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

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.”

Sessions 8:30 – 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

IMPLEMENTATION PHASES Need, Agreements, Adoption, & Outcomes Local Demonstration w/ Fidelity Sustained Capacity, Elaboration, & Replication 4. Systems Adoption, Scaling, & Continuous Regeneration

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.

Valued Outcomes Continuous Self-Assessment Practice Implementation Effective Practices 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 Valued Outcomes Practice Implementation Identifying & Modifying Practices Fidelity EffectivenessPriority Continuous Regeneration Continuous Measurement Data- Based Prob. Solving Capacity Building Efficiency

Sustaining School-wide Positive Behavior Support CEC Conference Kent McIntosh

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 “The distribution and adoption of an innovation are only significant if its use can be sustained...” (Coburn, 2003, p. 6)

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 Definitions Sustainability  Durable implementation of a practice at a level of fidelity that continues to produce valued outcomes (Han & Weiss, 2005) Scaling Up  Durable implementation of a practice at a level of fidelity that continues to produce valued outcomes on a scale of social importance

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 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

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 (McIntosh, Horner, & Sugai, in press) Valued Outcomes Practice Implementation Identifying & Modifying Practices Fidelity Effectiveness Priority Continuous Regeneration Continuous Measurement Data- Based Prob. 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 (McIntosh, Horner, & Sugai, in press) Valued Outcomes Practice Implementation Identifying & Modifying Practices Fidelity Effectiveness Priority Continuous Regeneration Continuous Measurement Data- Based Prob. 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 Valued Outcomes Priority PRIORITY Importance in comparison to other practices Connection to other initiatives Incorporation into core system components

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 Valued Outcomes Practice Implementation Identifying & Modifying Practices Fidelity EffectivenessPriority Continuous Regeneration Continuous Measurement Data- Based Prob. 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 Identifying & Modifying 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

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 Valued Outcomes Practice Implementation Identifying & Modifying Practices Fidelity EffectivenessPriority Continuous Regeneration Continuous Measurement Data- Based Prob. 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 Practice Implementation 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

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 Valued Outcomes Practice Implementation Identifying & Modifying Practices Fidelity EffectivenessPriority Continuous Regeneration Continuous Measurement Data- Based Prob. 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 Continuous Regeneration Continuous Measurement Data- Based Prob. 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

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 Valued Outcomes Practice Implementation Identifying & Modifying Practices Fidelity EffectivenessPriority Continuous Regeneration Continuous Measurement Data- Based Prob. 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 Intended for use at the state, regional, or district level

Leadership Team Funding VisibilityPolitical Support TrainingCoaching 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

TrainingCoaching Evaluation SWPBS Implementers’ Blueprint BUILD CAPACITY (training expertise) Support coaches Ensure coaches implement with fidelity Establish community of learning BUILD CAPACITY (implementation expertise) Support school teams Ensure teams implement with fidelity DATA-BASED DECISION MAKING Create data systems Fidelity Student outcomes Design process for evaluation Establish eval cycles COORDINATION ACTIVITIES

Funding VisibilityPolitical Support SWPBS Implementers’ Blueprint 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 SWPBS Implementers’ Blueprint 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

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 Contact Information Kent McIntosh 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 Bailey National Implementation Research Network Louis de la Parte Florida Mental Health Institute Sustaining Implementation with Benefits to Students CEC Conference April 2008

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Education 65 million kids 6 million teachers and staff 100,000 schools 3,143 counties 60 states & U.S. jurisdictions

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Science to Service SCIENCE SERVICE GAP IMPLEMENTATION

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Science to Service Science 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.

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 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

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Ineffective Methods Excellent 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

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Ineffective Methods Excellent 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

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainability EBPs 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

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 A Sobering Observation "All organizations [and systems] are designed, intentionally or unwittingly, to achieve precisely the results they get." R. Spencer Darling Business Expert

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 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

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Sustainability To scale up interventions we must first scale up implementation capacity Building implementation capacity is essential to sustaining EBPs and other innovations

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 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

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Team Prepare Communities Prepare schools faculty, staff Work with Researchers Assure Implementation Prepare Districts Assure Student Benefits

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Implementation Team School Management (leadership, policy) Administration (HR, structure) Supervision (nature, content) Teacher State and Community Context District Implementation Team Simultaneous, Multi-Level Interventions

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 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

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Systems Change State Department Districts Schools Teachers/ Staff Effective Practices ALIGNMENT Federal Departments Implementation Teams FORM FOLLOWS FUNCTION

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 A Functional System Bureaucracy Practitioners Policies Agencies

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Creating Implementation Capacity New OSEP Center State Implementation and Scaling up of Evidence-based Practices (SISEP)

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 Thank You We 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)

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 For More Information Dean L. Fixsen Karen A. Blase National Implementation Research Network At the Louis de la Parte Florida Mental Health Institute University of South Florida

Copyright © Dean L. Fixsen and Karen A. Blase, 2008 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: Implementation Research: A Synthesis of the Literature