Intervention Selection in School-Based Practice: Using Public Health Models to Enhance Systems Capacity of Schools

Article excerpt

Abstract. Recent federal initiatives and efforts within education and psychology professional organizations have contributed to an increased focus on scientifically based practices in education. Although interventions are available to educators, there is a need to enhance systems capacity through identification, selection, and implementation of appropriate interventions that will meet the diverse needs of students. This article presents a selection model for education using the public health model of prevention work, based on primary, secondary, and tertiary levels of need, combined with the RE-AIM (Reach-Efficacy-Adoption-Implementation-Maintenance) framework of evaluating interventions along five main dimensions. This model can help systems identify appropriate prevention and intervention approaches for their settings, taking into account the efficacy and effectiveness of the efforts, available resources, and other critical considerations.

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Compared to only three or four decades ago, an optimistic appraisal regarding current efforts in developing evidence-based interventions in education, psychology, and related fields might be that we are making significant strides in the area of prevention and intervention science. In the United States, the effects of federal legislation such as the No Child Left Behind Act and the Reading First initiative have placed a focus on scientifically based practices such as has never before been seen at this level of influence. The What Works Clearinghouse of the U.S. Department of Education's Institute of Education Sciences (located at http://www.whatworks.ed.gov/), which provides comprehensive reviews and ratings of various types of educational intervention research studies and intervention tools, is an example of this new federal commitment to science in educational intervention. Although schools still use well-intentioned but ineffective curricula and interventions because educators believe them to be appropriate or because of the claims and marketing efforts of curriculum publishers, there are good reasons to be optimistic that we are beginning to see a shift toward a scientifically based discipline in education.

The field of school psychology is likewise experiencing notable advances in developing and articulating methodology and frameworks for evaluating and selecting evidence-based interventions to affect the academic, behavioral, and social-emotional problems of children and adolescents in school settings. Similar to efforts in clinical and counseling psychology, recent work by members of the Task Force on Evidence-Based Interventions in School Psychology, as exemplified by the writings by Kratochwill and his colleagues (e.g., Kratochwill & Shernoff, 2004), has gained momentum. This work holds the possibility for a future where practitioners and administrators select interventions based not only on their likely match to the needs of particular students, but also on the aggregated evidence regarding their effectiveness and the conditions under which they are most likely to be effective. Likewise, the evidence-based intervention movement holds the possibility for a future where researchers use a common framework for evaluating and disseminating the efficacy of new intervention tools. The implications of this movement for the expanding capacity of schools are obvious. As practitioners and administrators within educational and mental health systems select and implement interventions based on their known efficacy under specified conditions, the capacity of these systems for helping to meet the needs of children and their families will be enhanced.

Efficacy Versus Effectiveness of Interventions

How does one determine whether a particular intervention works? There are two primary models used to test the effect of an intervention: the efficacy and effectiveness models (Fishman, 2000; Seligman, 1996). …