Evidence-based programs (EBPs) can help change the world — but only if they reach the world.
Some interventions, which might reasonably be termed EBPs — such as the polio vaccine or some of the products and methods that produced the Green Revolution in agriculture — have achieved remarkable reach and impact. Others — such as the housing first approach for homeless individuals, or the Nurse-Family Partnership, which works to improve maternal and child outcomes — haven’t achieved anything like universal reach, but are nevertheless changing outcomes for significant numbers of people in the United States. However, research suggests that most EBPs reach only a small fraction of those who would benefit, and in some areas their use has stalled. For example, in the juvenile justice field, Scott Henggeler and Sonja Schoenwald find that only 5 percent of high-risk offenders are treated with evidence-based interventions annually.
What stands in the way of increasing the use of EBPs to solve some of our most challenging social problems? The question involves supply (the extent to which EBPs can reach the ‘market’), and demand (the extent to which, once in the market, they are used and scaled).
In our research, we analyzed 46 purveyor organizations which support 46 EBPs in child welfare and juvenile justice. Indeed, we found that most EBPs do, in essence, remain stuck on the shelf. While most purveyors are working to ensure their EBPs are effective and replicable, most are not working to expand their reach. Indeed, purveyors themselves identified a lack of growth efforts as the biggest challenge for the spread of EBPs. We found that three particular things are standing in the way: lack of resources, lack of expertise, and lack of incentive to expand the reach of their EBPs. We also found that when EBPs do spread significantly — and some do — this has been mainly driven by external forces that created a demand.
Read the full article about evidence-based programs by Alex Neuhoff, Eliza Loomis, and Farhana Ahmed at The Bridgespan Group.
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