Julia H. Littell

Stages of Change A Critique

The stages of change proposed by Prochaska and DiClemente have been applied to change efforts within and outside of formal treatment and in relation to virtually any problem behavior. This model has gained widespread popularity in health psychology and addictions and is being used to guide interventions and allocate treatment resources in several fields. In this article, the authors review 87 studies on the stages of change across problem behaviors. Research findings suggest that the proposed stages are not mutually exclusive and that there is scant evidence of sequential movement through discrete stages in studies of specific problem behaviors, such as smoking and substance abuse. Although the stage model may have considerable heuristic value, its practical utility is limited by concerns about the validity of stage assessments. The model’s underlying concepts and alternative views of readiness for change are considered, along with directions for future research.

Putting families first: An experiment in family preservation

This volume is a comprehensive evaluation of the largest randomized experiment to date on placement prevention programs: the Family First program in Illinois. It offers insights into the tensions between policies advocating family preservation and those favoring out-of-home placement. The authors conclude by suggesting that placement prevention programs are but one component in a comprehensive effort to reform the child welfare system, and that those efforts should include both improvements in the foster care system and more refined decision-making in individual cases.

Client Participation: Central and Underinvestigated Elements of Intervention

Although client participation is central to psychosocial interventions, most investigations conceptualize and measure participation in rather crude ways. This review suggests that essential elements of treatment participation are largely unknown, links between participation and outcomes are not clear, and most investigations of influences on within-treatment variations in participation are based on outdated causal models. Drawing on literature on health and mental health care, this article develops a comprehensive conceptual model of treatment participation. It proposes an agenda for future research aimed at understanding participation phenomena in various contexts.

A framework for mandatory impact evaluation to ensure well informed public policy decisions

Trillions of dollars are invested yearly in programmes to improve health, social welfare, education, and justice (which we will refer to generally as public programmes). Yet we know little about the eff ects of most of these attempts to improve peoples’ lives, and what we do know is often not used to inform decisions. We propose that governments and non-governmental organisations (NGOs) address this failure responsibly by mandating more systematic and transparent use of research evidence to assess the likely eff ects of public programmes before they are launched, and the better use of well designed impact evaluations after they are launched. Resources for public programmes will always be scarce. In low-income and middle-income countries, where there are often particularly severe constraints on resources and many competing priorities, available resources have to be used as effi ciently as possible to address important challenges and goals, such as the Millennium Development Goals. Use of research evidence to inform decisions is crucial. As suggested by Hassan Mshinda, the Director-General of the Commission for Science and Technology in Tanzania: “If you are poor, actually you need more evidence before you invest, rather than if you are rich.” But neither the problem nor the need for solutions is limited either to health or countries of low and middle income. Expenditures and the potential for waste are greatest in high-income countries, which also have restricted resources and unmet needs, particularly during a fi nancial crisis. Having good evidence to inform diffi cult decisions can be politically attractive, as shown, for example, by the US Government’s decision to include US

Study Quality Assessment in Systematic Reviews of Research on Intervention Effects.

1·1 billion for comparative research (including systematic reviews and clinical trials) as part of its

Effects of the duration, intensity, and breadth of family preservation services: A new analysis of data from the illinois family first experiment☆

787 billion economic stimulus bill. To paraphrase Billy Beane, Newt Gingrich, and John Kerry, who have argued for a health-care system that is driven by robust comparative clinical evidence by substituting policy makers for doctors: “Evidence-based health care would not strip [policymakers] of their decision-making authority nor replace their expertise. Instead, data and evidence should complement a lifetime of experience, so that [policymakers] can deliver the best quality care at the lowest possible cost.” Lancet 2010; 375: 427–31

Toward Evidence-Informed Policy and Practice in Child Welfare.

Objective: The goal of this study is to advance an approach to the assessment of the quality of studies considered for inclusion in systematic reviews of the effects of social-care interventions. Method: To achieve this objective, quality is defined in relation to the widely accepted validity typology; prominent approaches to study quality assessment are evaluated as to their adequacy. Results: Problems with these approaches are identified. Conclusion: A formal, yet explicit, multidimensional approach to assessment grounded in substantive issues relevant to the intervention and the broader context in which it is embedded is promoted. Uncritical and exclusive use of indicators of study quality such as publication status, reporting quality, and single summative quality scores are rejected.

The Campbell Collaboration: Providing Better Evidence for a Better World

Abstract Effects of key components of family preservation services were examined using data from a rigorous evaluation of intensive family preservation services in Illinois. Simultaneous equations were developed using two-stage least squares estimates to model relationships between case characteristics, service characteristics, and case outcomes. Results indicate that the duration, intensity, and breadth of family preservation services have little overall impact on out-of-home placement of children, the recurrence of child maltreatment, or the closing of cases in the public child welfare agency. Policy makers, practitioners, and researchers are advised to look beyond these features of family preservation programs in search of effective interventions for children and families.

Guest Editor’s Introduction to Special Issue: The Science and Practice of Research Synthesis

Drawing on the authors’ experience in the international Campbell Collaboration, this essay presents a principled and pragmatic approach to evidence-informed decisions about child welfare. This approach takes into account the growing body of empirical evidence on the reliability and validity of various methods of research synthesis. It also considers wide variations in the cultural, economic, and political contexts in which policy and practice decisions are made—and the contexts in which children live and die. This essay illustrates the use of Campbell and Cochrane systematic reviews to inform child welfare decisions in the diverse contexts that exist around the globe.

Do Haphazard Reviews Provide Sound Directions for Dissemination Efforts

In this article, we trace the development of the Campbell Collaboration and its renewed efforts to build a world library of accurate, synthesized evidence to inform policy and practice and improve human well-being worldwide. Campbell systematic reviews and related evidence synthesis products provide unbiased summaries of entire bodies of empirical evidence, making them uniquely useful sources of information for policy and practice. With recent changes in organizational structure and new leadership, the Campbell Collaboration is poised to dramatically increase the production, dissemination, and use of rigorous syntheses of research on social, economic, and behavioral interventions. Campbell provides opportunities for social work scholars, practitioners, and consumers to contribute to knowledge about the processes and outcomes of social, behavioral, and economic interventions.