217906 APPLES logic model for evaluating the dissemination of effective behavioral interventions

Tuesday, November 9, 2010

Lydia O'Donnell, EdD , Health and Human Development Division, Education Development Center, Inc., Waltham, MA
Ann Stueve, PhD , Health and Human Development Division, Education Development Center, Inc., New York, NY
Renee Wilson-Simmons, DrPH , The Annie E. Casey Foundation, Baltimore, MD
Logic models can guide researchers and practitioners in the development, delivery, and evaluation of behavioral interventions. Despite their potential to provide a theory of action for guiding dissemination efforts, there are few models that depict the linkages between the initial uptake of an EBI and its subsequent diffusion to populations that might most benefit. The APPLES logic model posits relationships between actions designed to support the dissemination of EBI and their intended dissemination outcomes. The model is grounded in theories of diffusion of innovation and stages of change, as well as social marketing principles and operations and systems research. By delineating factors that may influence the update and sustainability of EBI, APPLES provides a conceptual framework for testing empirical evidence to answer key dissemination questions: How do agencies adopt and implement an intervention, balancing the fidelity with adaptations based on local knowledge, needs, and realities (Adoption)? Do agencies recruit and deliver interventions to those at highest risk in their community (Population Penetration)? How long and consistently do agencies use interventions (Longevity)? How do agencies obtain evidence that an intervention is working, and use this evidence to strengthen adoption, population penetration, and longevity (Evaluability)? What supports are available for institutionalization and maintenance (Sustainability)? Examples illustrate how APPLES helps identify factors influencing success, including community/agency inputs and resources, intervention inputs and resources, and specific activities. Models like APPLES are needed to advance the scientific understanding of dissemination and ensure that EBI developed over the past two decades reach their intended audiences.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Identify key dissemination outcomes that are depicted in the APPLES model. 2. List two or more theories of dissemination and diffusion that inform the APPLES model. 3. Discuss how the APPLES logic model provides a theory of action that can help guide dissemination efforts and their evaluation.

Keywords: Evidence Based Practice, Community Preventive Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator of the study being presented in the abstract, and have led the conceptualization of the proposed dissemination model.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.