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Bridge-It: A System for Predicting Implementation Fidelity for School-Based Tobacco Prevention Programs

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Abstract

Properly implemented school programs to prevent tobacco use and addiction can lower smoking prevalence up to 60%. However, numerous programs are not successful due to poor implementation. A system for estimating likelihood of future implementation fidelity of school-based prevention programs was tested using data collected at baseline and two year follow-up in 47 middle schools and high schools participating in the Texas Tobacco Prevention Initiative. The Bridge-It system includes an eight-factor, 36-item survey to analyze capacity for program implementation and a companion Bayesian model which provides estimations of likelihood of implementation fidelity several years after program initiation. The survey also asks about amount of implementing activity for each of the multiple components recommended in federal guidelines for school programs to prevent tobacco use. Criterion referenced cross-tabulations showed the system's forecast of implementation fidelity was correct in 74% of cases (p < .01). Model reliability was confirmed in regression analyses. Implementation fidelity at follow-up was predicted by the combination of the model's eight capacity factors at baseline. It includes program, implementation support, and non-program factors. Integration of the Bridge-It system, or comparable tools, into the dissemination and evaluation of school-based prevention programs can help to increase understanding of factors that influence implementation and provide guidance for capacity building. If administrators can identify at baseline schools likely to fall short of implementation goals, plans for resource allocation and provision of guidance, training, and technical assistance can be specifically tailored to identified needs.

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Acknowledgments

This study was conducted as part of research sponsored by the Texas Department of State Health Services (TDSHS) under contract 74660013992.

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Authors and Affiliations

  1. Department of Health and Human Performance, University of Houston, Houston, TX, 77204-6015, US

    Phyllis M. Gingiss

  2. Resource Network, Galveston, TX, US

    Cynthia Roberts-Gray

  3. Health Network for Evaluation and Training Systems, University of Houston, Houston, TX, US

    Melynda Boerm

Authors
  1. Phyllis M. Gingiss
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  2. Cynthia Roberts-Gray
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  3. Melynda Boerm
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Correspondence to Phyllis M. Gingiss.

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Gingiss, P.M., Roberts-Gray, C. & Boerm, M. Bridge-It: A System for Predicting Implementation Fidelity for School-Based Tobacco Prevention Programs. Prev Sci 7, 197–207 (2006). https://doi.org/10.1007/s11121-006-0038-1

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