Ensuring a systems fit

Evidence-based programs, the major product of prevention scientists, still enjoy a very junior role within children’s services. For them to be sustainable most are dependent on the resources of major services like education, health, social welfare and juvenile justice. Typically these services spend about $8,500 on each child each year, but evidence-based programs hardly feature in any of the main public sector budgets. If they are to succeed, that must change.

Yet, at present, systems do not take well to evidence-based programs. They are administrative departments that sustain professional practice in the buildings that are home to children’s services.

The work of Bart Lubow and his colleagues shows how systems can be reformed. The Juvenile Alternative Prevention Initiative (JDAI) is an illustration of the reform of juvenile justice, along with many other reform programs. Can this reform work link with prevention science to create new ways to improve the lives of children and families?

If we are to answer this question positively, there are two considerations. First, if the program is to be a sustainable part of a mainstream service, how can that service be made ready, without compromising the internal logic of the intervention?

Second, as my monograph published by Demos demonstrates, services struggle with programs, so can we produce other evidence-based programs that will achieve the same ends but are more service-friendly?

The JDAI story gives an important clue here. Systems clearly take to processes better than they take to programs. A good chunk of policy time is devoted to working out process. Can this be done in an evidence-based way? There are good examples already. For example, Tom Dishion’s Brief Family Check-up is in essence a process. It changes the way we think about assessment, using the analogy with a dental check-up to induce prevention activity within families. It is proven to have an impact on child outcomes.

There is room for many other evidence- based processes. They are not an alternative to evidence-based programs: they are complimentary and system friendly.

Reformers like Bart Lubow can be useful to prevention scientists, but credibility in the academic world rests on a higher burden of proof. Would more notice be taken of system reform if higher standards of evidence were adopted?

More should be done to hypothesize the link between outcomes and outputs. There is good reason to assume that less might lead to improvements in child development, for example better behavior and emotions. There is some empirical evidence on which to support the hypothesis. We need, then, to express the hypothesis, and then test it, rigorously, much as a prevention scientist would do.

One can guess that proper evaluation of JDAI would confirm the existing, as yet insufficient, evidence that the process is responsible for lower rates of detention. But it would also demonstrate what matters most: that lower rates of detention converts into better behaved young people.

JDAI is an interesting story in its own right. But it also points us towards looking for ways of getting systems ready for evidence-based programs, and getting them ready for systems. And maybe it also gets us thinking about the possibility of a wider range of evidence-based programs, to embrace processes that systems find easier to implement.

References

Michael Little, Systems and Outcomes: Making Evidence-based Programmes and Other Practices Systematic, Demos, 2010

Links

http://www.aecf.org/MajorInitiatives/JuvenileDetentionAlternativesInitia...

Explainers

Bart Lubow

Bart Lubow is Director of the Juvenile Justice Strategy Group at the Annie E. Casey Foundation and pioneer of the Juvenile Detention Alternatives Initiative, or JDAI, a process used in over half of US states to reduce the number of young people placed in custody.

Juvenile Detention Alternatives Initiative

JDAI or the Juvenile Detention Alternatives Initiative is a process used by states to reduce the rate of young people placed in custodial settings.

System Reform

System Reform is activity dedicated to changing the processes or mechanisms that facilitate state involvement in children's lives.