intervention packages are then
selected and implemented by local agencies.
Some important lessons emerged from the implementation phase of
the initial REP packages:
- Importance of keeping the interventions as simple as possible,
focusing on “core elements”;
- Flexibility to allow adaptation to local contexts;
- Need for maintaining detailed records and documentation of implementation;
- Value of clear “how to” materials;
- Importance of collaboration among researchers, practitioners,
and communities; and
- Value of technical assistance during implementation.
DEBI represents the next step along the continuum of CDC’s technology
transfer and dissemination efforts in HIV prevention. It develops
and coordinates a national strategy for diffusing science-based
HIV interventions to state- and community-level programs. DEBI objectives
for each intervention are accomplished in three phases that involve
planning and development of curricula and related materials; implementation
of an institute for master trainers; and larger scale roll-out in
which up to 700 facilitators at state and local levels are trained
and provided technical assistance and individualized coaching. Additional
mechanisms for diffusing science-based interventions include satellite
broadcasts, newsletters, Web-based discussion forums, and conference
calls.
The DEBI model represents a further important effort to bridge
the gap that commonly exists between public health researchers and
practitioners. In the funding process for this initiative, there
were specific requirements and incentives for the collaborations
among researchers who have developed and evaluated the interventions,
the front-line practitioners who will be trained to replicate or
adapt these interventions, and the communities in which they will
be implemented. Lessons learned from DEBI include:
- Active partnership and clear communication among all stakeholders
are very important to a successful translation of research into
practice;
- Multiple disciplines and skills are needed for the process
to succeed;
- Implementing interventions with fidelity is important, but
local adaptation may also be necessary to maximize effectiveness;
- Differences between researchers’ and communities’ definitions
of “effective” interventions must be harmonized; and
- Successful diffusion may help to overcome myths about lack
of capacity and inability to collaborate across sectors.
A member of the audience noted that the TB field is far behind
the HIV field in such translation of research into practice, and
that this represents very important work in which there is much
to learn from the HIV experience.
Click
here for slideset of presentation
|
