Moving Beyond Good Ideas: The Importance of Integrating Evidence-based Prevention Practices in Our Work

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Dolores Cimini

When I began my career as a prevention professional at a large public university more than two decades ago, I made many of my programming choices based on an instinct that what I was implementing would reduce drug use among our students. After all, who could resist the power of a fraternity member or student-athlete who spoke about taking a friend’s life while driving under the influence? Who would not reduce their drug use immediately upon witnessing a crashed car in the middle of our residence quad, walking into a trailer containing an exhibit of the personal effects of a college student who died from a heroin overdose, or spending an hour sitting in a mock jail cell to experience what it’s like after a drug arrest?

While my instincts were well-intentioned, and initiatives such as the above do have their roles within prevention as elements of comprehensive, multi-component efforts based on a public health approach, we as preventionists have a responsibility to our campuses and communities to think strategically and critically about our choices of interventions and to integrate evidence-based or evidence-informed practices in our work. Coined in the early 1990s in medicine, “evidence-based practices” (EBPs) are defined in terms of a "three-legged stool" integrating three basic principles: 1) the best available research evidence bearing on whether and why a treatment works, 2) professional expertise (professional judgment and experience) to rapidly identify each individual’s unique health state and diagnosis, their individual risks, and benefits of potential interventions, and 3) the individual’s preferences and values.

It is important to remember that EBPs begin with good ideas that are developed using what we have learned from prevention science, delivered using clearly defined protocols, implemented with fidelity, and evaluated regarding how well they work. Here are four tips for selecting, implementing, and evaluating EBPs to meet your campus’s needs:
 

  1. Selecting EBPs: The prevention field has identified both effective and promising strategies that result in significant reductions in alcohol and other drug misuse and related consequences. There is no need to “reinvent the wheel”. There are two searchable resources that contain listings of peer-reviewed EBPs that have been tested with college students: the Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-based Programs and Practices (NREPP) and the National Institute on Alcohol Abuse and Alcoholism’s College Alcohol Intervention Matrix (AIM).
  2. Implementing EBPs: When implementing EBPs on college campuses, it is important to remember that “one size does not fit all.” There may need to be adaptations or modifications based on student demographics, availability of resources, and other factors. When making adaptations to EBPs, it is critical to develop and document protocols being used, implement these protocols with fidelity, and not move very far from the original intervention study protocols from which effectiveness was demonstrated.
  3. Evaluating EPBs: In evaluating EBPs, many preventionists have found it helpful to partner with faculty members on their campuses who have experience in research methodology. These colleagues can assist in designing evaluation strategies to help determine whether the EBPs being implemented are working. Many times, faculty colleagues in this role benefit from partnerships with prevention practitioners by being able to collect data for publications which are necessary to advance their careers.

     

    And finally…

  4. Let the buyer beware: When considering the purchase of a product that describes itself as an EBP, ask for the data supporting the effectiveness of the product for the specific college student population of focus. The polished appearance or expense of a product does not necessarily correlate with the existence of data supporting the fact that it works.

 

Keep calm and carry on, and may the force of EBPs be with you!