Evidence Based Practices Violence Prevention Summer Institute 2005

What is it? An Evidence Based Practice (or EBP) is a practice that has been shown to produce results in several settings (replication) and can be exported (manuals, etc.).

SB 267 Does Senate Bill 267 apply to me? Department of Corrections Oregon Youth Authority Oregon Commission on Children & Families That part of the Department of Human Services that deals with Mental Health and Addiction issues Oregon Criminal Justice Commission

SB 267 Timelines By Sept. 30, 2004: Conduct an assessment of existing programs and establish goals that enable the agency to meet the requirement of the law. Submit a report to the legislature containing: An assessment of each program on where the agency expends funds, including by not limited to whether the program is an evidence-base program. The percentage of state moneys the agency receives for programs that is being expended on evidence-based programs. The percentage of federal and other moneys the agency receives for programs that is being spent on evidence-based programs. Description of efforts being made to comply.

SB 267 2005 Timelines For the biennium beginning July 1, 2005: The five agencies shall spend at least 25 percent of state moneys that each agency receives for programs on evidence-based programs. Submit a report to the interim legislative committee dealing judicial matters no later than Sept. 30, 2006. Description of efforts to meet the requirements.

SB 267 2007 Timelines For the biennium beginning July 1, 2007: The five agencies shall spend at least 50 percent of state moneys that each agency receives for programs on evidence-based programs. Submit a report to the interim legislative committee dealing judicial matters no later than Sept. 30, 2008. Description of efforts to meet the requirements.

SB 267 2009 Timelines For the biennium beginning July 1, 2009: The five agencies shall spend at least 75 percent of state moneys that each agency receives for programs on evidence-based programs. Submit a report to the interim legislative committee dealing judicial matters no later than Sept. 30, 2010. Description of efforts to meet the requirements.

Levels of Evidence for EBP Clinical practices and research are placed on an evidence continuum with six levels ranging from: Multiple studies using randomized assignment of patients in clinical setting. To no evidence that supports the efficacy or efficiency of the practice on the other. To evidence that suggests that the practice is harmful.

OMHAS Levels of Evidence The Office of Mental Health and Addiction Services (OMHAS) suggests that the first three levels (I-III) of evidence describe practices that meet sufficient scientific standards to be defined as evidence-based practices.

Level 1 Level I – A prevention or treatment practice, regimen, or service that is: Grounded in consistent scientific evidence showing that it improves client/participant outcomes in both scientifically controlled and routine care settings and Sufficiently documented through research to permit the assessment of fidelity

Level 1 Key Points Level I – Key Points Supported by scientifically sound randomized controlled studies that have shown consistently positive outcomes. Positive outcomes have been achieved in scientifically controlled and in routine care settings. Level 2 is similar to Level 1 with one setting demonstrated (routine care or scientifically controlled).

Level 3 Modified or adapted for a population or setting that is different from the one in which it was formally developed and documented. The modification’s effect on outcomes is measured and documented. Based on the results of the outcomes, elements of the service are continually adapted or modified to achieve outcomes similar to those in the original practice. Sufficiently documented to provide a framework for replication of the practice and outcomes in a similarly modified setting.

Level 4 Level 4 – A prevention or treatment service or practice not yet sufficiently documented and/or replicated through scientifically sound research procedures. Practice is building evidence through documentation of procedures and outcomes. Intended to fill a gap in the service system. Not yet sufficiently researched for the development of a fidelity tool.

Level 5 Level 5 – A prevention or treatment service based solely on clinical opinion and/or non-controlled studies without comparison groups. Has not produced a standardized set of procedures or elements that allow for replication of the service. Has not produced consistently positive measured outcomes.

Key Points Standardization - An intervention must be standardized so that it can be replicated elsewhere. Standardization typically involves a manual or book that clearly defines the practice and measures to assess if the intervention is being practiced accurately. Replication - Replication of research findings means that more than one study finds similar positive effects when consumers receive the service.

Key Points Presence of a Fidelity Scale - A fidelity scale is used to verify that an intervention is being implemented in a manner consistent with the treatment model. Meaningful Outcomes - Effective interventions must show that they can help consumers achieve important goals or outcomes related to impairments and/or risk factors.

Follow Up Questions? Pamela Clark Chief Drug and Alcohol Research Analyst Oregon Office of Mental Health and Addiction Services, 500 NE Summer St. E86 Salem OR 97301. clark_pamela@yahoo.com (with an underscore between clark and pamela) 503-805-9668