Project Spotlight: Aligning Evidence Based Practice (EBP) Implementation Standards for Diverse State Agencies
By Stephanie Bradley, Founder, All Youth Access
I have been promoting evidence-based models in Pennsylvania since 2011. While at the EPISCenter, I frequently synthesized and translated implementation science for policymakers. In 2016, several state leaders expressed interest in identifying which evidence-based models were funded by other agencies and developing funding strategies to sustain local implementations. However, not all systems define “evidence-based” in the same way and funding mechanisms also vary across systems. In response to these issues, I recommended development of a comprehensive prevention strategy modeled after the process used to develop PA’s Juvenile Justice System Enhancement Strategy.
Figure 1. Five Phases of CTC
This led to the emergence of the Pennsylvania Cross-Systems Prevention Workgroup (CSPW) which is a working group of over 20 state and county agency representatives and local practitioners collaborating to develop a comprehensive, multi-agency, prevention strategy. CSPW is essentially a state-level implementation of Communities That Care (CTC; Figure 1). The CSPW uses a structured process of examining risk and protective factor data to select priorities and is conducting a resource analysis on programs and services being delivered locally. We secured funding for a position to support coordination of CSPW efforts, which is comparable to a CTC mobilizer/facilitator position who supports and guides the group’s work. Using a CTC-informed process, the CSPW is integrating available evidence, navigating coordination across systems, leveraging unique strengths across sectors, and establishing a unified, collaborative vision for universal prevention in PA.
While evidence-based models continue to rise as the gold standard for funding and implementation, we must also acknowledge inherent biases that feed into the development of “evidence” (Kirmayer, 2012; Prussing, 2014; House, 2017) which has been predominantly generated from a white, male, heteronormative, and top-down perspective. In 2018, I founded All Youth Access (AYA). My primary focus through AYA is to improve policies and programs for minority and underserved youth by leveraging frameworks like health equity and social determinants of health. These approaches provide (1) a broader view of effective strategies for improving behavioral and physical health, such as affordable housing, transportation, access to health care, quality education and employment, and (2) address the impact of systemic, historical, and ongoing discrimination of communities of color (Sotero, 2006; Figure 2). Ultimately such strategies may yield greater impact than individual programs and would also benefit from high quality implementation and cross-sector collaboration.
Figure 2: Conceptual model of historical trauma; Sotero, 2006
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