Adoption, Implementation, and Maintenance of Evidence-Based Falls Prevention Programs.

We evaluate the implementation of evidence-based falls prevention programs (EBFPPs) of the Administration for Community Living (ACL) Grantees by (1) describing adoption; (2) evaluating implementation through participant adherence; and (3) describing program maintenance. Secondary data analysis of a national data repository included forty-four ACL grantees spanning 31 states who were funded between September 2014 and December 2019 and provided information on over 80,000 older adult participants. Descriptive statistics including frequencies, percentages, and means were used to describe adoption, implementation (adherence), and maintenance of EBFPPs. Senior centers were the most common organizations to adopt EBFPPs. Most programs were maintained at their respective organizational site through repeat offerings, with several programs (60%) being offered greater than 10 times. Information regarding adoption, implementation, and maintenance of EBFPPs is valuable in identifying the best programs suited for different organizations and their clientele, which can inform policy for scaling and sustaining EBFPPs across the nation.

Can Online Parent Education Meet the Needs of the Courts and Improve the Well-Being of Children? The Critical Roles of Goal, Program, and Evidence Alignment.

Parent education in family courts can significantly impact children's well-being after divorce if programs are (1) widely accessible, (2) acceptable to parents, (3) feasible to implement by courts, and (4) have evidence of effectiveness in improving key outcomes for children. In light of recently raised concerns about whether court-ordered/court-mandated parent education is justified; it is critical to identify effective parent education programs. Online parent education programs have the potential to be widely accessible, acceptable to parents and courts, and effectively promote children's well-being. However, few effective online parent education programs are being widely adopted by family courts. There is some controversy about whether online parent education meets the needs of family courts in being cost-effective programs that offer ways to hold parents accountable for their participation. We articulate the wide array of goals for parent education programs and present a framework to identify and select programs that meet specific goals. We discuss access, cost, evidence of effectiveness, acceptability, credibility, and compliance tracking. We highlight two online parent education programs to illustrate differences in contexts and goals and to show that online programs have great potential to be effective in accomplishing goals valued by the courts.

Review of the effects of social and emotional learning on mental health and academic outcomes: The role of teacher training and supportive interactions.

Child and youth mental health in France has become an important public health priority. Social and emotional learning has been shown to contribute to mental health in children and adolescents. Therefore, an increasing number of interventions are being proposed in schools. However, teachers are not yet trained to develop these competencies through evidence-based interventions during their initial training. One way of increasing motivation and investment in teacher training in social and emotional learning is to increase awareness of the effects on academic outcomes. The aim of this scoping review based on systematic reviews and meta-analyses is to present the effectiveness of school-based social and emotional learning programs on mental health and academic success, while specifying the contributing processes such as motivation, teacher training, and student support. The discussion section suggests several avenues to promote the development of psychosocial competencies in school settings, notably based on teacher training.

Unpacking Technical Assistance (TA) Strategies Within a State-Level Prevention Support System: A Mixed-Method Study in Determining Types and Amount of TA.

The research-practice gap between evidence-based intervention efficacy and its uptake in real-world contexts remains a central challenge for prevention and implementation science. Providing technical assistance (TA) is considered a crucial support mechanism that can help narrow the gap. However, empirical measurement of TA strategies and their variation is often lacking. The current study unpacks the black box of TA, highlighting different TA strategies, amounts, and their relation to intervention characteristics. First, we qualitatively categorized interactions between TA providers and implementers. Second, we explored how characteristics of implementing organizations and the intervention related to variations in the amount of TA delivered. Using data spanning six years, we analyzed over 10,000 encounters between TA providers and implementers. Content analysis yielded four distinct strategies: Consultation (27.2%), Coordination Logistics (24.5%), Monitoring (16.5%), and Resource Delivery (28.2%). Organizations with prior experience required less monitoring and resource delivery. Additionally, characteristics of the intervention were significantly associated with the amount of consultation, monitoring, coordination logistics, and resource delivery provided. The specific features of the intervention showed significant variation in their relation to TA strategies. These findings provide initial insights into the implications of intervention characteristics in determining how much of which TA strategies are needed to support implementations in real-world settings.

Science for behavioral health systems change: evolving research-policy-public partnerships.

Potent partnerships among researchers, policymakers, and community members have potential to produce positive changes in communities on a range of topics, including behavioral health. The paper provides a brief illustrative review of such partnerships and then describes the development and evolution of one partnership in particular in Virginia. The origin of the partnership is traced, along with its founding vision, mission, and values. Some of its several projects are described, including (a) needs assessment for implementation of evidence-based programs (EBPs) pursuant to the Family First Prevention Services Act; (b) statewide fidelity monitoring of key EBPs; and (c) projects to synergize state investments in specific EBPs, like multisystemic therapy, functional family therapy, and high fidelity wraparound. The paper concludes with some themes around which the center has evolved to serve the state and its citizens more effectively.

Where's the BIPOC Blueprint for Healthy Youth Development? The Role of Scientific Omissions in Our Struggle for Science Translation and Racial Equity in the United States.

Prevention Science seeks to advance the prevention research and to translate scientific advances into the promotion of healthy development for all youth. Despite tremendous progress creating a robust evidence-base and set of translational tools, elaborations and expansions for equity are required. Our collective errors of omission as prevention researchers have left prevention practitioners and policy-makers without sufficient information to identify strategies that have been demonstrated to prevent behavioral health problems in young people who identify as Black, Indigenous, or other People of Color (BIPOC). We first describe the current shortcomings of available evidence, and then we call for individual and collective action to conceptualize equity-enhancing prevention, sample more inclusively, and improve analytic approaches such that we can truly promote the healthy development of all youth.

Implementing Dementia Caregiver Programs in Real-World Settings: Fidelity Considerations.

Testing interventions in real-world settings requires fidelity monitoring to ensure implementation integrity. However, strategies to enhance, monitor, and measure fidelity deployed in efficacy trials may not be feasible in pragmatic trials or sustainable in practice. This paper reviews published translational or pragmatic studies of dementia caregiver support interventions to understand how fidelity was previously treated in order to derive recommendations for future pragmatic-like trials. A search using SCOPUS, EMBASE, and Google Scholar identified 31 translational caregiver intervention studies of which 20 (64.5%) referenced fidelity. Of these 20, 11 (55.0%) reported fidelity measurement, whereas 9 (45.0%) only recognized its importance. Of the 11 studies, fidelity was assessed using investigator-developed scoring forms, audio/video recordings, evaluations from caregivers and interventionists, and by comparing outcomes with the original efficacy trial. Additionally, 7 (63.6%) of 11 studies reported fidelity results, representing only 22.5% of 31 studies reporting outcomes demonstrating the inconsistency in the field concerning the reporting outcomes of fidelity. We conclude that fidelity methods used in translational studies to date are not practical nor sustainable for ongoing monitoring of evidence-based programs in real-world settings and that only 2 aspects of fidelity, intervention and adherence, are considered. New approaches are needed to ensure fidelity integrity in pragmatic trials and which can be sustained thereafter.

Experiences With and Access to Evidence-Based Health Promotion Programs for Older American Indian, Alaska Native, and Native Hawaiian Peoples.

Evidence-based programs (EBPs) work effectively for participants whose characteristics match those of the EBP research participants. However, EBPs have been almost exclusively developed and evaluated for the general U.S. population with limited American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) community engagement. Thus, an AI/AN/NH Evidence-Based Program Advisory Council sought to identify AI/AN/NH peoples' experiences with and access to EBPs. We held 20 listening sessions with AI/AN/NH Elder services program staff (n = 118) and with AI/AN/NH Elders (n = 82) and conducted a self-administered online survey with Title VI Directors (n = 63). The six themes that emerged from the listening sessions with staff included misunderstanding community engagement, valuing fidelity over flexibility, lack of cultural awareness, assumptions about available infrastructure, unrealistic implementation timelines, and funding restrictions. Listening session themes with Elders included definitions of aging well, participation motivators, preferred activities, participation barriers, and unmet needs. Survey data indicated that programming of greatest interest for Elders as identified by Title VI Directors and staff included and/or addressed cultural activities (81%), socialization (75%), diabetes (73%), caregiving (68%), and nutrition (68%). Seventy-six percent of survey respondents had heard of EBPs and 24% indicated that EBPs were not being implemented in their community. The Advisory Council developed specific action steps with the goal of improving AI/AN/NH communities' access to culturally appropriate and feasible EBPs. The steps require collective action from federal agencies, national partners, EBP program developers and administrators, local organizations, and Elders to ensure EBPs are accessible and culturally appropriate for AI/AN/NH Elders.

Using an academic-community partnership model to deliver evidence-based falls prevention programs in a metropolitan setting: A community case study.

Background: Prevention is an effective approach for mitigating the negative health outcomes associated with falls in older adults. The Administration for Community Living (ACL) has sponsored the implementation of evidence-based falls prevention programs (EBFPPs) across the United States through cooperative agreement grants to decrease the health and economic burden of falls. Marymount University received two of these grants to deliver three EBFPPs into the northern Virginia region. This community case study describes the development of a collaboration between a university and community-based organizations to adopt and implement multiple evidence-based programming in an area where none previously existed. Methods: Through an academic-community partnership, EBFPPs were introduced to and implemented by senior-focused organizations. Target adopters were senior and community centers, multi-purpose senior services organizations, recreational organizations, and residential facilities serving older adults. The three EBFPPs were (1) Stay Active and Independent for Life (SAIL), (2) a Matter of Balance (MOB) and (3) Otago Exercise Program (OEP). Key interdependent project elements included: (1) fostering ongoing community organization collaboration, (2) introducing programs in the community, (3) growing and sustaining delivery sites, (4) preparing trained program leaders, and (5) building community demand for the programs. Results: From August 2016-June 2022, 5,857 older adults participated in one of the three EBFPPs. SAIL classes were offered at 33 sites and MOB workshops at 31 with over 70% of them occurring at community or senior centers. OEP was offered at 4 sites. Factors that influenced the implementation of these programs included having: key advocates at host organizations, programs embedded into site workflows, sufficient capacity and workforce, engaged invested partners, and flexibility in working with a complex set of agencies and systems with different administrative structures. Conclusion: By connecting academic faculty with various community members from multiple sectors, new initiatives can be successfully implemented. Results from this ACL-funded project indicate that using an academic-community partnership model to build relationships and capacity for ongoing delivery of health promotion programming for older adults is feasible and effective in delivering EBFPPs. In addition, academic-community partnerships can develop a strong network of invested partners to foster continued support of fall prevention activities.

Adapting Evidence-Based Falls Prevention Programs for Remote Delivery - Implementation Insights through the RE-AIM Evaluation Framework to Promote Health Equity.

COVID-19 disproportionally impacted the health and well-being of older adults-many of whom live with chronic conditions-due to their higher risk of dying and being hospitalized. It also created several secondary pandemics, including increased falls risk, sedentary behavior, social isolation, and physical inactivity due to limitations in mobility from lock-down policies. With falls as the leading cause of preventable death and hospitalizations, it became vital for in-person evidence-based falls prevention programs (EBFPPs) to pivot to remote delivery. In Spring 2020, many EBFPP administrators began re-designing programs for remote delivery to accommodate physical distancing guidelines necessitated by the pandemic. Transition to remote delivery was essential for older adults and persons with disabilities to access EBFPPs for staying healthy, falls and injury free, out of hospitals, and also keeping them socially engaged. We collaborated with the Administration on Community Living (ACL), the National Council on Aging (NCOA), and the National Falls Prevention Resource Center (NFPRC), for an in-depth implementation evaluation of remotely delivered EBFPPs. We examined the process of adapting and implementing four EBFPPs for remote delivery, best practices for implementing the programs remotely within the RE-AIM evaluation framework. This enhances NFPRC's ongoing work supporting dissemination, implementation, and sustainability of EBFPPs. We purposively sampled organizations for maximum variation in organization and provider type, geographic location, and reach of underserved older populations (Black, Indigenous, or other People of Color (BIPOC), rural, disabilities). This qualitative evaluation includes provider-level data from semi-structured interviews (N = 22) with program administrators, staff, and leaders. The interview guide included what, why, and how adaptations were made to EBFPP interventions and implementation strategies using Wiltsey-Stirman (2019) adaptations framework (FRAME), reach, and implementation outcomes (acceptability, feasibility, fidelity, and costs; Proctor et al., 2011), focusing on equity to learn for whom these programs were working and opportunities to address inequities. Findings demonstrate remote EBFPPs made planned and fidelity-consistent adaptations to remote delivery in partnership with researchers and community organizations, focusing on participant safety both in program content and delivery. Supports using and accessing technology were needed for delivery sites and leaders to facilitate engagement, and improved over time. While remote EBFPP delivery has increased access to EBFPPs for some populations from the perspective of program administrator, leaders, and staff (e.g., caregivers, rural-dwellers, persons with physical disabilities), the digital divide remains a barrier in access to and comfort using technology. Remote-delivered EBFPPs were acceptable and feasible to delivery organizations and leaders, were able to be delivered with fidelity using adaptations from program developers, but were more resource intensive and costly to implement compared to in-person. This work has important implications beyond the pandemic. Remote delivery has expanded access to groups traditionally underserved by in-person programming, particularly disability communities. This work will help answer important questions about reach, accessibility, feasibility, and cost of program delivery for older adults and people with disabilities at risk for falls, those living with chronic conditions, and communities most vulnerable to disparities in access to health care, health promotion programming, and health outcomes. It will also provide critical information to funders about elements required to adapt EBFPPs proven effective in in-person settings for remote delivery with fidelity to achieve comparable outcomes.

Study Protocol: Multi-level Determinants of Implementation and Sustainment in the Education Sector.

Evidence-based programs (EBPs) delivered in elementary schools show great promise in reducing risk for emotional and behavioral disorders (EBDs). However, efforts to sustain EBPs in school face barriers. Improving EBP sustainment thus represents a priority, but little research exists to inform the development of sustainment strategies. To address this gap, the Sustaining Evidenced-Based Innovations through Multi-level Implementation Constructs (SEISMIC) project will: (a) Determine if malleable individual, intervention, and organizational factors predict EBP treatment fidelity and modifications during implementation, sustainment, or both; (b) Assess the impact of EBP fidelity and modifications on child outcomes during implementation and sustainment; and (c) Explore the mechanisms through which individual, intervention, and organizational factors influence sustainment outcomes. This protocol paper describes SEISMIC, which builds upon a federally-funded RCT evaluating BEST in CLASS, a teacher-delivered program for K-3rd grade children at risk for EBDs. The sample will include 96 teachers, 384 children, and 12 elementary schools. A multi-level, interrupted time series design will be used to examine the relationship between baseline factors, treatment fidelity, modifications, and child outcomes, followed by a mixed-method approach to elucidate the mechanisms that influence sustainment outcomes. Findings will be used to create a strategy to improve EBP sustainment in schools.

Scaling Up Implementation Support for Violence Prevention and Resilience Promotion in the Air Force.

Closing the gap between research and practice requires that organizations can consistently incorporate new ideas and best practices. The Department of the Air Force (DAF) Integrated Resilience Directorate is leading a coordinated effort to increase the adoption of evidence-based violence prevention and resilience promotion programs across the entire Department. To support this effort, DAF is using Getting To Outcomes (GTO), an evidence-based implementation support that helps organizations plan, implement, and self-evaluate programs. Thus, the DAF is not only scaling up prevention programs but is also embarking on the largest scale-up of GTO to date. The study team trained personnel from every Air Force installation across the world to use GTO for their programs. Quantitative findings from training questionnaires and ratings of implementation plans as well as qualitative results from resilience personnel interviews suggest some lessons learned for scaling up implementation support. This study builds on established implementation science frameworks for scaling up interventions by identifying critical tasks and unique supports needed to scale up evidence-based prevention. Results suggest GTO helped DAF scale-up prevention across the Department, and that establishing leadership buy-in, simplifying evidence-based program selection and adaptation, monitoring implementation and outcomes, and creating dedicated prevention practitioner roles are critical tasks to support scale-up of evidence-based prevention. Unique supports needed to scale-up evidence-based prevention include multitiered learning systems; integrated tools that improve access to data and evolving evidence; prevention personnel with skills in program management, adaptation, and evaluation; timely crosscutting data; continuous learning to support sustainability; and leadership buy-in.

Sistematización del programa preventivo para menores en situación de conflictividad en el ámbito familiar en la comunidad de Andalucía: Programa NAYFA / Systematization of the preventive program for minors in conflict situations in the family environment in the community of Andalusia: NAYFA Program

En este artículo se describe el proceso de investigación-acción llevado a cabo para la redefinición y el diseño de un programa destinado a niños, niñas y adolescentes con dificultades y/o situaciones conflictivas en el ámbito familiar. El diseño del nuevo programa NAYFA se ha realizado siguiendo los estándares de calidad de los programas basados en la evidencia y mediante un proceso colaborativo entre responsables políticos, profesionales e investigadores. Se utilizó la técnica DAFO para identificar las principales fortalezas y debilidades de las actuaciones previas desarrolladas en diferentes provincias andaluzas. Los resultados pusieron de manifiesto una importante falta de sistematización que se ha tratado de solventar definiendo, mediante un proceso colaborativo y de acuerdo con los criterios de calidad más consensuados, los componentes clave del nuevo programa: fundamentación teórica y metodológica, destinatarios, objetivos, contenidos, condiciones de implementación y diseño de la evaluación. El alto grado de acuerdo de profesionales y responsables con las características propuestas puede contribuir a que la implementación del programa se lleve a cabo con fidelidad al diseño original y, con ello, favorecer su efectividad (AU)

This article describes the action-research process carried out to redefine and design a program for children and adolescents with difficulties and/or conflictive situations in the family. The design of the NAYFA program has been carried out following the quality standards of evidence-based programs and through a collaborative process between policymakers, professionals and researchers. The SWOT technique was used to identify the main strengths and weak-nesses of the previous actions carried out in different Andalucía provinces. The results revealed an important lack of systematization that an attempt has been made to solve by defining, through a collaborative process and in accordance with the most agreed quality criteria, the key components of the new program: theoretical and methodological founda-tions, recipients, objectives, contents, implementation conditions and evaluation design. The high degree of agreement of professionals and managers with the proposed characteristics can contribute to the implementation of the program being carried out with fidelity to the original design and, thus, favor its effectiveness. (AU)

Visitors' Assessment and Utilization of Evidence-Based Program Resources (EBPR) Websites.

Background: Evidence-based program resources (EBPR) websites for behavioral health are a potentially useful tool to assist decision-makers and practitioners in deciding which behavioral health interventions to implement. EBPR websites apply rigorous research standards to assess the effectiveness of behavioral healthcare programs, models, and clinical practices. Method: Visitors to a convenience sample of six EBPR websites (N=369, excluding students) were recruited for telephone interviews primarily by means of a pop-up invitation on the sites. Results: The visitors view the EBPR sites as important sources of information to support the identification and adoption of evidence-based programs/practices (EBPs) in behavioral healthcare, which aligns with the primary mission of EBPRs. For repeat visitors, there was some indication that the information obtained helped effect certain changes in their agencies' programs and policies. However, increased or improved guidance on EBP implementation was also requested. Conclusion: EBPR websites should be better publicized to the behavioral healthcare field.

Adaptations in the Context of COVID-19: Application of an Implementation Science FRAMEwork.

Invest in Kids (IIK) is a Denver, Colorado, USA-based intermediary organization that works to bridge the research-to-practice gap for programs that support Colorado's youngest children and their families. IIK supports evidence-based programs (EBPs) including three universal, prevention programs from The Incredible Years® (IY)-Dinosaur School (a classroom curriculum), Teacher Classroom Management (teacher professional development training), and Parent Program (parent training). IIK employs staff (the IIK-IY Team) to deliver implementation supports such as training, coaching, and managing implementation teams with professionals at schools and community agencies who deliver IY programs throughout Colorado. The COVID-19 pandemic presented challenges and opportunities for practitioners using EBPs, and for the IIK-IY Team. The Framework for Reporting Adaptations and Modifications-Expanded, known as the FRAME (Stirman et al., 2019), was identified as a useful tool for documenting information about COVID-19-related adaptations to local sites' delivery of the programs, IIK's implementation supports, and IIK's annual statewide evaluation of IY. This case study includes an in-depth description of the various adaptations made by the IIK-IY Team, highlighting specific examples that demonstrate how the FRAME can be used to support adaptations for numerous sites in a geographic region or state. This case study provides important lessons about what successful IY delivery and implementation supports looked like in the context of the ongoing COVID-19 pandemic, including a description of IY fidelity and program outcomes. Supplementary Information: The online version contains supplementary material available at 10.1007/s43477-022-00048-1.

Promoviendo la sensibilidad parental con una intervención tempranabasada en la evidencia / Promoting parental sensitivity with an evidence-based early intervention

Las experiencias tempranas son clave como cimientos de las trayectorias de desarrollo. Sufrir adversidad temprana está relacionado con dificultades en regular el comportamiento, las emociones y la fisiología. Las intervenciones que promueven la sensibilidad parental pueden proteger a los niños de las consecuencias negativas de la adversidad temprana y promover trayectorias de desarrollo positivas. Una de estas intervenciones es Attachment & BiobehavioralCatch-up (ABC), un programa de visitas domiciliarias basado en la evidencia que promueve un cuidado sensible y contingente. En este artículo, revisamos los objetivos de la intervención ABC y su eficacia. Describimos también la supervisión de la fidelidad al programa y su diseminación, incluida la implementación de ABC en diversos contextos y con familias de habla hispana en Estados Unidos. Por último, discutimos el potencial de implementar ABC en España y Latinoamérica como una innovación en el campo de la intervención familiar y la protección a la infancia.(AU)

Early caregiving experiences set the stage for children’s developmental trajectories. Children who experience earlyadversity are more likely to show difficulties regulating their behaviors, emotions, and physiology than children whodo not experience adversity. Parenting interventions designed to enhance parental sensitivity and responsivenesscan buffer children from the detrimental effects of early adverse experiences and ultimately enhance child outcomes.One such intervention is Attachment and Biobehavioral Catch-up (ABC), an evidence-based home visiting programdeveloped to enhance parental sensitivity and responsive care. In this paper, we review the intervention objectivesand effectiveness of ABC. We then describe efforts made to supervise the fidelity and dissemination of ABC,including its implementation in diverse cultural contexts and with Spanish-speaking families in the United States.Lastly, we discuss the potential of ABC as a novel intervention to be implemented within the child welfare systemin Spain and Latin America.(AU)

State Department and Provider Agency Utilization of Evidence-Based Program Registries in Behavioral Healthcare and Child Welfare.

Evidence-based program registries (EBPRs) are web-based compilations of behavioral healthcare programs/interventions that rely on research-based criteria to rate program efficacy or effectiveness for support of programmatic decision-making. The objective was to determine the extent to which behavioral health decision-makers access EBPRs and to understand whether and exactly how they use the information obtained from EPBRs. Single State Authorities (SSAs) and service provider agencies in the areas of behavioral health and child welfare were recruited nationally. Senior staff (n = 375) responsible for the selection and implementation of programs and/or policies were interviewed by telephone concerning their visits (if any) to 28 relevant EBPRs, the types of information they were seeking, whether they found it, and how they may have used that information to effect changes in their organizations. At least one EBPR was visited by 80% of the respondents, with a median of three different registers being visited. Most visitors (55%) found all the information they were seeking; those who did not desired more guidance or tools for individual program implementation or were unable to locate the program or practice that they were seeking. Most visitors (65%) related using the information obtained to make changes in their organizations, in particular to select, start or change a program, or to support the adoption or improvement of evidence-based clinical practices. EBPRs were shown to be important resources for dissemination of research-based program effectiveness data, leading to increased use of evidence-based practices in the field, but the study also identified needs for greater awareness of EBPRs generally and for more attention to implementation of specific recommended programs and practices.

Dissemination and Implementation of Evidence-Based Falls Prevention Programs: Reach and Effectiveness.

BACKGROUND: Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, we describe the implementation of evidence-based fall prevention programs (EBFPPs) by Administration for Community Living grantees during 2014-2019. METHOD: Forty-four grantees contributed to the national data repository. Data components include workshop information, participant information, attendance records, and organizational data. Data were collected before and after implementation of the EBFPPs. RESULTS: Ten different programs were offered in 35 states with the most common settings being senior centers (25.3%), residential facilities (16.8%), health care organizations (12.5%), and faith-based organizations (11.1%). Individuals who participated in the programs (N = 85 848) had an age of 75.5 ± 9.7 years and were primarily female (79.7%), and the majority (86.2%) reported at least some fear of falling. At the postprogram assessment, 31.8% reported less fear of falling, 21.6% reported fewer falls, and 10.1% reported fewer injurious falls (all p < .0001). CONCLUSIONS: EBFPPs implemented by Administration for Community Living grantees reached over 85 000 older adults. Participation in the EBFPPs resulted in improved confidence, decreased fear of falling, and fewer falls and injurious falls. Future efforts should focus on reaching specific underserved minorities and examining the effectiveness of individual programs.

The Impact of COVID-19 on the Delivery of an Evidence-Based Child Maltreatment Prevention Program: Understanding the Perspectives of SafeCare® Providers.

Child maltreatment (CM) is a global public health problem. Evidence-based home visiting programs, such as SafeCare®, reduce CM risk, and enhance parent-child relationships and other protective factors. As the result of the COVID-19 pandemic and resulting restrictions, SafeCare Providers transitioned from home to virtual delivery for the SafeCare curriculum. The purpose of this study is to 1) examine active SafeCare Providers' opinions on the feasibility and effectiveness of SafeCare via remote delivery, and 2) better understand workforce concerns for human service professionals within the context of COVID-19 mitigation efforts. Data are from a cross-sectional survey of SafeCare Providers (N = 303) in the United States, Canada, and Australia. The majority of Providers reported they were actively delivering SafeCare virtually and were comfortable with the delivery format. Providers indicated that the majority of SafeCare families are making progress on target skills, and that engagement is high among many families. Some service delivery challenges were reported, ranging from family data plan limitations to difficulty with delivery of specific components of the SafeCare curriculum related to modeling and assessment. The impact of COVID-19 on Providers' daily routines, stress level, and work-life balance has been significant. Remote, virtual delivery of CM prevention programming offers the opportunity to continue serving vulnerable families in the midst of a pandemic. Barriers related to family technology and data access must be addressed to ensure reach and the effective delivery of prevention programming during the pandemic and beyond.

Enhancing the Adoption of Evidence-Based Health Marketing and Promotion Strategies in Local Communities: Building a Communication Dissemination and Support System for the National Diabetes Prevention Program.

The Centers for Disease Control and Prevention (CDC) created a health communication marketing and promotion support system (support system) to help 10 CDC-funded national organizations (recipients) grow enrollment of underserved populations in the National Diabetes Prevention Program. This article describes the creation of a successful support system to increase the use of effective marketing approaches and key messaging. The support system was developed using a systematic approach. It included a needs assessment, audience research, marketing strategy identification, expert panel review, materials development, and dissemination guidance. Hands-on, individualized, and group end-user training and technical assistance was also included. Recipients received culturally and linguistically tailored marketing materials to support their specific priority audiences, as well as corresponding training on recommended dissemination methods. In in-depth key-informant interviews, staff from six recipients reported increased knowledge of local communities and audiences, efficacy and skills to conduct media interviews, capacity to identify and train champions and influencers, and greater community partner investments. With marketing support, 90% of recipients reported increased enrollment, of which 40% exceeded self-set targets and another 40% doubled or tripled their enrollment numbers. These findings indicate that a customized strategic health communication marketing and promotion support system presents a significant opportunity to help recipients increase enrollment in evidence-based interventions. Practitioners disseminating evidence-based interventions may consider a support system to increase program uptake.