Sustaining an Evidence-Based Program Over Time: Moderators of Sustainability and the Role of the Getting to Outcomes® Implementation Support Intervention.

Problematic rates of alcohol, e-cigarette, and other drug use among US adolescents highlight the need for effective implementation of evidence-based programs (EBPs), yet schools and community organizations have great difficulty implementing and sustaining EBPs. Although a growing number of studies show that implementation support interventions can improve EBP implementation, the literature on how to improve sustainability through implementation support is limited. This randomized controlled trial advances the literature by testing the effects of one such implementation intervention-Getting To Outcomes (GTO)-on sustainability of CHOICE, an after-school EBP for preventing substance use among middle-school students. CHOICE implementation was tracked for 2 years after GTO support ended across 29 Boys and Girls Club sites in the greater Los Angeles area. Predictors of sustainability were identified for a set of key tasks targeted by the GTO approach (e.g., goal setting, evaluation, collectively called "GTO performance") and for CHOICE fidelity using a series of path models. One year after GTO support ended, we found no differences between GTO and control sites on CHOICE fidelity. GTO performance was also similar between groups; however, GTO sites were superior in conducting evaluation. Better GTO performance predicted better CHOICE fidelity. Two years after GTO support ended, GTO sites were significantly more likely to sustain CHOICE implementation when compared with control sites. This study suggests that using an implementation support intervention like GTO can help low-resource settings continue to sustain their EBP implementation to help them get the most out of their investment. ClinicalTrials.gov Identifier: NCT02135991.

Suicide Prevention Hotlines in California: Diversity in Services, Structure, and Organization and the Potential Challenges Ahead.

This article evaluates the landscape in which suicide prevention hotlines operate, focusing on California but with nationwide implications, and provides recommendations to ensure that callers at risk of suicide seek and receive the help they need.

RAND's Silent Monitoring Protocol for Assessing Suicide Crisis Line Call Content and Quality.

This article describes the methods for developing and testing a silent monitoring protocol for California suicide crisis call centers to evaluate call content and quality, document staff strengths and weaknesses, and identify areas for further training.

Evaluation of California's Statewide Mental Health Prevention and Early Intervention Programs: Summary of Key Year 2 Findings.

This article summarizes key findings from the second year of an evaluation of the California Mental Health Services Authority's statewide prevention and early intervention programs.

Recommendations for Sustaining California's Statewide Mental Health Prevention and Early Intervention Programs.

Provides preliminary advice about which of the California Mental Health Services Authority's Prevention and Early Intervention activities seem most valuable to sustain or, in some cases, enhance.