Efficacy vs Effectiveness Trial Results of an Indicated "Model" Substance Abuse Program: Implications for Public Health
The US Department of Education requires schools to choose substance abuse and violence prevention programs that meet standards of effectiveness. The Substance Abuse and Mental Health Services Agency certifies "model" programs that meet this standard. We compared findings from a large, mult...
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| Veröffentlicht in: | American journal of public health (1971) 2006-12, Vol.96 (12), p.2254-2259 |
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| creator | Hallfors, Denise Cho, Hyunsan Sanchez, Victoria Khatapoush, Shereen Kim, Hyung Min Bauer, Daniel |
| description | The US Department of Education requires schools to choose substance abuse and violence prevention programs that meet standards of effectiveness. The Substance Abuse and Mental Health Services Agency certifies "model" programs that meet this standard. We compared findings from a large, multisite effectiveness trial of 1 model program to its efficacy trial findings, upon which the certification was based.
1370 high-risk youths were randomized to experimental or control groups across 9 high schools in 2 large urban school districts. We used intent-to-treat and on-treatment approaches to examine baseline equivalence, attrition, and group differences in outcomes at the end of the program and at a 6-month follow-up.
Positive efficacy trial findings were not replicated in the effectiveness trial. All main effects were either null or worse for the experimental than for the control group.
These findings suggest that small efficacy trials conducted by developers provide insufficient evidence of effectiveness. Federal agencies and public health scientists must work together to raise the standards of evidence and ensure that data from new trials are incorporated into ongoing assessments of program effects. |
| doi_str_mv | 10.2105/AJPH.2005.067462 |
| format | Article |
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1370 high-risk youths were randomized to experimental or control groups across 9 high schools in 2 large urban school districts. We used intent-to-treat and on-treatment approaches to examine baseline equivalence, attrition, and group differences in outcomes at the end of the program and at a 6-month follow-up.
Positive efficacy trial findings were not replicated in the effectiveness trial. All main effects were either null or worse for the experimental than for the control group.
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1370 high-risk youths were randomized to experimental or control groups across 9 high schools in 2 large urban school districts. We used intent-to-treat and on-treatment approaches to examine baseline equivalence, attrition, and group differences in outcomes at the end of the program and at a 6-month follow-up.
Positive efficacy trial findings were not replicated in the effectiveness trial. All main effects were either null or worse for the experimental than for the control group.
These findings suggest that small efficacy trials conducted by developers provide insufficient evidence of effectiveness. Federal agencies and public health scientists must work together to raise the standards of evidence and ensure that data from new trials are incorporated into ongoing assessments of program effects.</description><subject>Academic achievement</subject><subject>Adolescent</subject><subject>Behavior</subject><subject>Bias</subject><subject>Biological and medical sciences</subject><subject>Certification</subject><subject>Children & youth</subject><subject>Drug abuse</subject><subject>Drug use</subject><subject>Education policy</subject><subject>Effectiveness</subject><subject>Federal government</subject><subject>Female</subject><subject>Health promotion</subject><subject>Health services</subject><subject>Humans</subject><subject>Intervention</subject><subject>Juvenile delinquency</subject><subject>Learning</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Mental health</subject><subject>Mental health care</subject><subject>Miscellaneous</subject><subject>Models, Organizational</subject><subject>Outcome Assessment (Health Care)</subject><subject>Peer Group</subject><subject>Prevention programs</subject><subject>Program Evaluation</subject><subject>Public health</subject><subject>Public Health Administration</subject><subject>Public health. 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Hyunsan</au><au>Sanchez, Victoria</au><au>Khatapoush, Shereen</au><au>Kim, Hyung Min</au><au>Bauer, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy vs Effectiveness Trial Results of an Indicated "Model" Substance Abuse Program: Implications for Public Health</atitle><jtitle>American journal of public health (1971)</jtitle><addtitle>Am J Public Health</addtitle><date>2006-12-01</date><risdate>2006</risdate><volume>96</volume><issue>12</issue><spage>2254</spage><epage>2259</epage><pages>2254-2259</pages><issn>0090-0036</issn><eissn>1541-0048</eissn><coden>AJPEAG</coden><abstract>The US Department of Education requires schools to choose substance abuse and violence prevention programs that meet standards of effectiveness. The Substance Abuse and Mental Health Services Agency certifies "model" programs that meet this standard. We compared findings from a large, multisite effectiveness trial of 1 model program to its efficacy trial findings, upon which the certification was based.
1370 high-risk youths were randomized to experimental or control groups across 9 high schools in 2 large urban school districts. We used intent-to-treat and on-treatment approaches to examine baseline equivalence, attrition, and group differences in outcomes at the end of the program and at a 6-month follow-up.
Positive efficacy trial findings were not replicated in the effectiveness trial. All main effects were either null or worse for the experimental than for the control group.
These findings suggest that small efficacy trials conducted by developers provide insufficient evidence of effectiveness. Federal agencies and public health scientists must work together to raise the standards of evidence and ensure that data from new trials are incorporated into ongoing assessments of program effects.</abstract><cop>Washington, DC</cop><pub>Am Public Health Assoc</pub><pmid>16809591</pmid><doi>10.2105/AJPH.2005.067462</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0090-0036 |
| ispartof | American journal of public health (1971), 2006-12, Vol.96 (12), p.2254-2259 |
| issn | 0090-0036 1541-0048 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1698156 |
| source | MEDLINE; PAIS Index; Business Source Complete; PubMed Central; Alma/SFX Local Collection |
| subjects | Academic achievement Adolescent Behavior Bias Biological and medical sciences Certification Children & youth Drug abuse Drug use Education policy Effectiveness Federal government Female Health promotion Health services Humans Intervention Juvenile delinquency Learning Male Medical sciences Medical treatment Mental health Mental health care Miscellaneous Models, Organizational Outcome Assessment (Health Care) Peer Group Prevention programs Program Evaluation Public health Public Health Administration Public health. Hygiene Public health. Hygiene-occupational medicine Research and Practice Risk factors Sample size School districts School Health Services - organization & administration School Health Services - standards Secondary schools Student Dropouts - psychology Students Studies Substance abuse treatment Substance-Related Disorders - ethnology Substance-Related Disorders - prevention & control United States United States Substance Abuse and Mental Health Services Administration Urban Health Services - organization & administration Urban Health Services - standards |
| title | Efficacy vs Effectiveness Trial Results of an Indicated "Model" Substance Abuse Program: Implications for Public Health |
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