1. Strand D Sustaining & Scaling Implementation of SWPBS: Systems & Applications Rob Horner & George Sugai OSEP Center on PBIS April 4, 2008 www.pbis.org robh@uoregon.edu george.sugai@uconn.edu

2. www.pbis.org

3. www.scalingup.org

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.”

5. 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

6. IMPLEMENTATION PHASES Need, Agreements, Adoption, & Outcomes Local Demonstration w/ Fidelity Sustained Capacity, Elaboration, & Replication 4. Systems Adoption, Scaling, & Continuous Regeneration 2. 3. 1.

7. 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.

8. Valued Outcomes Continuous Self-Assessment Practice Implementation Effective Practices Relevance Priority Efficacy Fidelity SUSTAINABLE IMPLEMENTATION & DURABLE RESULTS THROUGH CONTINUOUS REGENERATION

9. 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

10. Sustaining School-wide Positive Behavior Support CEC Conference Kent McIntosh

11. 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)

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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.orgwww.pbis.org Intended for use at the state, regional, or district level

25. Leadership Team Funding VisibilityPolitical Support TrainingCoaching Evaluation Local School Teams/Demonstrations SWPBS Implementers’ Blueprint Elements

26. 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

27. 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

28. 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

29. 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

30. 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 kent.mcintosh@ubc.ca University of British Columbia 2125 Main Mall Vancouver, BC V6T 1Z4

31. 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

32. 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

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

34. 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.

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. 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

42. 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

43. 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

44. 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

45. 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

46. 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

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

48. 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) www.scalingup.org

49. 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)

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

51. 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: http://nirn.fmhi.usf.edu/resources/publications/Monograph/index.cfm Implementation Research: A Synthesis of the Literature