The study of implementation: Current findings from effective programs thatprevent mental disorders in school-aged children

Prevention science is a rapidly advancing field and is at the point where a number of preventive interventions have documented the ability to change d evelopmental trajectories and reduce negative outcomes. Recently, reports s um marizing these "effective" programs have circulated among researchers an d practitioners. Surprisingly, many of the highest-quality programs fail to take adequate steps to monitor and verify program integrity. This weakens the conclusions that can be drawn regarding the program outcomes and reduce s the likelihood that replications will resemble the original program. The next challenge facing the prevention field is to help consumers who are imp lementing effective programs in naturalistic settings do so with quality an d fidelity to the original program so that they achieve similarly successfu l outcomes. This article reviews implementation issues in prevention trials and specifi cally highlights the study of implementation in the 34 programs determined to be effective in a recent review conducted by the Prevention Research Cen ter for the Center for Mental Health Services. Reasons for the lack of atte ntion to implementation and suggestions for way to incorporate implementati on measurement into prevention initiatives are discussed.