Evaluating fidelity: The role of program and organizational structure in replication outcomes

Current economic realities suggest a continued decrease in funding available for public health prevention and services. Diminishing public resources require strategic investments of the limited funds and resources available. Recent investments into evidence-based programs suggest an assurance on the return on these investments. While the logic behind this investment strategy is clear, past research indicates that the results of bringing these models to scale, have been less than stellar. Plain Talk is a teen pregnancy and STI prevention program. The initial evaluation of Plain Talk indicated positive trends towards improving adolescent reproductive health outcomes. These positive findings lead to investments in the Plain Talk National Replication Center, with the charge of bringing the model to scale. Although all approved replication sites were provided training on the program and core components of the model, there were broad variations on the indicators of success during program replication. This session will highlight the assumptions behind the recent study and implications for social change. A sequential-explanatory mixed-method design was used to explore the frequency of adaptation of Plain Talk structural elements and the impact that the most frequently altered elements had on replication outcomes. In phase 1, a quantitative assessment on 28 Plain Talk replication sites was conducted to determine adaptation frequency of six structural elements. Contingency tables and Fisher's exact test were used to analyze relationship between these variables and replication outcomes. In the second phase, two case studies with semi structured interviews were developed on one successful and one unsuccessful replication site.