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Fourth Annual Policy Makers' Summit: November 17, 2006

Small and Large Group Work

Following panel presentations, participants were asked to work at their tables to:

• discuss key conclusions from the presentations
• generate questions for the speakers
• develop at least one strategy for implementation and scale up of the research findings, and
• post questions and strategies for all to review

The final portion of the Summit was spent in large group discussion.

Small and Large Group Recommendations for Scale Up:

Implementation/Scale up:

• need greater training in implementation, e.g. how to maintain the integrity of the evidence-based practice (EBP)
• need sustained partnerships between practitioners and researchers and policy makers
• make visible the attention and importance of family
• steps to maintain fidelity of treatment need to be defined
• design reviewer friendly templates and communication devices for payers
• information dissemination on EBPs should be accessible
• package EBP in relation to outcomes
• metaphor of road: can see the steps toward implementation, but how do you make more visible the progress toward implementation? How do you measure the “in-between”? How do you know you are getting there? “Road signs”
• need to have rewards for progress; what are the rewards for each level; implementation should not be “fear driven”
• use a comprehensive model of change:
  • plan for each step toward implementation/comprehensive change and how it will occur at each level
  • need feed-back loops
  • may require change in personnel or job description/role
  • for sustainability: need supports of on-going supervision
  • trade offs: what are you not doing while you are learning this?
  • build ownership
  • build infrastructure
  • change program policy to support stronger implementation
• use learning collaborative model which brings together teams of stakeholders in the community to bring about little “chunks” of change
• Design implementation plan:
  • Pre-work
  • Training/workshops
  • Follow-up work
• Provide resources that can be individualized while preserving fidelity of the model
• need braided funding
• need strong administrative infrastructure
• stress support for providers including on-going coaching and mentoring
• provide “staff-centered” consultation
• understand the supports teachers, parents, and children need to facilitate optimal functioning; e.g. pre-k programs should have family coordinators
• provide practitioners theoretical background of practices
• use distance-education technology to reach more people
• use videos of what EBP looks like and before and after videos
• need “facilitative” administrative approaches
• develop/support “early adapters” or demonstration sites to work with a state group that develops supportive infrastructure for sustainability
• demonstration sites need to have the infrastructure to be a demonstrate site: they will have demands on them re: visitors, workshops, evaluation procedures, etc.
• “systems change: systems don’t change, people do”

Policy/Public Support:

• a voice needs to be provided to those who do not have direct access to policy makers
• social marketing strategies: the need is great and solutions exist; positive and hopeful
• evidence-based practice should inform policy
• take into account everyone’s perspectives; what do different agencies/systems want
• work to educate state leadership (e.g. Governors-NGA, Lt. Governors, Legislators-NCSL, Department Secretaries-CCSSO) to champion evidence-based practice
• community advocacy, e.g. education of legislators for scale up; help “competing” advocacy groups to see areas of common interest to advocate for a practice
• work with medical field to expand collaboration and awareness (AAP)
• increase national organizations’ with links to center materials; on-line libraries, various databases (NICHY, IDEA PARTNERSHIPS, What Works Clearinghouse etc.)
• help “competing” advocacy groups to see areas of common interest to advocate for a practice
• the power of “story” for all stakeholders from parents to policy makers; present the data and story that is meaningful to them
• market data across different federal agencies; how does this play out in different agencies: be a focus of multiple agencies?
• need state infrastructure to support and fund
• build TA strategies for on-site support, coaching mentoring
• get buy-in from family organizations
• need community exemplars and data to get more funding; use outcome data to sell people (including business, general public, etc.); we need supernanny to be our PR! Corporate Sponsor?
• need child development and parenting classes in junior and high schools
• personnel preparation programs should have family strategies and positive behavior support embedded in courses
• community colleges need to be supported
• present findings to personnel prep groups
• need “champions”
• what is a good “Implementation Support System”?
• obtain funding from state for evaluating outcomes and for “growing” state models (some states are doing this, e.g., Maryland)
• SAMHSA, Head Start and other agencies including MH promotion in their focus areas

Research on Evidence-based Practices (EBP):

• practices need to be ready for scale up, i.e. evidence of effectiveness
• make research relevant to family models of care, specifically the intergenerational focus
• research social validity: consumers help set research questions; what will practitioners find useful (in their words); do interventions make sense to them, do they value them?; relevance to community
  

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