Craig Blakely

The fidelity-adaptation debate: Implications for the implementation of public sector social programs

The modified Research, Development, and Diffusion (RD&D) model, as exemplified by change agents in federal organizations, was examined as a viable strategy for disseminating social program innovations. This study of seven nationally disseminated education and criminal justice projects was designed to refine the methodology for measuring innovation implementation. We measured program fidelity, reinvention, and effectiveness in a diverse set of program settings. Results of the research suggested that high-fidelity adopters tended to produce more effective implementations than low-fidelity adopters. Local modifications to the model were unrelated to effectiveness, whereas local additions to the model tended to enhance effectiveness. Findings supported the utility of the modified RD&D model of innovation dissemination with public sector social programs.

Immunization status and sociodemographic characteristics: the mediating role of beliefs, attitudes, and perceived control.

OBJECTIVES This study examined how immunization-related beliefs, attitudes, and perceived control mediate up-to-date immunization among various sociodemographic groups. METHODS Statewide estimates of immunization rates among children up to the age of 2 years were obtained via a multistage cluster sample. In-person interviews were conducted with 4832 parents. Information about immunization was obtained from official records or from health care providers. RESULTS Differences in immunization among sociodemographic groups were mediated by beliefs about objective barriers to immunization, protection, medical contraindication, safety concerns, distrust, and natural immunity. Protection beliefs contributed to positive attitudes toward immunization; beliefs in natural immunity and safety concerns contributed to negative attitudes. Beliefs about objective barriers, distrust, safety concerns, and medical contraindications influenced perceived control over immunization. Positive attitudes and a strong sense of control contributed to higher immunization rates. CONCLUSION These findings provide a basis for efficient educational campaigns by specifying which beliefs should be bolstered (because they facilitate proper immunization) and which should be targeted for change (because they hinder proper immunization) in various sociodemographic groups.

Ethnic Identity as a Predictor of Attitudes of Adolescents Toward Fighting

The purpose for this study was to examine to what extent ethnic identity would predict attitudes toward fighting among African American and Latino and Latina early adolescents (n = 330) in the presence of two factors, parental involvement and negative peer behaviors, which have emerged consistently as predictors of violent and antisocial behaviors among adolescents. Results indicated that for the African American participants, ethnic identity accounted for variation in their nonfighting attitudes beyond that accounted for by parental control and negative peer behaviors. Ethnic identity did not emerge as a predictor of attitudes toward fighting for the Latino and Latina adolescents. Girls from both ethnic groups reported higher endorsement of profighting attitudes than did boys. However, gender did not emerge as a statistically significant predictor of fighting attitudes in the presence of the other three predictor variables: ethnic identity, parental involvement, and negative peer behaviors.

Innovation in Education and Criminal Justice: Measuring Fidelity of Implementation and Program Effectiveness.

The arena of social program implementation has been divided over the issue of whether new programs should be disseminated and implemented with fidelity (i.e., with close correspondence to the original validated model) or implemented according to the idiosyncratic needs, values, and resources of the local adopting organization. To empirically examine this issue, seven innovative programs were examined. Each of the four educational and three criminal justice programs had been carefully evaluated and widely disseminated. Fidelity and effectiveness criteria were developed for each program. A multimethod data collection strategy included lengthy phone interviews, on-site interviews, and archival analysis of program adopters. The results indicated that well-operationalized programs are usually adopted and implemented with a degree of fidelity acceptable to program developers. Furthermore, this fidelity is positively correlated with the effectiveness of the adopted program. Implications for educational policy and construct measurement are discussed.

ESID, Dissemination, and Community Psychology: A Case of Partial Implementation?

Dissemination, the second stage of Experimental Social Innovation and Dissemination (ESID) is a critical, if not defining, element of this social change model. This paper attempts to assess the extent to which community psychology has adopted and implemented ESIDs dissemination focus in its training and publications. We identify four levels of commitment to dissemination: dissemination advocate, dissemination activist, dissemination researcher, and experimental dissemination researcher. Content analyses of textbooks, journal publications, and conference papers and a brief survey of doctoral training in the field were conducted. Findings suggest that the dissemination aspects of ESID have been modestly and partially implemented within the field. That is, although there is some evidence of a commitment to dissemination practice (advocate, activist), there is much less evidence of a commitment to dissemination research. The implications of these findings for the effectiveness of the ESID model and for training and practice in community psychology are discussed.

Environmental and Contextual Influences on School Violence and its Prevention

School violence has received unprecedented attention in recent years, particularly since the infamous events unfolded in Littleton, Colorado at Columbine High School. For many Americans, such events were not imagined possible while for others, they confirmed the need for urgent and careful examination of the nature and scope of school violence. It appears, however, that school violence research has been relegated to the individual level of analysis. In this introduction to the special issue about the environmental and contextual factors related to school violence, the authors examine what we know about school violence, how school violence has been addressed, and argue that environmental factors must be part of research and intervention in this area. Finally, the contributions of the articles included in this special issue are discussed.

Developing Effective University-Community Collaboration Through Grantwriting

America’s research universities, having become institutions of specialized knowledge creation, are now being called upon to change direction, to pull specialized knowledge out of the labs and lecture halls and translate it into know-how. As pointed out by Daniel Yankelovich, “For years, our institutions of higher education had remained exempt from these [public] criticisms” (Walshok, 1994), and leaders in higher education were unprepared to respond to what the public claimed was wasteful, self-serving and indulgent behavior on the part of research universities.

Pregnant Women Eligible under Medicaid Expansion of Maternity Services Implications for Outreach

Recent reforms in federal legislation have made Medicaid-financed prenatal care available to pregnant women from households at nearly twice the poverty leveL Census and birth certificate data provide little information about the newly eligible group beyond estimates of their size. This article reports on efforts to compare the Medicaid expansion group to traditional Medicaid prenatal care patients in terms of demographics, access problems, and prenatal care adequacy by employing a short-term, hospital-based survey of postpartum women in Michigan. Differences between pregnant women eligible under the expansions and traditionally eligible pregnant women suggested that major changes in outreach and enrollment activities of state Medicaid agencies may be necessary to fulfill the opportunity represented by the Medicaid expansions.

Formative evaluation of a community-based maternity services program for the uninsured.

Blue Cross and Blue Shield of Michigan (BCBSM) funded a 1-year pilot program to expand prenatal services in 7 Michigan cities. These cities were selected because they had high unemployment (20 to 34%) rates and high infant mortality rates. The objective was to provide antenatal care to women ineligible for Medicaid and without private health insurance whose household income fell below 185% of the poverty level. The program was locally operated by community action agencies (CAAs). These are nonprofit antipoverty agencies. Data sources include interviews with project administrators a review of a sample of medical records and surveys of providers and patients. 6 out of the 7 local projects had an overall response rate of 82% (673 of 817) to the participant survey. A response rate of 57% was achieved for physicians (n=41). Locating and enrolling eligible women was likely to be difficult. The CAA administrators thought that outreach efforts needed to be intensive. The CAA put stories in newspapers and had public service announcements on radio and television. Physicians were recruited. Approximately 1/3 of the families were unemployed and had no prior insurance. About 18% of the families reporting prior insurance and unemployment are recently laid off losing insurance along with their jobs. The final group (14%) reflects families who had had jobs that provided insurance but after being laid off accepted lower paying jobs that did not have insurance benefits. About 60% had not received prenatal care before enrolling. They said they probably would not get care if it were not for the program and claimed they had some difficulty in getting care. Money was the main obstacle (71%) to care. A majority of physicians (62.5%) were very satisfied or satisfied with the overall program. The average age of patients in the sample of medical records was 24.8 years. About 12% were adolescents. Approximately 3.4 were White; 20% were Black. 8.2% was the low birth weight rate. The medical record specialists rated care as excellent or more than adequate for 80%. Overall project physicians followed the prescribed care guidelines. The voucher-medical record agreement rate for 6 components of care was more than 90%.