Louise Morpeth: Dartington Social Research Unit Seminar
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Transcript of Louise Morpeth: Dartington Social Research Unit Seminar
Scale, sustainability and evidence-based programmesLouise MorpethSocial Research Unit at Dartington
We struggle to scale things that work and sometimes scale things that harm
No EBP has achieved scale but FNP is heading in the right direction
SUSTAINABILITY
I’m evidence-based
NO! I am ignore her! look at me!
I’m not evidence-based, I’m evidence-informed
1. Intervention specificity - what is it?
2. Evaluation quality - is the method robust enough for us to believe the findings?
3. Intervention impact - which aspects of child health and development are affected and to what extent?
4. System readiness - is the intervention replicable?
Standards of Evidence
*Approximately 5,000 6th and 7th grade students @ baseline and follow-up
Data from Pentz, Trebow, Hansen, MacKinnon, Dwyer, Johnson, Flay, Daniels, &CormackEffects of Program Implementation on Adolescent Drug Use Behavior: The Midwestern Eval Rev.1990; 14: 264-289
Control Group (N=313)Individual Therapists (N=387)Group Mean (Average)
18
-Mo
nth
Un
adju
sted
Maj
or
Rec
idiv
ism
Per
cen
tage
17
12
55
47
42
14
34
18
23
3128
14
26
17
33
23
14
33
22
1717
11
0
C 1 2 3 4 5 6 7 M 8 9 10111213M 1415161718M 19202122232425M
Low Fidelity High Fidelity
8
1820
43
47
63
26
FFT Results
From: Outcome Evaluation of Washington State's Evidence-Based Programs for Juvenile Offenders, January
2004. Washington State Institute for Public Policy, Report #04-01-1201
SCALE UP
Innovation vs invention
Small, simple, effective
When attending a home birth in rural Nepal, a birth attendant brings a delivery kit the size of a deck of cards: a small bar of soap for washing hands, a plastic sheet to serve as the delivery surface, clean string for tying the umbilical cord, and a new razor blade for cutting the cord. It’s cheap and basic, but it helps mothers and babies avoid infection.
Photo: Bill & Melinda Gates Foundation / Toni Greaves
Start with scale in mind
Community members participate in discussions after watching video documentaries screened by the Self Employed Women’s Association in an urban slum. (Ahmedabad, India, 2010)
Photo: Bill & Melinda Gates Foundation/PrashantPanjiar
What is core and what is adaptable?
Mother’s new car is a cargo bike
The residents of Christiania, a communal neighborhood in Copenhagen, have long had an affinity for customized bikes – easily personalized but practical to the core.
Photo: Mikael Colville-Andersen
Scale can be local
The potential of social networks
Charting contagion
Harvard medical sociologist Nicholas Christakis is one of the foremost researchers and communicators on social networks. He and his collaborators have found that many surprising phenomena are contagious, such as loneliness, altruism, and obesity.
Network image: Nicholas Christakis
Diffusion vs dissemination
The S-curve of diffusion
In 1962, sociologist Everett Rogers set out the ideas of “dissemination” and “diffusion.” The S-curve predicts how an innovation proceeds from a trickle of early adopters, to a flood of mainstream users, until only a few laggards remain.
Image: Everett M. Rogers. 2003[1962]. Diffusion of Innovations, 5th Ed. New York: Free Press.
Pull beats push
The demand for vaccination
In many parts of the world, the demand for vaccination shows how “pull” beats “push.” In Pantasma, Nicaragua, mothers are willing to wait in line for hours so that their children can receive the rotavirus vaccine – with the result that 80 percent of children in Nicaragua have been vaccinated against this life-threatening disease.
Photo: Bill & Melinda Gates Foundation / Brent Stirton
We need to understand demand as well as need
There are no blueprints for scale up
Any blueprints for our work?
A World War II poster from the US prescribes a “Blueprint for Victory.”
Image: US National Archives and Records Administration
Data is essential but we need stories too
It was 1970 when designer Jeremy Sinclair, at the advertising agency Cramer Saatchi, created the “pregnant man” poster for the UK’s Health Education Council. It aimed to tell a story that men would recognize.
Advertisement: Jeremy Sinclair
Great impact might come from a simple innovation widely adopted
A new use for an old wheel
The pulley – a simple re-configuring of wheels and rope – is one of the all-time great radical ideas. Here, a pulley helps to raise water from a traditional indoor well in a house in Chettinad. (Tamil Nadu, India, 2008)
Photo: Ramaswamy N.
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