When it comes to community-based programming and health education, the terms evidence-based and science-based are pretty popular. However, it seems many still don't understand what the buzz is about. In my humble opinion, schools of public health and nonprofit management programs don't seem to demonstrate the concepts well. I had never heard of fidelity or core components as an undergraduate or graduate student. It was not until I was able to go from theory to practice, in other words, paying my dues, I got a full understanding of the implementation and management of evidence-based programs (EBP). Thankfully, I found opportunities to do so while I was completing my studies. Of course, there are some variables not explained in this blog entry but I hope it provides a clearer picture of what evidence-based programming means.
Evidence-based programs are essentially programs that have been developed by someone (a student, a scientist, or an evaluator, etc.) who has written a curriculum or designed an intervention or program. They then find a way to research or evaluate that program; with or without funding funding. The more rigorous the research the more reliable the research findings are perceived to be. For example, the use of one or more comparison (control) groups may be seen as more rigorous than not using a control group. Once the findings and analyses are complete and if the research shows marked improvements in the intervention group(s), the developer may have themselves a new, evidence-based program. Repeating the intervention or program and evaluating the findings in more settings and with more [of the same or diverse] audiences will continue to give the program credibility if the positive outcomes are indeed replicated.
One of the primary requirements that need to be met for a program to be deemed evidence-based is the program must have the ability to be replicated or redone with similar results. Let's take for instance, any one of the behavioral interventions for HIV listed on the CDC's Effective Interventions website. For the most part, these are packaged programs. Imagine an organization is seeking to solve a problem in their community. They choose the program they feel best fits their needs (and their capacity), contact the developer for training, if necessary, then they are off to replicate that program in their community. Replicating a program according to fidelity means the implementer will follow the program core components and key characteristics as they were conducted in the research and Voilà! they can reap the same benefits as did the original researcher. Those benefits are an improvement in behavior, attitude, or other variables.
Anyone who has ever implemented an evidence-based program knows it is never as easy as it seems to stick to fidelity. A program that works well in the North may not be implemented as easily in the South, for example. Rural areas have different challenges and needs that suburban and metropolitan areas. One thing is for sure. You should get familiar with EBP's like, yesterday! Granting agencies, foundations, governments, and other types of funders want to see results and EBP's are often the best route to those results. Evidence-based programming is one of the best tools we have to help get people healthy, happy, or productive. It's a good place to start.