Strand D Sustaining & Scaling Implementation of SWPBS: Systems & Applications Rob Horner & George Sugai OSEP Center on PBIS April 4, 2008 .

Strand D

Sustaining & Scaling Implementation of SWPBS:

Systems & Applications

Rob Horner & George SugaiOSEP Center on PBIS

April 4, 2008

www.pbis.org

robh@uoregon.edu

george.sugai@uconn.edu

www.pbis.org

www.scalingup.org

Problem Statement

“We give schools strategies & systems for developing positive, effective, achieving, & caring school & classroom environments, but implementation is not accurate, consistent, or durable. Schools need more than training.”

Sessions8:30 – Overview of Sustainability & Scaling

(Kent & Dean)

9:45 – State Examples I (Susan, Howard, & Char

1:15 – State Examples II (Steve, Diann, & Kiki

3:45 – Secondary & Tertiary Tier Interventions & Systems (Cindy, Lucille, & Leanne

IMPLEMENTATIONPHASES

Need,Agreements, Adoption, &Outcomes

LocalDemonstration

w/ Fidelity

Sustained Capacity,

Elaboration, &Replication

4. SystemsAdoption, Scaling,

& ContinuousRegeneration

Sustainability + Scaling

Organizational capacity for & documentation of accurate (90%) &

expandable implementation of evidence-based practice across

desired context (e.g., district, classroom,

school-wide, nonclassroom) over time w/ local resources & systems for

continuous regeneration.

ValuedOutcomes

ContinuousSelf-Assessment

Practice Implementation

EffectivePractices

Relevance

Priority Efficacy

Fidelity

SUSTAINABLE IMPLEMENTATION & DURABLE RESULTS THROUGH CONTINUOUS REGENERATION

T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A

ValuedOutcomes

Identifying& Modifying

Practices

Fidelity

EffectivenessPriority

Continuous Regeneration

Continuous

Measurement

Data-BasedProb.

Solving

Capacity

Building

Efficiency

Sustaining School-wide Positive Behavior Support

CEC ConferenceKent McIntosh

“The distribution and adoption of an innovation are only significant if its use can be sustained...”

(Coburn, 2003, p. 6)

Definitions

SustainabilityDurable implementation of a practice at a

level of fidelity that continues to produce valued outcomes (Han & Weiss, 2005)

Scaling UpDurable implementation of a practice at a

level of fidelity that continues to produce valued outcomes on a scale of social importance

Efforts to Implement and Sustain

“Train and Hope”Not an effective approach to implement a

practice “Implement and Hope”

Not an effective way to sustain a practice

(McIntosh, Horner, & Sugai, in press)

ValuedOutcomes

Practices

Fidelity

Continuous

Measurement

Data-BasedProb.

Solving

Capacity

Building

Efficiency

(McIntosh, Horner, & Sugai, in press)

ValuedOutcomes

Practices

Fidelity

Continuous

Measurement

Data-BasedProb.

Solving

Capacity

Building

Efficiency

ValuedOutcomes

Priority

PRIORITY Importance in

comparison to other practices

Connection to other initiatives

Incorporation into core system components

ValuedOutcomes

Practices

Fidelity

Continuous

Measurement

Data-BasedProb.

Solving

Capacity

Building

Efficiency

Practices

Effectiveness

EFFECTIVENESS Extent to which the

practice results in desired outcomes

Choice of practices should be based on proven effectiveness

Effects must be observed and attributed to the practice

ValuedOutcomes

Practices

Fidelity

Continuous

Measurement

Data-BasedProb.

Solving

Capacity

Building

Efficiency

Fidelity

FIDELITY and EFFICIENCY Without fidelity of implementation, effectiveness of

the practice is compromised Relationship between continued effort and

continued effectiveness Weighed against other potential practices

Efficiency

ValuedOutcomes

Practices

Fidelity

Continuous

Measurement

Data-BasedProb.

Solving

Capacity

Building

Efficiency

Continuous

Measurement

Data-BasedProb.

Solving

Capacity

Building

CONTINUOUS REGENERATION Iterative monitoring of

fidelity, outcomes, and context

Adaptation and re-implementation over time while keeping critical features intact

Ongoing investment in training and spread

ValuedOutcomes

Practices

Fidelity

Continuous

Measurement

Data-BasedProb.

Solving

Capacity

Building

Efficiency

T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A A Tool for Sustainable

Implementation of SWPBS

SWPBS Implementers’ Blueprint(Center on PBIS, 2004)

Available at www.pbis.org Intended for use at the state, regional, or

district level

Leadership Team

FundingVisibility Political

Support

Training Coaching Evaluation

Local School Teams/Demonstrations

SWPBS Implementers’ Blueprint Elements

Leadership Team

SWPBS Implementers’ Blueprint

• Representation from key stakeholders

• Meet regularly with a regular process

• Complete regular self-assessment and long term action planning

• Led by Coordinator with FTE

Training Coaching Evaluation

BUILD CAPACITY

(training expertise)

• Support coaches

• Ensure coaches

implement with

fidelity

• Establish community

of learning

BUILD CAPACITY

(implementation

expertise)

• Support school

• Ensure teams

implement with

fidelity

DATA-BASED

DECISION MAKING

• Create data systems

•Fidelity

•Student outcomes

• Design process for

evaluation

• Establish eval cycles

COORDINATION ACTIVITIES

FundingVisibility Political

Support

• Identify recurring

funding sources

• 3 to 5 yrs. of support

• Disseminate results

to multiple audiences

•Websites

•Newsletters

•Conferences

•Media (TV, etc.)

• Presentations to:

school boards,

state departments

• Write into policy

• Connect with key

administrators

LEADERSHIP ACTIVITIES

Local School Teams/Demonstrations

• Support schools implementing SWPBS– Coaching

– Funding

• Showcase schools with high fidelity and positive outcomes– Present data linking fidelity to student outcomes

– Arrange visits from key stakeholders

Contact Information

Kent McIntoshkent.mcintosh@ubc.ca

University of British Columbia

2125 Main Mall

Vancouver, BC V6T 1Z4

Dean L. Fixsen, Karen A. Blase,

Michelle A. Duda, Sandra F. Naoom,

Melissa Van Dyke, Frances Wallace BaileyNational Implementation Research Network

Louis de la Parte Florida Mental Health Institute

Sustaining Implementation with Benefits to Students

CEC Conference April 2008

Education

65 million kids

6 million teachers and staff

100,000 schools

3,143 counties

60 states & U.S. jurisdictions

Science to Service

SCIENCE SERVICEGAPIMPLEMENTATION

Science to ServiceScience to Service Gap

What is known is not what is adopted to help children, families, and caregivers

Implementation Gap What is adopted is not used with fidelity

and good outcomes for consumers.

What is used with fidelity is not sustained for a useful period of time.

What is used with fidelity is not used on a scale sufficient to impact social problems.

Implementation Reviews

Human service prevention and treatment programs (e.g. substance abuse, adult / children’s MH, justice, health, education)

Advanced manufacturing technologies

AMA clinical guidelines

Engineering: bridge maintenance

Hotel service management

National franchise operations

Cancer prevention & treatment

Ineffective MethodsExcellent experimental evidence for

what does not work

Diffusion/dissemination of information by itself does not lead to successful implementation (research literature, mailings, promulgation of practice guidelines)

Training alone, no matter how well done, does not lead to successful implementation

Ineffective MethodsExcellent evidence for what does

not work

Implementation by edict by itself does not work

Implementation by “following the money” by itself does not work

Implementation without changing supporting roles and functions does not work Paul Nutt (2002). Why

Decisions Fail

SustainabilityEBPs now are boutique operations

Now have convincing demonstrations that EBPs can work in the real world

Pretty neat but not used on a sustainable scale sufficient to solve social problems

What will it take to have 100,000 replications that produce increasingly effective outcomes for 100 years?

Start with the end in mind

A Sobering Observation

"All organizations [and systems] are designed, intentionally or unwittingly, to achieve precisely the results they get."

R. Spencer DarlingBusiness Expert

Sustainability

Innovative practices do not fare well in old organizational structures and systems

Organizational and system changes are essential to successful implementation

Expect it

Plan for it

Sustainability

To scale up interventions we must first scale up implementation capacity

Building implementation capacity is essential to sustaining EBPs and other innovations

Sustainability

Interventions that are and remain effective through several generations of teachers, principals, superintendents, and state and national leaders

Implementation supports that are and remain effective through several generations of interviewers, trainers, coaches, evaluators, administrators, and state leaders

Implementation Team

Prepare Communities

Prepare schools faculty, staff

Work with Researchers

Assure Implementation

Prepare Districts Assure Student Benefits

Implementation Team

School

Management (leadership, policy)

Administration (HR, structure)

Supervision (nature, content)

Teacher

State and Community Context

District

Simultaneous, Multi-Level Interventions

Creating Implementation Capacity

Start with too many overqualified people

“Generation 1” practitioners become:

Generation 2 interviewers, trainers, coaches, evaluators

Generation 3 administrators, directors, and leaders

Generation 4 state and federal officials

Systems Change

State Department

Districts

Schools

Teachers/ Staff

Effective Practices

Federal Departments

FORM FOLLOWS FUNCTION

Outcomes for Children, Families,

& Communities

A Functional System

Bureaucracy

Practitioners

Policies

Agencies

Creating Implementation Capacity

New OSEP Center

State Implementation and Scaling up of Evidence-based Practices (SISEP)

www.scalingup.org

Thank YouWe thank the following for their support

Annie E. Casey Foundation (EBPs and cultural competence)

William T. Grant Foundation (implementation literature review)

Substance Abuse and Mental Health Services Administration (implementation strategies grants; NREPP reviews; SOC analyses of implementation; national implementation awards)

Centers for Disease Control & Prevention (implementation research contract)

National Institute of Mental Health (research and training grants)

Juvenile Justice and Delinquency Prevention (program development and evaluation grants

Office of Special Education Programs (Capacity Development Center contract)

Agency for Children and Families (Child Welfare Leadership Development contract)

For More Information

Dean L. Fixsen

813-974-4446

dfixsen@fmhi.usf.edu

Karen A. Blase

813-974-4463

kblase@fmhi.usf.edu

National Implementation Research Network

At the Louis de la Parte Florida Mental Health Institute

University of South Florida

http://nirn.fmhi.usf.edu

For More Information

Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005). Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).

Download all or part of the monograph at:http://nirn.fmhi.usf.edu/resources/publications/Monograph/index.cfm

Implementation Research: A Synthesis of the Literature

Strand D Sustaining & Scaling Implementation of SWPBS: Systems & Applications Rob Horner & George Sugai OSEP Center on PBIS April 4, 2008 .

practicet h e u n

o statementwe

schools strategies systems

state examples

based practice

effective way

effective approach

level of fidelity

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